Can I Lower The Risk Of Prostate Cancer Progressing Or Coming Back
If you have prostate cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. While there are some things you can do that might be helpful, more research is needed to know for sure.
What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.
Cost And Health Insurance
Before you go in for the test, you may want to contact your insurance provider and confirm what costs will be covered and what you may have to pay for out of pocket. A DRE is often covered if performed for prostate cancer screening, but this can vary by provider as well as depend on state laws. Men over 50 who have Medicare are covered for a yearly PSA blood test and DRE.
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Keeping Health Insurance And Copies Of Your Medical Records
Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and although no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment.
Open Rp Versus Robotic
The ability to perform robotic-assisted laparoscopic RP was first described in 2000. Over the past decade, RALRP has gained widespread acceptance and now is the dominant approach to RP in the United States. Many attribute the adoption of the RALRP to marketing as opposed to any objective outcomes data showing superiority over the open approach.
All of the intermediate- and long-term HRQOL outcomes reported in the literature are limited to open RP. The question is, are these findings relevant to RALRP?
Unfortunately, there are no randomized studies comparing HRQOL outcomes following open versus robotic RP. The majority of studies comparing HRQOL outcomes between the two techniques are flawed in design. First, the level of experience of surgeons performing the two techniques and their patient volume are often not comparable. In addition, validated instruments for capturing outcomes are usually not employed. Surgeons are sometimes involved in the data acquisition, entry, and interpretation, which can introduce bias. There are several studies that have examined large administrative databases, which often mitigate bias, but the quality of outcome measures is subject to criticism. A few studies stand out as objective and worthy of comment.
Barocas and colleagues compared men undergoing open and RALRP and failed to show any advantages of either approach for preventing biochemical recurrence.
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Why Do Guidelines Change
Screening recommendations change over time. They can also differ between organizations. The changes are necessary because of the cost of testing and the accuracy of the tests.
The U.S. Preventative Services Task Force stopped recommending screening with PSA in 2012. It has not issued a statement about DRE.
One example is the rate of false positives and false negatives. This means that sometimes, a test says that a person has cancer when they do not. Other times, a person has cancer but the test says that they don’t.
This can happen with PSA and DRE tests, depending on how sensitive they are. If the test is too sensitive, a person might be diagnosed when they do not really have cancer. On the other hand, if the test is not sensitive enough, the diagnosis can be missed.
Why Is A Prostate
A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.
When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.
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Benefits Of Prostate Artery Embolization
The benefits of the PAE procedure include:
- It is a non-invasive, outpatient procedure
- Patients can expect to see results within a few days
- Recovery time is significantly lower
- Less risk of urinary incontinence
- Less risk of sexual side effects
- Less pain/discomfort during and after the procedure
Patients who have BPH typically suffer from the following symptoms:
- Difficulty starting the urination process
- Frequent and urgent need to urinate
- Weak stream of urine or a stream of urine that stops and starts
- Increased nocturnal urination
- Blood in the urine
Once a man undergoes this procedure, it typically takes a couple of weeks to get relief and feel like his body is functioning like it did when he was younger.
Open Or Laparoscopic Radical Prostatectomy
In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.
In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.
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Who Should Get A Psa Test
Not everyone should get a PSA test. Why? Because many in this country are treated for low-risk prostate cancer that is discovered through the PSA test, even when it is unlikely that the disease will ever cause symptoms or lead to death. And treatment is associated with significant side effects, including impotence and incontinence . You should discuss whether prostate cancer early detection is right for you with your personal primary care physician.
To avoid the risks of over-treatment, Roswell Park follows the guidelines established by the National Comprehensive Cancer Network . The NCCN brings together world-renowned experts from 30 of the nations top cancer centers to write guidelines that specify the best ways of preventing, detecting and treating cancer. The guidelines are updated at least every year, on the basis of the latest research.
Michael Kuettel, MD, PhD, MBA, Chair of Roswell Park’s Department of Radiation Medicine, serves on the NCCN Prostate Cancer Panel.
If you decide that Prostate Cancer Early Detection is right for you, the NCCN recommends PSA testing as follows:
When Should I Get Tested
Beginning at about age 45, all men should talk to their doctor about screening for prostate cancer. If you are Black or have a family history of prostate or other cancers, you may be at higher risk and should talk to your doctor beginning at age 40. Other risk factors include an increased age and a history of exposure to chemicals.
Routine prostate cancer screening starts with a PSA blood test and may include a rectal examboth are quick and simple.
A Prostate-Specific Antigen blood test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated for other reasons. Learn more about the PSA test here.
A Digital Rectal Exam is a physical exam that is done when a doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
Talk to your doctor about your risk for prostate cancer and when to begin screening. If you do not have a doctor, do not have insurance, or cannot afford a test, find out if free screenings are available in your area on our Free Testing Map. If you do not see a free screening in your area, check back in the fall. Many screenings occur in September, during Prostate Cancer Awareness Month.
Watch prostate cancer experts Dr. Lowentritt and Dr. Siegel in this video discuss screening and diagnosis:
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Whats The Best Treatment For Prostate Symptoms
Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.
One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.
What Are The Symptoms Of Benign Prostatic Hyperplasia
Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include
- urinary frequencyurination eight or more times a day
- urinary urgencythe inability to delay urination
- trouble starting a urine stream
- a weak or an interrupted urine stream
- dribbling at the end of urination
- nocturiafrequent urination during periods of sleep
- urinary incontinencethe accidental loss of urine
- urine that has an unusual color or smell
Symptoms of benign prostatic hyperplasia most often come from
- a blocked urethra
- a bladder that is overworked from trying to pass urine through the blockage
The size of the prostate does not always determine the severity of the blockage or symptoms. Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms. Less than half of all men with benign prostatic hyperplasia have lower urinary tract symptoms.3
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What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.
Tests Are Used To Screen For Different Types Of Cancer When A Person Does Not Have Symptoms
Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection helps a person live longer or decreases a person’s chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.
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If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
How Do I Get Ready For A Dre
You do not need to do anything special to prepare for a DRE. But there are a few things to keep in mind.
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If you are concerned about the cost of your DRE, find out from your insurance provider what costs they will cover beforehand. Ask how much of the cost you will have to pay out of pocket.
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You will be asked to sign a consent form before your DRE. The form will state that you understand the benefits and risks of the DRE and agree to have the test. Your doctor or nurse will explain the test before you sign the form, and you can ask questions.
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What Are Some Common Prostate Problems
The most common prostate problem in men younger than age 50 is inflammation, called prostatitis. Prostate enlargement, or benign prostatic hyperplasia , is another common problem. Because the prostate continues to grow as a man ages, BPH is the most common prostate problem for men older than age 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.
The Role Of Psa In Choosing The Best Treatment
If you have received a diagnosis of prostate cancer, your PSA levels can be used along with the results of other tests and physical exams and your tumors Gleason score to help determine which tests are needed for further evaluation and to decide on the best treatment plan. After treatment has begun, your PSA and other tests will be used to determine how well the treatment is working: The more successful the therapy, the lower the PSA.
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Prostate Cancer Screening Ages 40 To 54
The PSA test is a blood test that measures how much of a particular protein is in your blood. Its been the standardfor prostate cancer screening for 30 years.
Your doctor will consider many factors before suggesting when to startprostate cancer screening. But hell probably start by recommending the PSAtest.
While the general guidelines recommend starting at age 55, you may need PSAscreening between the ages of 40 and 54 if you:
- Have at least one first-degree relative who has had prostate cancer
- Have at least two extended family members who have had prostate cancer
- Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers
What Types Of Radiotherapy Are There
There are two common types of external beam radiotherapy:
- intensity-modulated radiotherapy
- 3-dimensional conformal radiotherapy .
You may also hear about image guided radiotherapy . This is part of all radiotherapy treatments. Taking images of the prostate before each treatment allows your radiographer to make small changes to the area that is going to be treated, in case the prostate has moved slightly since your last treatment session. This makes sure the surrounding healthy tissue gets as little radiation as possible. It also makes sure the whole prostate is treated.
Intensity-modulated radiotherapy
This is the most common type of external beam radiotherapy in the UK. A computer uses the scans from your radiotherapy planning session to map the location, size and shape of your prostate. The radiotherapy machine gives beams of radiation that match the shape of the prostate as closely as possible. This helps to avoid damaging the healthy tissue around it, reducing the risk of side effects.
The strength of the radiation can be controlled so that different areas get a different dose. This means a higher dose of radiation can be given to the prostate without causing too much damage to surrounding tissue.
3D conformal radiotherapy
As with IMRT, the radiation beams are mapped to the size, shape and position of the prostate. But the strength of the radiation cant be controlled in 3D-CRT, so all areas are treated with the same dose.
Other types of radiotherapy
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