Best Treatment For Prostate Cancer In Early Stages

Symptoms Of Prostate Cancer

Making Decisions After Being Diagnosed with Early Stage Prostate Cancer | UCLAMDChat

Usually, prostate cancer is discovered before any symptoms appear. However, frequent toilet trips or a sluggish stream of urine may be early signs of prostate cancer. Typically, a big prostate gland is the cause of these symptoms . Erectile dysfunction and blood in the urine or semen are two additional, considerably less typical symptoms. Benign prostatic hyperplasia Patient Education: Beyond the Basics

If you have an abnormal blood test or an abnormal rectal examination, your doctor or nurse may often assume that you have prostate cancer. You must get a prostate biopsy in order to be assured of the diagnosis.

Causes Of Prostate Cancer

Prostate cancer is the most common form of male reproductive organ cancer. There are two types of prostate cancers, glandular and non-glandular.

Glandular tumours are more aggressive, spread faster than other forms, and require surgery to remove them completely.

Non-Glandular prostate tumours grow slower but can still be a concern if theyre not monitored extensively by your physician or specialist. Its also important to note that some men with benign prostatic hyperplasia may have an increased risk for developing both types of prostate cancer over time as well.

The causes of prostate cancer can be attributed to a few factors.

Age Prostate cancer is more likely the older you get, with about 50% of prostate cancers found in men over 65 years old. Men who have lived past age 80 are at an even higher risk for developing this condition.

Diet Research from the University of Southern California suggests that eating foods high in soy or calcium may reduce your risk for developing prostate cancer. Other studies have pointed out a connection between omega-three fatty acids and lower levels of testosterone , so be sure to include those in your diet if youre looking into prevention methods.

Other factors which have been linked to higher risks are certain chemical exposures like pesticides or heavy metals, such as cadmium and mercury.

Causes Of Early Prostate Cancer

Certain things called risk factors may increase the risk of developing prostate cancer. If you are Black, you have a much higher risk of developing prostate cancer. You are also more likely to develop it at a younger age. Having a strong family history of prostate cancer is also a risk factor.

We have more information about the risk factors of prostate cancer.

How To Prevent Prostate Cancer

Stop smoking

Eat less fat and cholesterol

Limit alcohol consumption to one drink per day or less

Reduce stress in your life. It is not a cure, but it can help you manage the disease by eating healthy foods, exercising regularly and avoiding tobacco smoke.

A large study found that men who reported being stressed had twice as many prostate cancers detected during screening . Men are more likely to be diagnosed with cancer when they have high blood pressure or other risk factors like diabetes. Though these changes dont cause cancer themselves, they may make symptoms show up earlier on scans so doctors find them sooner. This could mean spotting tumours before they become dangerousor finding smaller tumours that dont need to be treated.

Maintain a healthy weight

Limit red meat, avoid processed meats and dairy products high in fat or calories

Get enough calcium and vitamin D

Limit alcohol consumption to one drink per day or less

Reduce stress in your life. It is not a cure, but it can help you manage the disease by eating healthy foods, exercising regularly and avoiding tobacco smoke.

Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

A PSA test every 3 to 6 months
A DRE at least once every year
Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

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How Is Stage I Prostate Cancer Treated

As the cancer is small and is confined to the prostate gland and the growth and spread may be slow and it may never show symptoms. The course of action depends on the age of the patient and their overall health and if they can withstand the treatment. The following are the treatment methods generally preferred for stage I prostate cancer treatment:

Active surveillance:

Because this cancer type grows very slowly, men may often not require any treatment immediately if not throughout their lifetime. Active surveillance is a method of monitoring the cancer closely regularly. PSA blood test, DRE , prostate biopsies may be done once in six months or so. If the results show signs of the cancer spreading, the treatment options are reviewed to eliminate the cancer.

Radiation therapy:

This treatment uses high beams of x-rays to kill the malignant cells. The radiation is aimed at the cancer cells to kill them, restrict their growth and to shrink tumours. The two main types of radiation therapy used in the treatment of prostate cancer:

Radical prostatectomy:

Symptoms Of Early Prostate Cancer

Early prostate cancer may not cause any symptoms. Symptoms only happen when the cancer is large enough to press on the tube that carries the urine from the bladder . Some prostate cancers grow very slowly. Symptoms may not develop for many years.

The prostate can also become enlarged due to a non-cancerous condition called benign prostatic hyperplasia .

The symptoms of benign prostate conditions and prostate cancer are similar. They can include:

needing to pee more often than usual, especially at night
difficulty peeing for example, a weak flow or having to strain to start peeing
feeling like you have not completely emptied your bladder
an urgent need to pee
blood in urine or semen
rarely, pain when peeing or ejaculating.

If you have any of these symptoms, it is important to have them checked by your doctor. Your GP can do some tests to find out if you need a referral to a specialist doctor.

Considering Complementary And Alternative Methods

You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.

Complementary and Integrative Medicine

Treating Advanced Prostate Cancer

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If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

hormone treatment
chemotherapy

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

What Is The Prognosis For People Who Have Prostate Cancer

Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.

Stage I Prostate Cancer Treatment

In This Section

High-intensity focused ultrasound therapy.

Vascular-targeted photodynamic therapy using a photosensitizing agent has been tested in men with low-risk prostate cancer. In the CLIN1001 PCM301 randomized trial, 413 men with low-risk cancer were randomly assigned in an open-label trial to receive either the photosensitizing agent, padeliporfin , or active surveillance. Median time to local disease progression was 28.3 months for patients receiving padeliporfin and 14.1 months for patients who were assigned to active surveillance . However, the appropriate population for photodynamic therapy may be quite narrow, as it may overtreat men with very low-risk disease and undertreat men with higher-risk disease.

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What Form Of Treatment Is Best For Me

The choice between radiation treatment and surgery for men with early stage prostate cancer mostly comes down to personal taste. According to the facts at hand, cancer treatment results are consistent irrespective of the chosen therapy. The likelihood that the cancer may spread fast or recur after therapy will also influence the decision. Men with favourable intermediate-risk tumours may elect for active monitoring, although this is often only an option for men with extremely low- and low-risk tumours.

Surgery, RT, and active surveillance each have their own special risks and problems.

Men with localised prostate cancer have the choice of treatment or monitoring , with treatment being postponed until there is indication that the disease may be evolving into an aggressive form. Men who are older or who have other significant conditions may choose active monitoring or careful waiting over surgery or RT.

Men with aggressive, high-risk malignancies that might be difficult to treat later on are often advised to seek therapy very away . Short-term androgen deprivation treatment is often advised for males with RT .

Men with locally advanced prostate cancer are not eligible for any one particular therapy that is shown to be effective. The majority of doctors advise a combination of either surgery with adjuvant RT with or without ADT, or ADT plus RT.

Prostate cancer that has progressed The treatment for advanced prostate cancer is covered separately. ).

Ii Stages Treatment For Prostate Cancer

Cancer that has not migrated to the lymph nodes or other distant organs is referred to as localised prostate cancer. There are three common methods for treating locally advanced prostate cancer:

Prostate gland removal surgery, sometimes known as a radical prostatectomy

Androgen deprivation treatment is sometimes used in conjunction with radiation therapy (RT external beam or brachytherapy.

Active monitoring

Cryotherapy and high-intensity focused ultrasound are two other therapies that are currently being explored. These methods may specifically target the prostate glands tumor-bearing region . These procedures lack long-term data and have not been thoroughly compared to conventional treatment methods, but given all the possible dangers and rewards, they could be appropriate for certain men.

The ideal course of action is determined by your age, general health, personal preferences, and cancer stage.

Radical prostatectomy

A radical prostatectomy, also known as a prostatectomy, is a procedure that disconnects the bladder and urethra after removing the prostate gland .

The following are the most typical side effects of prostatectomy:

Continence issues

Erection problems

Open and robotic prostatectomy procedures are also available.

A three to four-inch long up-and-down incision , starting from the top of the pubic bone, is necessary for an open prostatectomy.

To decide which form of prostatectomy is best for you, discuss the possible risks and advantages with your physician.

Prostate Cancer Treatment & Clinical Trials

Clinical trials provide alternative treatment options for cancer patients. Some aim to test new drugs, reduce side effects, improve current treatment methods, and more. For some patients, clinical trials may be their best option. Once clinical trials complete all four phases, the FDA decides whether to approve the treatment, which may eventually become a standard treatment option.

Below is a list of treatments currently being studied in clinical trials:

Cryosurgery: A cryoprobe is used to freeze and destroy abnormal tissue within the prostate.

High-intensityfocused ultrasound therapy: In this procedure, sound waves are directed at the area of cancer. The sound waves produce heat that kills the cancer cells.

: For tumors just below the surface of the skin, a drug can be injected and activated when exposed to light, killing the nearby cancer cells.

Bisphosphonate therapy: This is used to reduce bone disease once the cancer cells have metastasized to the bone. Clodronate or zoledronate are used to slow the growth of cancer cells within the bone.

Alpha emitter radiation therapy: For patients who have had prostate cancer metastasize to the bone. Radium-223 is injected, which then finds and kills cancer cells in areas of the bone

Tissue Ablation And Focal Therapy

Tissue ablation treatments destroy the prostate cancer through freezing or heating. These treatments can be applied to all or just part of the prostate . Whereas whole gland ablation has largely fallen out of favor, focal ablation has gained popularity. The two most commonly used energy sources are as follows:

Cryosurgery kills cancer cells in the prostate by freezing them through special needles that are inserted into the gland. The needles are placed under ultrasound guidance. This method is effective in curing cancer but can’t treat lymph nodes and commonly causes erectile dysfunction if the entire prostate is treated. Urinary incontinence is a rare but possible side effect.

High-intensity focused ultrasound uses the high temperatures created by focused sound wave energy to kill cancer cells. While HIFU results over the years have been mixed, modern systems such the one used at UCSF allow real-time monitoring of tissue temperatures during treatment, improving outcomes.

Less commonly used ablation methods include interstitial laser ablation, electroporation , vascular targeted photodynamic therapy, gold nanoparticle therapy, and others under development. Focal radiation is used occasionally as well. Currently, there is little data comparing these technologies.

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However, in our clinical opinion, analyzing these factors alone may not be an accurate guide to precision-targetedtreatments. The absence of precision-targeted treatments in standard treatment protocols can lead to metastaticdisease,despite early diagnosis and prostate gland removal via surgeries like radical prostatectomy. Though the prostate isremoved, the micro metastatic cancer cells may be sitting dormant in your blood stream for years before manifestingwithsymptoms, such as bone pain, back pain, blood in urine, and elevated PSA levels.

According to the American Cancer Society, which relies on data compiled and maintained by theNationalCancerInstitute, prostate cancer is thesecond leading cause of cancer death in American men, due to these challenges instandard cancer care regimens.

Prostate cancer survival rates drop dramatically if the cancer metastasizes, pointing to the need forprecision-targetedtreatments to decrease the chances of cancer spread. Medical studies show how variouschemotherapeutic drugs andradiation therapies may allow aggressive prostate cancer cells to gainadvantageous mutations rendering them resistant to treatment.

To address these challenges of overtreatment and sometimes undertreatment instandard cancer care facilities, we useprecision oncology which helps in identifying the key cancer drivers of each patient and the most appropriateanti-cancer medicines to treat them.

Screening For Prostate Cancer

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At UCSF, we believe in testing men so they know if they have prostate cancer, but that doesn’t mean every man diagnosed should have aggressive treatment. Screening is the only way to detect high-risk, potentially life-threatening prostate cancer early, while it can still be cured.

Most prostate cancers in the U.S. are identified through the following screening tests:

Prostate-specific antigen . This simple blood test checks levels of prostate-specific antigen, a protein produced by prostate cells. The higher the PSA level, the more likely prostate cancer is present. But PSA elevations can also occur in benign conditions, most commonly benign prostatic hyperplasia, in which the prostate enlarges, as occurs in most men over their lifetime.
Digital rectal exam . For this physical examination, your doctor inserts a lubricated gloved finger into your rectum to feel for any irregular or abnormally firm areas. While most prostate cancers are detected by PSA screening, some cancers produce little PSA but are detected by DRE.

In some circumstances, your doctor may order a repeat PSA or other tests to help determine whether a benign condition led to an elevated PSA. These tests may include:

Free PSA
MyProstateRisk
Multiparametric MRI

An MRI exam of the prostate is helpful and can allow for a more targeted biopsy.

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