Is Prostate Cancer Curable
Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.
What Affects My Treatment Options
Your treatment options will depend on whether your cancer is contained within the prostate gland , has spread just outside of the prostate or had spread to other parts of the body .
You may have a choice of treatments. Your doctor or specialist nurse will explain all your treatment options, and help you to choose the right treatment for you.
Your treatment options and which treatment you choose may depend on several things, including:
- how far your cancer has spread
- how quickly your cancer may be growing
- the advantages and disadvantages of each treatment
- what each treatment involves
- the possible side effects of each treatment
- practical things, such as how often you would need to go to hospital, or how far away your nearest hospital is
- your own thoughts about different treatments
- how the treatment you choose now could affect your treatment options later if your cancer comes back or spreads
- your general health
- how long youre expected to live for.
The first treatment you have may affect which treatments you can have in the future, if you need further treatment. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. And to take someone to appointments, such as your partner, friend or family member.
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Stage I Of Prostate Cancer:
In this stage, the cancer is confined to the prostate only and has PSA levels less than 10. Stage I of prostate cancer cannot be felt in physical examinations because it is microscopic. Microscopic prostate cancers are contained in less than half of the lobe of the prostates. The Gleason score of stage I prostate cancers is less than 6. It is staged as cT1, N0, M0, Grade group 1. In this stage, the cancer has not spread to any lymph nodes or other organs.
When the cancer can be felt in DRE tests and has not metastasized, it is staged as cT2a, N0, M0, Grade group 1.
When the prostate has been removed when the cancer was in stage 1, it is staged as pT2, N0, M0, Grade Group 1.
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Cancer Staging May Miss Errant Cells
Once a pathologist confirms that cancer is present, the doctor will next determine how far the cancer extends a process known as cancer staging and discuss the implications with you. This is perhaps the most important information of all for you to obtain, as it determines whether the cancer is likely to be curable, or whether it has already spread to additional tissues, making prognosis much worse.
If you were my patient, I would ask you to consider two important points. First, cancer staging actually occurs in two phases: clinical and pathological . Of the two, pathological staging is more accurate.
A second point to understand, however, is that even pathological staging can be inaccurate . A cancer spreads, or metastasizes, once a primary tumor sheds cancer cells that travel elsewhere in the body and establish other tumor sites. Metastasis is a complex process that researchers do not fully understand. What is clear is that this process involves multiple genetic mutations and steps, and that each type of cancer spreads in a unique way.
Does Msk Offer Proton Therapy For Prostate Cancer
Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.
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Types Of Prostate Cancer Staging
There are two types of staging for prostate cancer: clinical staging and pathological staging.
Clinical staging is determined by the PSA testing, Gleason score, and results of the Digital Rectal Exam . Once the doctor has all of this information, then you may need additional testing . The results of these tests can provide more information that your doctor and medical team can then use to identify the stage.
- Pathological staging is discovered during surgery as well as through laboratory results of biopsies from the tissue removed from the prostate during surgery. This is typically when lymph node involvement is determined.
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Access The Right Treatments At The Right Time
When it comes to treating prostate cancer, it is important to have access to the best expertise possible so you can receive the right treatments at the right time. The University of Maryland Cancer Network gives you the opportunity to connect with the best treatment options available.
Led by the University of Maryland Greenebaum Comprehensive Cancer Center , the UM Cancer Network provides you access to nationally renowned experts, the latest treatments, and promising clinical trials close to home. When you work with a UM Cancer Network cancer center, your community hospital will work in partnership with UMGCCC to help you beat cancer.
Find out more about prostate cancer treatments.
Find an UMMS cancer center near you.
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Treatment For Cpg 1 Localised Prostate Cancer
You might not have treatment straight away. Instead, your doctor recommends monitoring your cancer closely and then discussing treatment if the cancer begins to grow. This is called active surveillance.
If you decide to have treatment, it might include:
- surgery to remove your prostate or
- external radiotherapy
What Active Surveillance Means
For many men, prostate cancer never affects their lives, said Christopher L. Runz, DO, attending urologist at University of Maryland Shore Regional Health. Active surveillance means we actively watch the cancer and make sure it stays low-grade, which means the cancer may potentially never spread.
Active surveillance requires regular prostate specific antigen screenings and MRIs, with occasional biopsies. Men who are older and have a shorter life expectancy become candidates for active surveillance when they have a Gleason score of 7 .
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Staging Of Prostate Cancer
Doctors will use the results of your prostate examination, biopsy and scans to identify the stage of your prostate cancer .
The stage of the cancer will determine which types of treatments will be necessary.
If prostate cancer is diagnosed at an early stage, the chances of survival are generally good.
How Do You Determine Whats Right For You
Whether youve recently been diagnosed with prostate cancer or youre dealing with recurrent or metastatic cancer, you may be facing difficult decisions about your treatment. Its normal to be unsure about what steps to take, and most patients have more than one choice.
Start by talking to your oncologist about the specifics of your case and your options. The American Society of Clinical Oncology has a helpful list of questions to ask your doctor about prostate cancer you may want to reference.
If possible, see a multi-specialty cancer care team to get a bigger picture of your case and your options. This is also important because, sometimes, factors outside of your cancer stage may impact your treatment options. For example, you may have an obstruction in your urinary tract that makes surgery a more appropriate choice than radiation. Or maybe you have another health condition that makes surgery more risky for you. In that case, radiation may be a better choice. You want these doctors to talk to one another about your case each has expertise that makes an important contribution to the decision-making process. To facilitate this coordination, you may have to set up appointments to see multiple doctors and ask them to discuss your case.
If youre interested in getting a second opinion for prostate cancer, or if youd just like to talk with someone at CTCA about your cancer care, or chat online with a member of our team.
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Your Age And General Health
Your doctor takes your age into account because some prostate cancers grow very slowly. If you are older and your prostate cancer is not causing you any symptoms, you may live just as long without having any active treatment. So you might be offered regular checkups instead of treatment.
You may find it hard to wait and see if you are offered regular checkups. But it could be the right choice for you if the side effects from the treatment might be worse than the effects of the cancer. This is particularly so if you have other health problems. If your cancer starts to cause symptoms you and your doctor can then consider which treatment is best for you.
Prevalence Of Prostate Cancer
Prostate cancer is the second most common cancer in U.S. men and is the second leading cause of cancer death in men. One in nine men born in the U.S. today will be diagnosed with prostate cancer during his lifetime. The risk of dying from prostate cancer, however, is much lower, at one in 41. Your individual risk depends on your risk factors. Continue reading this document to better understand your particular risk.
The American Cancer Society has estimated that more than 248,000 new cases of prostate cancer will be diagnosed each year in the United States and more than 33,000 men will die from the disease. The death rate for prostate cancer is twice as high for African American men as for the general population.
Most cases are diagnosed when men are in their 60s and 70s , although prostate cancer is sometimes detected in men in their 50s or younger. The good news is that the five-year survival rate for all stages of prostate cancer has increased from 69% to almost 99% over the past 20 years. These rates vary depending on the extent of disease. Reasons for this improvement include increased public awareness, earlier detection though screening with prostate specific antigen blood tests, and advances in the treatments for this cancer.
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Options For Dealing With Recurrence
With a persistently increasing PSA, the suspicion for recurrence increases. The most important factor in assessing your long-term outcome is determining the location of the prostate cancer cells producing the PSA. Advanced imaging techniques, such as MRI and PSMA PET/CT, are often helpful in learning where the cancer is located, and in the case of post-radiation recurrence, repeat biopsy may be required.
If a man underwent surgery as an initial treatment, revisiting the post-operative pathology report may help to identify what contributed to the recurrence. If there was still cancer present , the cancer was aggressive , or genomic profiling of the tumor showed high-risk features, several options are available:
- EBRT to the prostate bed with or without the pelvis.
- EBRT accompanied by hormone therapy. The duration of hormone therapy will depend on the PSA level just prior to radiation and to a lesser extent on the Gleason score and staging of the cancer.
- Systemic treatment using hormone therapy, other treatments for those at risk for metastatic disease, or a combination.
- Active surveillance if the remaining cancer appears insignificant. You and your doctor can decide whether to intervene more aggressively and, if so, when.
If you’re seeking additional or different approaches, you may be eligible to participate in an appropriate clinical trial . You can research this with the help of your doctor.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.
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Advances In Targeted Therapy
PARP inhibitors are a type of targeted therapy drug designed to prevent the DNA of cancer cells from repairing the damage caused by cancer treatment. In May 2020, the FDA approved two PARP inhibitors, rucaparib and olaparib, to treat patients with metastatic castration-resistant prostate cancer whose cancer tumors have certain homologous recombination repair genetic mutations and who meet other treatment-related criteria. These drugs are the first of their type to be approved by the FDA to treat prostate cancer.
Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.
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Who Should Have Focal Therapy
Candidates for focal therapy must be carefully selected, most often based on well-performed, image-guided biopsy techniques . Patients with intermediate-grade tumors visible in a single location on imaging may be considered for focal therapy. Low-grade cancers can be treated this way but are usually more suitable for active surveillance. Some doctors feel that cancer close to the urethra can also be treated in this fashion, but there may be a higher risk of side effects or incomplete treatment. Some feel that additional candidates for focal therapy include patients with one dominant tumor as described above and a microfocus of low-grade disease elsewhere. These smaller cancer foci are followed through active surveillance.
Results of ablation therapies to date have been favorable, but the experience and time of follow-up are still limited. In addition, these patients must be evaluated carefully to avoid undertreating their cancer, and after treatment, they need to have periodic imaging, PSA assessment and at least one follow-up biopsy.
How Prostate Cancer Is Treated
In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.
The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.
Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.
Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:
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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.