After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body
The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.
The following tests and procedures also may be used in the staging process:
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Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks, such as urinary incontinence and erectile dysfunction.
In extremely rare cases, problems arising after surgery can be fatal.
Its possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.
You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Age The Younger People Survive
People above the age of 55 are very unlikely to survive prostate cancer. Only 7% of diagnosed prostrate cancer die within the first five years. Studies show that the risk of getting prostate cancer increases with age, and the speed at which cancer spreads grows exponentially too. People younger than the age of 40 rarely contract prostate cancer, and when they do, almost all of them are cured easily.
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Hormone Therapy For Disseminated Pca
Metastatic PCa is currently not curative, but most patients will have significant initial responses to therapy. Upfront ADT has been the standard of care for treatment naïve PCa, based on Huggins and Hodges seminal work in 1941. Patients with symptomatic disease or metastasis at high risk sites should be treated promptly symptoms from metastatic PCa can rapidly resolve within days to weeks if responsive to initial ADT, and thus it is important to consider this when evaluating PS and treatment decisions. The addition of a continuous anti-androgen to an LHRH analogue has been extensively studied, and meta-analyses have shown a small but significant benefit of combined androgen blockade.6,7 However, there is currently no recommendation for or against combined androgen blockade in this setting.8
Current Psa Screening Recommendations
PSA-based screening refers to testing healthy men without symptoms.
Until recently, physician societies disagreed on screening recommendations, but with the publication of the U.S. Preventive Services Task Force Guideline in May 2018, all the major physician groups are broadly in agreement, including the American College of Physicians , the American Cancer Society , American Urological Association , and American Society of Clinical Oncology :
- They advise supporting men so that they make informed decisions about screening that reflect their personal preferences and values.
- Routine screening is not recommended in men between ages 40 and 54 of average risk.
- For men ages 55 to 69 years, the U.S. Preventive Services Task Force concluded with moderate certainty that the net benefit of PSA-based screening is small for some men, making the decision up to the judgment of the physician and the values of the patient.
- For men 70 years and older, they recommend against routine screening because the expected harms are thought to outweigh the benefits.
- Your doctor should not screen you unless you express a preference for it.
- A discussion of the benefits and harms of screening should include a family history of prostate cancer, race or ethnicity, any medical conditions that affect your overall health and lifespan, and your values about risk and benefit.
- If you have less than a 10-year life expectancy, screening is not recommended.
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Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
Hormone Therapy For Prostate Cancer
Also known as androgen suppression therapy, the purpose of hormone therapy is to mitigate the influence of any prostate cancer. What happens is that prostate cancer cells are feeding on male hormones in order to grow. Using hormone therapy, the body puts a stop on supplying cancer with what it requires in order to grow.
Nonetheless, hormone therapy is not a cure for prostate cancer. Doctors can recommend this procedure when the cancer has spread too far or before chemotherapy in order to shrink the tumor and maximize the efficiency of the treatment.
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Fast Facts On Prostate Cancer
- Prostate cancer rarely reaches an advanced stage.
- People with the condition normally have a very good outlook when they receive an early diagnosis and treatment.
- Hormone therapy is a treatment option for advanced prostate cancer, as are chemotherapy and immunotherapy.
- Prostate cancer can spread to the bones, brain, and lungs.
Prostate cancer occurs when cells in the prostate gland mutate and start to develop abnormally, multiplying at an uncontrolled rate. In some instances, the cancerous cells can spread to other body parts through tissue, the blood, or the lymphatic system.
After a doctor diagnoses prostate cancer, they will test to see if the cancer has spread to other areas of the body, or how much of the body is affected.
The doctor will assign a stage of prostate cancer from 1 to 4. Stage 4 is the most advanced form.
Stage 4 prostate cancer has spread to pelvic lymph nodes or is blocking the ureters. The ureters are the tubes that connect the kidneys to the bladder. Stage 4 prostate cancer may also have spread to the bladder, the rectum, the bones, or distant lymph nodes.
Doctors will test any cancerous cells in the body to determine if the additional cells came from the prostate. Even if they detect cancer in the bones, doctors still consider this prostate cancer if that is where the cancer originated.
There are two types of stage 4 prostate cancer:
Are Other Tests Needed
A doctor will not generally recommend further treatment after a single PSA test result. They will typically monitor a persons PSA levels over time to see whether they are rising.
PSA testing is only one way to check a persons health after having a prostatectomy. A doctor may use an imaging test to look for a tumor or a growing number of cancer cells.
They are also likely to ask the individual about any possible symptoms that could suggest that prostate cancer has returned.
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Secondary Cancer In The Bones
After the lymph nodes, the most common place for prostate cancer to spread to is the bones. Prostate cancer may spread to bones, such as the:
It may affect different areas of the bones rather than only one area.
- Pain
The first sign of a secondary cancer in the bones is usually an ache in the bone. This is often in the hips or in the back. A secondary cancer in the bone may gradually make the bone weaker. Bones that are very weak may break more easily. There are treatments you can have to help strengthen the bones and reduce pain.
- Spinal cord compression
If the bones in the spine have cancer in them, the cancer may press on the spinal cord. This is called Malignant spinal cord compression . It usually affects your legs and may cause:
- numbness or tingling in your legs.
Spinal cord compression is not common. But if you notice these symptoms, you should contact your doctors straight away even at the weekend or during a holiday period. If you cannot contact your GP or cancer doctor, you should go to the nearest emergency department .
Prostate cancer can sometimes spread from the bone to the bone marrow. Bone marrow is the spongy material in the middle of our bones where our blood cells are made. This includes red blood cells, which carry oxygen around the body.
If the bone marrow cannot produce enough red blood cells, you may become anaemic. This can make you feel very tired and breathless, and you may look very pale.
Standard Treatment Options For Stage Iii Prostate Cancer
Standard treatment options for patients with include the following:
External-beam radiation therapy with or without hormonal therapy
EBRT alone, luteinizing hormone-releasing hormone agonist, or orchiectomy, in addition to EBRT, should be considered. Definitive radiation therapy should be delayed until 4 to 6 weeks after transurethral resection to reduce the incidence of stricture.
Hormonal therapy should be considered in conjunction with radiation therapy especially in men who do not have underlying moderate or severe comorbidities. Several studies have investigated its utility in patients with locally advanced disease.
Evidence :
Evidence :
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Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- a chemotherapy nurse
- a diagnostic radiographer
- a therapeutic radiographer
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
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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Prostate Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Prostate
The prostate is agland in the malereproductive system. It lies just below the bladder and in front of the rectum . It is about the size of a walnut and surrounds part of the urethra . The prostate gland makes fluid that is part of the .
Prostate cancer is most common in older men. In the U.S., about 1 out of 5 men will be diagnosed with prostate cancer.
The First Question If Youve Been Diagnosed With It Is: Can Prostate Cancer Be Cured With Early Detection And Todays Treatments The Survival Rate Is High
Can prostate cancer be cured? With todays treatments, the prostate cancer cure rate is high when the disease is found early enough and managed appropriately.
Receiving a diagnosis of prostate cancer is shockingso much so that you might not fully process anything your doctor says after the C word. Consequently, you might forget about another C wordcureand fail to understand that a prostate cancer diagnosis is not a death sentence. So, can prostate cancer be cured?
If youre undergoing regular screening, chances are that any prostate cancer you have will be identified at an earlier stage, when your likelihood of a cure is greater. According to the Prostate Cancer Foundation, the cure rate for men with low-risk prostate cancer is nearly 91 percent, thanks, in part, to todays modern treatments. And, because prostate cancer often grows slowly, you might not require treatment right away.
Although any cancer diagnosis is scary, dont rush into treatment. Rather, think through your many options, gather all the information you need, and talk to multiple specialists about the available treatments, their risks, and possible outcomes.
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Androgen Biosynthesis Inhibitors In Crpc
The development of selective CYP17 inhibitors has largely replaced older agents. Abiraterone is the only FDA approved selective CYP17 inhibitor and has been evaluated and approved in both the pre- and post-chemotherapy mCRPC setting. In the COU-AA-301 trial, 1195 men with mCRPC who received prior docetaxel chemotherapy were randomized to abiraterone 1000 mg plus prednisone versus placebo plus prednisone.14 The primary end point was met with a 3.9 month OS improvement . Improvements in PSA progression and PFS were also noted. Abiraterone has also been shown to be effective prior to chemotherapy. In the COU-AA-302 trial, 1088 chemotherapy-naïve mCRPC patients were randomized to receive abiraterone or placebo, both with prednisone. Treatment with abiraterone was associated with an improvement in median OS with an improvement in PFS as well.15 A longer term follow-up study confirmed the OS improvement .16 The side effect profile was similar in both studies with notable adverse events occurring in the abiraterone group including fluid retention, hypertension, electrolyte and liver enzyme abnormalities.
Can Prostate Cancer Be Completely Cured
Prostate cancer is the second most common cancer in men. The average age of diagnosis is 66 year olds, although it may affect younger men as well. By age 80, more than half of all men have some cancerous growth in their prostate.
Due to routine screening of prostate-specific antigen levels in the United States, nearly 90% of prostate cancers get detected in early stages. In most cases, the cancer is confined only to the prostate and does not spread to other organs. With the widespread use of screening tests in the United States, early diagnosis of prostate cancer has become much easier.
When found early, there are several treatment options available and prostate cancer has a high chance of getting cured. Moreover, prostate cancer is a slow-growing cancer that takes many years to become big enough to cause symptoms. It also takes quite long to spread to other organs. This gives sufficient time for the doctors to treat it.
Oncologists recommend patients to not rush and take some time to understand the various treatment options available after consulting with more than one doctor. Patients can discuss various modes of treatment with the doctor and select the most appropriate option for their prostate cancer.
The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. There are more than three million survivors of prostate cancer in the United States today.
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