Symptoms Of Prostate Cancer
Once a tumor causes your prostate gland to swell, or once cancer spreads beyond your prostate, you may have symptoms including:
- The need to pee often, especially at night
- Trouble starting or stopping a stream of urine
- A weak stream or one that starts and stops
- Leaking pee when you laugh or cough
- Not being able to pee standing up
- Pain or burning when you pee
- Pain or burning when you ejaculate
- Less fluid when you ejaculate
- Blood in your pee or semen
- Pressure or pain in your rectum
- Pain or stiffness in your lower back, hips, pelvis, or thighs
- New trouble getting an erection
These arenÃ¢t symptoms of the cancer itself. They happen because the cancer growth is blocking your prostate.
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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.
A widely used method of staging is a number staging system. The stages are:
- Stage 1 the cancer is very small and completely within the prostate gland
- Stage 2 the cancer is within the prostate gland, but is larger
- Stage 3 the cancer has spread from the prostate and may have grown into the tubes that carry semen
- Stage 4 the cancer has spread into the lymph nodes or another part of the body, including the bladder, rectum or bones about 20-30% of cases are diagnosed at this stage
If prostate cancer is diagnosed at an early stage, the chances of survival are generally good. About 90% of men diagnosed at stages 1 or 2 will live at least five more years and 65-90% will live for at least 10 more years.
If you are diagnosed with stage 3 prostate cancer, you have a 70-80% of chance of living for at least five more years.
However, if you are diagnosed when your prostate cancer has reached stage 4, there is only a 30% chance you will live for at least five more years.
Want to know more?
- Cancer Research UK: the stages of prostate cancer
What Are The Risks Of Having A Psa Test
Often the PSA test can show high levels of PSA that aren’t caused by cancer .
If your PSA test is high, you may need more testsâlike a prostate biopsyâto check for prostate cancer. These tests can be harmful. For example, prostate biopsies can cause infections. For a few men, these infections are very serious. These tests can also cause a lot of worry.
PSA tests may miss some cancers. Not all prostate cancers cause a high PSA, so some PSA tests will be normal when there is cancer . But the more serious prostate cancers usually do cause a high PSA.
A PSA test can find cancers that would not have caused a problem . You might have this type of cancer, but a PSA test can’t tell if the cancer is harmless. So you may get cancer treatmentâincluding surgery or radiationâthat you don’t need.
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Can Prostate Cancer Be Prevented
There are no clear prevention strategies for prostate cancer. There is some conflicting evidence that a healthy diet composed of low fat, high vegetables and fruits may help reduce your risk of prostate cancer. Routine screening, with PSA blood test and physical exam, is important to detect prostate cancer at an early stage. A healthy diet and regular exercise are also critical in maintaining good health and preventing disease in general.
What Kind Of Treatment Will I Need
There are many ways to treat prostate cancer. The main kinds of treatment are observation, active surveillance, surgery, radiation, hormone therapy, and chemo. Sometimes more than one kind of treatment is used.
The treatment thats best for you will depend on:
- Your age
- Any other health problems you might have
- The stage and grade of the cancer
- Your feelings about the need to treat the cancer
- The chance that treatment will cure the cancer or help in some way
- Your feelings about the side effects that might come with treatment
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How Does The Doctor Know I Have Prostate Cancer
Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.
Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.
If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:
PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.
Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.
Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.
Tests Used To Check The Prostate
This first step lets your doctor hear and understand the “story” of your prostate concerns. You’ll be asked whether you have symptoms, how long you’ve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
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So What Causes Prostate Cancer
The exact cause of prostate cancer is unknown. Most prostate cancers happen by chance, or due to shared environmental and common genetic factors. But what we do know is that prostate cancer happens when some prostate cells become abnormal.
Abnormal cells grow and multiply more quickly than normal cells. And as abnormal cells continue to accumulate, normal cells die and a tumor forms. That tumor can grow and spread to nearby tissue, and those abnormal cells can also spread to other parts of the body.
Who Is At Risk For Prostate Cancer
Certain men are at higher risk than others for prostate cancer, which may affect when they should start being screened. The risk increases with age, particularly after age 50. Some risk factors include:
- African American men are twice as likely as white men to develop the disease.
- Having a family history a father or a brother diagnosed with prostate cancer, particularly if it is at a relatively early age increases the risk.
- Having a family history of breast and ovarian cancer may also be associated with an inherited risk of developing prostate cancer
- High-fat diet and/or obesity
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What Do The Experts Recommend
Experts disagree on how useful PSA testing is. PSA testing can help find prostate cancer early. But it may not help you live any longer than if you had no screening. And it could lead to harmful treatments you don’t need. Talk with your doctor about your age, your health, your risk factors for prostate cancer, and the pros and cons of PSA testing. The choice is up to you.
The Canadian Cancer Society recommends that men talk to their doctor about the potential benefits and risks of prostate cancer screening at about age 50.footnote 4 Men with higher risk may wish to discuss the need for screening at a younger age.
Your doctor may recommend PSA testing if you have an increased risk of getting prostate cancer. Some things that put men at a higher risk include:
- Being of African ancestry.
- Having a father or brother who had prostate cancer before age 65.
- Knowing that a gene change, such as BRCA, runs in your family.
What Are The Prostate Cancer Symptoms I Need To Look Out For
In its early stages, prostate cancer may not show any symptoms. Symptoms of early prostate cancer can include:
- difficulty passing urine
- a slow, interrupted flow of urine
- frequent passing of urine, including at night
Symptoms associated with advanced prostate cancer include:
- blood in urine
- pain during urination
- lower back or pelvic pain.
These symptoms are also found in men who may have benign prostatic hyperplasia , a common, non-cancerous enlargement of the prostate gland.
If you experience these symptoms, visit your doctor.
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The Choice To Do Nothing
The thing is, you can also do nothing and still survive. This was an attractive option for me. I found myself in the care of Dr. Laurence Klotz , who is a leading proponent of active surveillance of low-grade, slow-growing prostate cancers.
Dr. Klotz has won the Order of Canada for his contributions in this field, though his research remains controversial.
Q: What Are The Best Treatment Options For Someone Who Is In The High
- Dr. Richstone:For patients with high-risk disease, the central treatment options are either surgery or radiation combined with a type of hormone therapy known as androgen deprivation therapy, which is oral medication that reduces levels of male hormones in the body.
- Dr. Potters:Men with high-risk prostate cancer need to meet with both a radiation oncologist and urologist to discuss which approach may be best. Not everyone is a candidate for radiation or for surgery, so each patient requires a multidisciplinary review to develop a personalized and best treatment approach. The good news is that we have all the tools and technology at Northwell, as well as the expertise of the physicians, to use them correctly and with the highest quality and best outcomes possible.
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I Have Prostate Cancer Now What
What men need to consider when making treatment decisions.
7 min read
In 2018, more than 164,000 men in the U.S. will learn that they have prostate cancerthe most common type of cancer in men , and the second leading cause of cancer deaths .
Like any cancer diagnosis, the news can leave men and their loved ones feeling anxious and unsure about the future. And with so many different options available for treating prostate cancerincluding surgery, radiation, hormonal therapy, and even the option to initially do no treatment at allthe decision-making process can often be complicated.
To find out more about prostate cancer treatment options and the various factors that both doctors and patients must consider when making a decision, I spoke to three Northwell Health physicians who care for patients with prostate cancer: Dr. Louis Potters and Dr. Richard Byrnes, who are radiation oncologists, and Dr. Lee Richstone, a urologist.
Heres what they had to say:
Recognizing The Risk Factors
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Causes Of Prostate Cancer
It is not known exactly what causes prostate cancer, although a number of things can increase your risk of developing the condition.
- age risk rises as you get older and most cases are diagnosed in men over 50 years of age.
- ethnic group prostate cancer is more common among men of African-Caribbean and African descent than in men of Asian descent.
- family history having a brother or father who developed prostate cancer under the age of 60 seems to increase the risk of you developing it. Research also shows that having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer.
- obesity recent research suggests that there may be a link between obesity and prostate cancer.
- exercise men who regularly exercise have also been found to be at lower risk of developing prostate cancer.
- diet research is ongoing into the links between diet and prostate cancer. There is evidence that a diet high in calcium is linked to an increased risk of developing prostate cancer.
In addition, some research has shown that prostate cancer rates appear to be lower in men who eat foods containing certain nutrients including lycopene, found in cooked tomatoes and other red fruit, and selenium, found in brazil nuts. However, more research is needed.
Want to know more?
My Prostate Cancer Diagnosis
I was diagnosed two years ago, at the relatively young age of 51, after a routine PSA test. I had no symptoms, no urinary issues and no troubles in the bedroom, as the health magazines carefully refer to it. But I found doctors curiously unwilling to advise me on what to do.
They load you up with documents about the possible side effects of each treatment option. They direct you to online decision-making tools that ask you questions about how afraid of death you are and how important your sex life is. They make a lot of hand gestures that signal that youre weighing equally heavy things.
They tell you: yes, I can make pretty sure your cancer doesnt spread. But your quality of life will be diminished forever. Then they ask: you sure you want me to go ahead?
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Other Conditions That Can Cause Urinary Symptoms
- Benign prostatic hyperplasia BPH is when the prostate gland grows larger. BPH is common in middle-aged and elderly men because the prostate gland often gets bigger as you get older. BPH is not cancerous but it may cause prostate urinary symptoms.
- ProstatitisProstatitis means that the prostate gland has become inflamed. It can be caused by an infection in the prostate gland. It is not a form of prostate cancer. Symptoms can include pain in your testicles, pain when passing urine or an uncomfortable feeling when sitting down.
Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
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Q: What Are Some Of The Reasons Why A Man Might Choose To Have Surgery
- Dr. Richstone:There are several factors that make surgery an appealing treatment option for men with prostate cancer. First, its the only treatment that allows you to get full pathology results on the entire prostate, the seminal vesicles and lymph nodes. This is important because biopsies can underestimate the grade and stage of cancer in up to a third of cases. Knowing exactly whats going on with the cancer can also help you make decisions about whether or not additional treatments are necessary. If you do need a secondary treatment for your cancer, its better to have surgery before radiation rather than the other way around.Its also a time tested treatment for prostate cancer with some of the best follow-ups supporting its efficacy. Its certainly one of the true gold standards for prostate cancer treatment.Finally, surgery gives you a very clear benchmark on treatment success because after surgery, your PSA becomes undetectable, meaning its less than 0.01.
Early Signs Of Prostate Cancer
While any of the above symptoms can be your first indication that you have prostate cancer, urinary symptoms are more likely than other symptoms to appear early.
Its important to keep in mind that most of these symptoms can also be caused by other conditions that arent cancer. These conditions include benign prostatic hyperplasia and prostatitis.
So, while its important to keep tabs on any symptoms you may have, remember that theres a good chance theyre not caused by cancer.
That said, neither of these conditions causes blood to appear in your urine. If you have this symptom, call your doctor right away.
Centers for Disease Control and Prevention .
Its also because the results from the prostate-specific antigen test, which can be part of the screening, may lead to a misdiagnosis of cancer. For both of these reasons, screening could cause unnecessary worry and unneeded treatment.
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