What Are The Early Warning Signs And Symptoms Of Prostate Cancer
Most men with prostate cancer have no symptoms.
- Erectile dysfunction
- Bone pain and/or fractures
One should go to the nearest hospital emergency department without delay if any of the following symptoms occur:
- Urinary tract infection : Burning pain on urination, urgency, or frequent urination, especially with fever.
- Bladder obstruction: Not urinating or urinating very little despite drinking enough fluid producing little urine despite straining pain due to a full bladder.
- Acute kidney failure: Not urinating or urinating little, with little discomfort, despite drinking enough fluid.
- Deep bone pain, especially in the back, hips, or thighs, or bone fracture: Possible sign of advanced prostate cancer that has spread to the bone.
- Spinal cord compression: This occurs when the cancer has spread to vertebrae of the spine and tailbone region. The weakened vertebrae can collapse on the spinal cord. Typical symptoms that might signal acute spinal cord compression include weakness in the legs and difficulty walking, increased difficulty urinating, difficulty controlling the bladder or bowels, and decreased sensation, numbness, or tingling in the groin or legs. These are often preceded by a persistent new central pain in the back lasting a few days or weeks. This condition is a true emergency and requires immediate evaluation in the nearest hospital emergency department. Failure to be treated immediately can result in permanent spinal cord damage with paralysis.
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Treatment: Prostate Cancer Vaccine
This vaccine is designed to treat, not prevent, prostate cancer by spurring your body’s immune system to attack prostate cancer cells. Immune cells are removed from your blood, activated to fight cancer, and infused back into the blood. Three cycles occur in one month. It’s used for advanced prostate cancer that no longer responds to hormone therapy. Mild side effects can occur such as fatigue, nausea, and fever.
Bpathology And Diagnosis Of Prostate Cancer
Almost all prostate tumors are classified as adenocarcinomas , and occur most commonly in the peripheral zone of the gland. Accordingly, a physician can often feel them during DRE. A unique feature of human prostate cancer is the high frequency of small, latent tumors in older men. Autopsy reports have found such asymptomatic lesions in more than 80% of men in the United States over the age of 80 . Although the relationship between these occult tumors and those that become clinically apparent has not been established, it is commonly assumed that clinical lesions evolve from these latent foci as a consequence of additional genetic mutations.
LAURENCE N. KOLONEL, in, 2001
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
Identification Of Candidates For Observation
Prostate cancer is in most cases a slowly progressive disease. However, early localized disease is curable whereas metastatic disease is not. Thus, a continued debate among clinicians is whether to treat early to prevent disseminated disease, or observe and delay treatment until there is evidence of progression. The former risks harm from overtreatment of an indolent disease whereas the latter risks missing an opportunity for cure among those destined to experience progression. An unmet need is to identify the relatively small proportion of men with a lethal phenotype in whom death can be prevented by curative intervention, while avoiding treatment of the large pool of indolent disease that can be detected with screening.
Selection of patients for active surveillance depends upon patient and tumor metrics, as well as a patient’s personal preferences. The age, comorbidities, and estimated life expectancy of the patient are important to consider given that prostate cancer can be a slowly progressive disease that may not have time to progress in those whose remaining years of life are limited. In this respect, tools for estimating life expectancy can be useful in decision making.
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Cancer Lethality Set Early
The study looked for changes in cancer aggressiveness in men diagnosed with prostate cancer from 1982 to 2004. All of the men had their prostates removed after diagnosis, and biopsy samples were taken from the glands. The Harvard team reexamined the samples and graded them using a tool called the Gleason score, which assigns a number from 2 to 10 based on how abnormal the cells look under a microscope. High-scoring or high-grade cancers tend to be the most lethal.
Over the study period, fewer and fewer men were diagnosed with advanced, late-stage prostate cancers that had spread beyond the prostate gland. This reflected the growing use of prostate-specific antigen testing to diagnose prostate cancers earlier and earlier. In contrast, the proportion of high-grade cancers, as measured by the Gleason score, remained relatively stable rather than gradually becoming more aggressive. Previous studies have seen a similar pattern.
Its a very interesting study that confirms what previous studies have found, says Dr. Marc B. Garnick, a prostate cancer specialist at Harvard-affiliated Beth Israel Deaconess Medical Center who was not involved in the study. There may be rare exceptions, but in the vast majority the cancer is born with a particular Gleason score.
Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
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When Should Men Be Evaluated For Prostate Cancer Growth
Prostate cancer growth is treatable when gotten early, prompting an accentuation on screening. However various associations suggest being screened at various ages, which can prompt some disarray. Around 1 out of 9 men will be determined to have prostate disease during their lifetime, so understanding ones degree of hazard is pivotal.
What age should men be evaluated for prostate cancer growth?The Prostate Cancer Foundation suggests that Black men or men with a family background of cancer growth be screened at 40 years old in any case, the association exhorts getting screened at 45. The American Cancer Society suggests that men at normal danger be screened at 50 years old, while men at high danger of creating prostate cancer growth like Black men and men who have a first-degree relative, similar to a dad or sibling, who were determined to have prostate disease before the age of 65, be screened at 45. Men at considerably higher danger ought to be screened at 40.
In 2018, the U.S. Preventive Services Task Force gave a proposal encouraging men to begin discussing screenings with their primary care physicians at 55 years old.
These changing rules are because of the distinctive danger factors that every individual appearances. Things like family ancestry, ecological variables, race and more would all be able to become an integral factor with regards to evaluating prostate malignant growth hazard.
What Causes Prostate Cancer And Am I At Risk
Every man is at risk for prostate cancer as he ages. Although prostate cancer can affect younger men, about 6 out of 10 cases are diagnosed in men over the age of 65. The average age of diagnosis is 66. After non-melanoma skin cancer, prostate is the most common cancer diagnosed in men in the United States. The American Cancer Society estimates there will be 248,530 new cases of prostate cancer each year.
Although there are several known risk factors for getting prostate cancer, no one knows exactly why one man gets it and another doesn’t. Some important risk factors for prostate cancer are:
Prostate Cancer Survival Rates
The good news about prostate cancer is that it usually grows slowly, and 9 out of 10 cases are found in the early stages. Overall, the 5-year relative survival rate is 100% for men with disease confined to the prostate or nearby tissues. Many men live much longer. When the disease has spread to distant areas, that figure drops to 31%. But these numbers are based on men diagnosed at least 5 years ago. The outlook may be better for men diagnosed and treated today.
What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
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What Are The Stages Of Prostate Cancer
The primary staging assessment of prostate cancer is usually made by digital rectal examination , prostate specific antigen measurement, and bone scan, supplemented with computed tomography or magnetic resonance imaging and chest X-ray in specific situations.
Staging is a system of classifying tumors by size, location, and extent of spread, local and remote.
Staging is an important part of treatment planning because tumors respond best to different treatments at different stages.
Stage is also a good indicator of prognosis, or the chances of success after treatment.
Clinical staging provides the initial information about the extent of disease that is used to plan therapy. However, clinical staging can underestimate the extent of the tumor, when compared with results based upon pathologic examination of a resection specimen .
Conventional stages of prostate cancer are as follows:
- Stage I : The cancer cannot be felt on digital rectal exam, and there is no evidence that it has spread outside the prostate. These are often found incidentally during surgery for an enlarged prostate.
- Stage II : The tumor is larger than a stage I and can be felt on digital rectal exam. There is no evidence that the cancer has spread outside the prostate. These are usually found on biopsy when a man has an elevated PSA level.
- Stage III : The cancer has invaded other tissues neighboring the prostate.
- Stage IV : The cancer has spread to lymph nodes or to other organs.
External Beam Radiation Therapy
The following three sections refer to treatment using x-rays.
Conventional external beam radiation therapy
Historically conventional external beam radiation therapy was delivered via two-dimensional beams using kilovoltage therapy x-ray units, medical linear accelerators that generate high-energy x-rays, or with machines that were similar to a linear accelerator in appearance, but used a sealed radioactive source like the one shown above. 2DXRT mainly consists of a single beam of radiation delivered to the patient from several directions: often front or back, and both sides.
Conventional refers to the way the treatment is planned or simulated on a specially calibrated diagnostic x-ray machine known as a simulator because it recreates the linear accelerator actions , and to the usually well-established arrangements of the radiation beams to achieve a desired plan. The aim of simulation is to accurately target or localize the volume which is to be treated. This technique is well established and is generally quick and reliable. The worry is that some high-dose treatments may be limited by the radiation toxicity capacity of healthy tissues which lie close to the target tumor volume.
Intensity-modulated radiation therapy
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Can Prostate Cancer Be Prevented Or Avoided
Some risk factors, such as family history and hormone levels, cant be prevented. However, your weight, physical activity, and diet may lower your risk for prostate cancer. Work toward a healthy lifestyle by eating the recommended daily amount of fruits and vegetables, exercising, and maintaining a healthy weight .
How Is Prostate Cancer Staged
With these tests, a stage is assigned to help decide the treatment plan. The stage of cancer, or extent of disease, is based on information gathered through the various tests as the diagnosis and work-up of the cancer is being performed.
Prostate cancer is most commonly staged using the TNM system plus the Gleason score. The TNM system is used to describe many types of cancers. In prostate cancer it has four components:
- T- Describes the extent of the “primary” tumor .
- N- Describes if there is cancer in the lymph nodes.
- M- Describes if there is spread to other organs .
- G- Describes the Gleason score and takes into account the PSA and the histologic grade of the tumor.
The staging system is very complex. The entire staging system is outlined at the end of this article. Though complicated, the staging system helps healthcare providers determine the extent of the cancer, and in turn, make treatment decisions for a patient’s cancer.
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Deformation Of The Prostate Due To Pca
We considered three artificial tumors placed in characteristic locations within the prostate: the basal PZ, the apical PZ, and the CG. Each tumor had ellipsoidal geometry with one semiaxis measuring 4 mm and the others 3 mm. The largest dimension was oriented in anteroposterior direction. We selected the parameters that regulate tumor dynamics so that these tumors were aggressive and showed the typical morphologies of localized PCa: massive and fingered . shows the growth of these artificial tumors and how they deformed the patients prostate .
Deformation of the prostate over 1 y produced by a tumor originated on basal PZ , apical PZ , and median CG . Tumor growth over the original prostate geometry. Length of the displacement field vector over original anatomy at t = 1 y. The contour of the tumor is depicted with black curves. Original and deformed geometries of the prostate at t 1 y.
The CG tumor grew faster and larger than the PZ tumors, whose growth rates and initial volumes were similar. Because the tumor in apical PZ underwent the change in morphology earlier, its volume was larger than that of the basal PZ tumor for the second half of the simulation. The final volumes of the basal PZ tumor, the apical PZ tumor, and the CG tumor were 5.43 cc, 6.82 cc, and 9.02 cc, respectively.
How Serious Is My Cancer
If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.
The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.
Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.
If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.
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