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How Does Prostate Cancer Start

What Treatments Are Available

Radiation vs. Surgery for Prostate Cancer | Ask a Prostate Expert, Mark Scholz, MD

If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.

If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:

Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.

If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.

Before you start treatment

Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.

It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.

If you have any questions, speak to our Specialist Nurses.

What Are Prostate Tests And How Is Prostate Cancer Diagnosed

Tests which check for prostate cancer include:

  • A digital rectal exam . In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
  • A prostate-specific antigen blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
  • Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.

If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.

During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.

Enhancing Healthcare Team Outcomes

Prostate cancer diagnosis and treatment can be complex and is often controversial. an interprofessional team of specialty-trained nurses, nurse practitioners, physician assistants, primary care providers, oncologists, radiation therapists, genetic counselors, and urologists must work together to manage:

These and many more issues continue to challenge clinicians who deal with prostate cancer patients and men at risk for this common, potentially lethal male malignancy.

The interprofessional team can optimize the treatment of these patients through communication and coordination of care. Primary care providers, urologists, oncologists, radiation oncologists, and nurse practitioners provide diagnoses and care plans. Specialty care urologic nurses should work with the team to coordinate care and be involved in patient education and monitoring compliance. The interprofessional team can thus improve outcomes for patients with prostate cancer.

Read Also: What Are The Screening Tests For Prostate Cancer

Gleason Score Vs Grade Groups

The International Society of Urological Pathology released a revised prostate cancer grading system in 2014. The grade group system seeks to simplify Gleason scores and give a more accurate diagnosis.

One of the major problems with the Gleason score is that some scores can be made up in different ways. For example, a score of 7 can mean:

  • 3 + 4. The 3 pattern is the most common in the biopsy and 4 is the second most common. This pattern is considered favorable intermediate risk.
  • 4 + 3. The 4 pattern is the most common in the biopsy and 3 is the second most common. This pattern is considered unfavorable and may mean local or metastatic spread.

So, although both situations give a Gleason score of 7, they actually have very different prognoses.

Heres an overview of how the two grading systems compare:

Cancer grade
grade group 5 910

Not all hospitals have switched to the grade group system. Many hospitals give both grade group and Gleason scores to avoid confusion until grade groups become more widely used.

Does Prostate Cancer Have Any Symptoms

Enlarged Prostate (BPH) Symptoms, Diagnosis, Treatment

Most men with early prostate cancer dont have any signs or symptoms.

One reason for this is the way the cancer grows. Youll usually only get early symptoms if the cancer grows near the tube you urinate through and presses against it, changing the way you urinate . But because prostate cancer usually starts to grow in a different part of the prostate, early prostate cancer doesnt often press on the urethra and cause symptoms.

If you do notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous problem called an enlarged prostate, or another health problem. But its still a good idea to get it checked out. Possible changes include:

  • difficulty starting to urinate or emptying your bladder
  • a weak flow when you urinate
  • a feeling that your bladder hasnt emptied properly
  • dribbling urine after you finish urinating
  • needing to urinate more often than usual, especially at night
  • a sudden need to urinate you may sometimes leak urine before you get to the toilet.

If prostate cancer breaks out of the prostate or spreads to other parts of the body , it can cause other symptoms, including:

  • back pain, hip pain or pelvis pain
  • problems getting or keeping an erection
  • unexplained weight loss.

These symptoms can all be caused by other health problems. But its still a good idea to tell your GP about any symptoms so they can find out whats causing them and make sure you get the right treatment, if you need it.

Also Check: How To Determine Enlarged Prostate

What Have Researchers Found About How These Treatments Compare With Each Other

Researchers found that for some men:

  • The risk of the cancer spreading to other parts of the body is much lower with surgery to remove the prostate gland than with watchful waiting.
  • Surgery to remove the prostate gland appears to increase the chance of surviving the cancer more than external-beam radiation therapy.
  • A combination of 3D-CRT and hormone therapy appears to increase the chance of surviving the cancer more than 3D-CRT alone.

Note

Research is only one source that helps guide doctors when they treat localized prostate cancer. Doctors also rely on their experience and on guidelines for treatment based on evidence and recommendations by experts.

When thinking about what treatment may be best for you, your doctor will consider several things, including:

  • Other health problems you may have
  • How long you are expected to live
  • Your preferences

Your doctor will also discuss possible side effects to help you decide about treatment. Talk with your doctor about your options and the trade-offs between possible benefits and side effects. Usually, you have time to think about your options before making a decision.

Note

What Have I Learned By Reading This

You learned about:

  • Why prostate cancer treatment can cause erectile dysfunction
  • What can be done about erectile dysfunction
  • How erectile dysfunction may affect your sex life
  • What your partner can expect

If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.

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Read Also: Is An Enlarged Prostate Bad

Looking For More Of An Introduction

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with prostate cancer and general survival rates. Use the menu to choose a different section to read in this guide.

ON THIS PAGE: You will find information about the number of people who are diagnosed with prostate cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

Statistics adapted from the American Cancer Societyâs publication, Cancer Facts & Figures 2021, and the ACS website .

Sexuality And Prostate Cancer

10 Warning Signs of Prostate Cancer

Most treatments for prostate cancer cause side effects that can affect your sex life, some more than others. This can have a huge effect on your mood, self-esteem and body image. It is important to discuss your concerns with your specialist before treatment starts, so that you are aware of any potential problems and how you can manage and limit their impact.

If you are having problems with your sex life after your treatment is over, ask your doctor or nurse for help. If you have a partner, it also helps to be as open as possible with them about how you are feeling. Prostate Cancer Foundation of Australias booklet called Understanding Sexual Issues following prostate cancer treatment may be helpful to read.

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Can Drinking Cause Prostate Cancer

No. Alcohol use can increase the risk for many types of cancer, but prostate cancer is not on this list.

Prostate cancer treatment: The care you need is one call away

Your multidisciplinary team will work with you to develop a personalized plan to treat your prostate cancer in a way that fits your individual needs and goals.

What Are The Treatments For Prostate Cancer

Your treatment options usually depend on your age, your general health, and how serious the cancer is. Your treatment may include one or more of options:

  • Observation,which is mostly used if you are older, your prostate cancer isn’t likely to grow quickly, and you don’t have symptoms or you have other medical conditions. Your doctor will keep checking on your cancer over time so to see whether you will need to start treatment for the cancer. There are two types of observation:
  • Watchful waiting means having little or no testing. If symptoms begin or change, you will get treatment to relieve them, but not to treat the cancer.
  • Active surveillance means having regular tests to see if your prostate cancer has changed. If the tests show the cancer is starting to grow or if you develop symptoms, then you will have treatment to try to cure the cancer.
  • Surgery to remove your prostate gland may be an option if your cancer hasn’t spread outside of your prostate.
  • Radiation therapy uses high energy to kill cancer cells or prevent them from growing.
  • Hormone therapy blocks cancer cells from getting the hormones they need to grow. It may include taking medicines or having surgery to remove the testicles.
  • Chemotherapy uses medicines to kill cancer cells, slow their growth, or stop them from spreading. You might take the drugs by mouth, as an injection , as a cream, or intravenously .
  • Immunotherapy helps your own immune system to fight cancer.
  • Also Check: What Are The First Signs Of Prostate Problems

    Types Of Prostate Cancer

    Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells .

    Other types of cancer that can start in the prostate include:

    • Small cell carcinomas
    • Neuroendocrine tumors
    • Transitional cell carcinomas

    These other types of prostate cancer are rare. If you are told you have prostate cancer, it is almost certain to be an adenocarcinoma.

    Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.

    Causes Of Prostate Cancer

    What Is Prostate Cancer

    The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.

    The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.

    For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.

    Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.

    Recent research also suggests that obesity increases the risk of prostate cancer.

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    Stage 2 Prostate Cancer

    In stage 2, the tumor is still confined to your prostate and hasnt spread to lymph nodes or other parts of your body. A doctor may or may not be able to feel the tumor during a prostate exam, and it may appear on ultrasound imaging. The survival rate is still .

    The PSA score for stage 2 is less than 20 ng/mL.

    Stage 2 cancer is further divided into three phases depending on the grade group and Gleason scores:

    • Gleason score: 6 or less

    Does Undergoing A Vasectomy Cause Prostate Cancer

    The link between prostate cancer and vasectomy is controversial. A 2020 study in the Journal of the National Cancer Institute suggests that undergoing a vasectomy may result in a small increased risk of prostate cancer that persists for at least three decades, regardless of the age at vasectomy. However, other studies have not found this to be true and more research is needed, according to the American Cancer Society.

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    What Are The Stages Of Prostate Cancer

    Your healthcare provider uses the Gleason score and Grade Groups to stage prostate cancer based on its projected aggressiveness. To get this information, the pathologist:

    • Assigns a grade to each type of cell in your sample. Cells are graded on a scale of three to five . Samples that test in the one to two range are considered normal tissue.
    • Adds together the two most common grades to get your Gleason score .
    • Uses the Gleason score to place you into a Grade Group ranging from one to five. A Gleason score of six puts you in Grade Group 1 . A score of nine or higher puts you in Grade Group five . Samples with a higher portion of more aggressive cells receive a higher Grade Group.

    What Are The Signs That Prostate Cancer Has Spread

    Intermittent Hormone Therapy for Prostate Cancer 101 | Ask a Prostate Expert, Mark Scholz, MD

    Men diagnosed with prostate cancer are already on a care plan or another at the recommendation of their doctors. This procedure most likely starts from an extensive set of tests in order to determine how advanced their form of prostate cancer is and the speed at which their tumor grows.

    Nonetheless, there are certain visible signs that indicate the fact that cancer cells have already started spreading outside the prostate gland. Keep in mind that prostate cancer manifests differently from case to case. Therefore, prostate cancer patients might experience some of the following signs or none at all.

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    Why Does Prostate Cancer Happen

    The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.

    The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.

    For reasons not yet understood, prostate cancer is more common in men of African-Caribbean or African descent, and less common in Asian men.

    Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.

    Recent research also suggests that obesity increases the risk of prostate cancer.

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    When Treatments For Advanced Prostate Cancer Fail

    Most men with advanced prostate cancer can live for a long time because of the treatments available. During this time, men will receive palliative care and/or end of life care.

    The purpose of palliative care is to quickly identify and treat physical symptoms of the disease and side effects of treatment, as well as to help the person manage the effects of the disease on their emotional, social and spiritual wellbeing. Research suggests that palliative care reduces pain and distress, improves comfort, mood and feelings of wellbeing, and may also help to extend survival times.

    Palliative care also helps partners, family and friends who love and care for the man with prostate cancer to better manage the impact of the disease. Studies have shown that it benefits not only the person with cancer, but the whole family.

    Prostate Cancer Foundation of Australia Understanding Advanced Prostate Cancer may be helpful to read.

    Also Check: Bleeding After Robotic Prostate Surgery

    Gleason Prostate Cancer Score

    1960s as a way to measure how aggressive your prostate cancer may be.

    A pathologist determines your Gleason score by looking at a biopsy of your prostate tissue under a microscope. They grade the cells in the biopsy on a scale of 1 to 5. Grade 1 cells are healthy prostate, whereas grade 5 cells are highly mutated and dont resemble healthy cells at all.

    The pathologist will calculate your Gleason score by adding together the number of the most prevalent type of cell in the sample and the second most prevalent type of cell.

    For example, if the most common cell grade in your sample is 4 and the second most common is 4, you would have a score of 8.

    A Gleason score of 6 is considered low-grade cancer, 7 is intermediate, and 8 to 10 is high-grade cancer.

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