What Are The Side Effects Of Hormone Therapy For Prostate Cancer
Testosterone is the primary male hormone and plays an important role in establishing and maintaining the male sex characteristics, such as body hair, muscle mass, sexual desire, and erectile function. Most men who are on hormone therapy experience at least some effects related to the loss of testosterone, but the degree to which you will be affected by any one drug regimen is impossible to predict. Side effects from testosterone-lowering therapies include hot flashes, breast enlargement or tenderness, loss of bone mineral density and fractures, increased weight gain , higher cholesterol, a higher risk of diabetes, and a slightly higher risk of heart problems like heart attacks and chest pains. Some men complain of mood problems and depression during this time as well. Dont be afraid to discuss these issues with your doctors. For all of these reasons, maintaining a healthy overall lifestyle is vital to doing well with hormonal therapies over time.
Staging And Grading Of Advanced Prostate Cancer
The stage of a cancer describes its size and how far it has spread, based on your test results. Doctors often use the TNM staging system or a number staging system.
A doctor decides the grade by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread. You and your doctors can then talk about the best treatment choices for you.
How Fast And Where Does Prostate Cancer Spread
Like other cancers, prostate cancer can spread from the site of where it first started to other sites of the body. Once it spreads, the disease may still respond to the treatment, but typically it is now no longer to be cured. Bones, liver, and lungs are the most common sites for prostate cancer metastasis. How do you know that it has spread? And how fast this metastasis?
Since the early detection of the disease is very crucial for the prognosis and outlook of patients , its very important to diagnose the disease as early as possible.
In the U.S, the number of men diagnosed with the disease at later stages decreases drastically due to the implementation of PSA screening test .
Men with many risk factors of prostate cancer should start discussing the test with their doctor earlier. Visit this section for more information about this!
The PSA test is also recommended in other countries . However whether this test is necessary for all men is debatable.
For those who eventually dont have prostate cancer in their life, the choice to take the test may put them at high risk of getting over-diagnosis, making anxiety more likely.
Therefore, some experts agree that the screening prostate cancer test is more recommended for those who have some /many risk factors of the disease. For more advice, consult more with your GP!
How prostate cancer is diagnosed?
PSA screening test
Rectal examinations
Biopsy procedure
IVU or IVP Intravenous urogram
Imaging tests
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What Are Bone Metastases With Prostate Cancer
The ACS describes bone metastases as areas of bone containing cancer cells that have spread from another place in the body. In the case of prostate cancer, the cells have spread beyond the prostate gland. Since the cancer cells originated in the prostate gland, the cancer is referred to as metastatic prostate cancer.
The cancer cells spread to the bones by breaking away from the prostate gland and escaping attack from your immune system as they travel to your bones.
These cancer cells then grow new tumors in your bones. Cancer can spread to any bone in the body, but the spine is most often affected. Other areas cancer cells commonly travel to, according to the ACS, include the pelvis, upper legs and arms, and the ribs.
What Does The Biopsy Say About Your Prostate Cancer
When abnormal results are discovered from prostate cancer screen tests, the Digital Rectal Exam and PSA Blood Test, a biopsy may be recommended. The Gleason Score is the rating system assigned to the results of the biopsy. This type of biopsy is normally performed using transrectal ultrasound guidance. The ultrasound allows the physician to take distributed samples from the prostate. Typically twelve separate samples are taken. A pathologist will then examine the tissue samples under a microscope to determine whether or not the prostate contains cancerous tissue. A grade is assigned to the tissue samples. The two most common grades are added together to create the Gleason Score.
When abnormal results are discovered from prostate cancer screen tests, the Digital Rectal Exam and PSA Blood Test, a biopsy may be recommended. The Gleason Score is the rating system assigned to the results of the biopsy. This type of biopsy is normally performed using transrectal ultrasound guidance. The ultrasound allows the physician to take distributed samples from the prostate. Typically twelve separate samples are taken. A pathologist will then examine the tissue samples under a microscope to determine whether or not the prostate contains cancerous tissue. A grade is assigned to the tissue samples. The two most common grades are added together to create the Gleason Score.
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Castrate Refractory Prostate Cancer: A Wider Range Of Options
In this section, we explain the treatments available at Birmingham Prostate Clinic for patients once their disease becomes resistant to hormone treatment, called castrate refractory prostate cancer. Two types of treatments are needed to:
- Control the cancer and prevent further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
What Goes Wrong With The Prostate
As men get older, the prostate gland increases in size. Many men will develop a condition called benign prostatic hyperplasia . BPH is not cancer. Men who have difficulty urinating may have drug therapy or an operation called a TURP to relieve the symptoms of BPH.
Prostate cancer can, in some advanced cases, cause urinary difficulties similar to those for BPH. So, some men with prostate cancer may be offered a TURP. This procedure involves cutting away part of the prostate in order to relieve symptoms associated with an enlarged prostate. It is done under general or spinal anesthetic so you will not feel any pain, and most patients will need to stay in hospital for around one to three nights following the procedure. This operation does not cure prostate cancer.
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When Prostate Cancer Risk Is All In The Family
Your familial risk of prostate cancer is greatest if you have a first-degree relative who had the disease, especially if they were diagnosed at a relatively young age. Having multiple first degree relatives with prostate cancer also increases risk. Having multiple second-degree relatives and third-degree relatives adds to the risk, Carroll explains. Its more concerning when we see all cancers on one side of the family, in one blood line, she adds.
In one study, researchers found that men with a brother who had prostate cancer were more than twice as likely as men in the general population to be diagnosed with the disease themselves, and they faced nearly twice the risk of developing aggressive prostate cancer by age 75. Also, men with both a father and brother who had prostate cancer faced about a threefold greater risk of prostate cancer and developing aggressive disease by age 75 compared with the general population.
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General Prostate Cancer Survival Rate
According to the American Cancer Society:
- The relative 5-year survival rate is nearly 100%
- The relative 10-year survival rate is 98%
- The 15-year relative survival rate is 91%
Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.
Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology
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What Are The Treatment Options For Aggressive Prostate Cancer
The majority of people with prostate cancer nearly 80% are diagnosed early and cured by their treatment, most often radiation or surgery.
But one in five of those diagnosed with prostate cancer has a more aggressive form of the disease. Even before the individual has received any treatment or experienced a recurrence, doctors can identify whether the cancer is likely to be more dangerous and aggressive.
Prostate cancer is determined to be high risk if it is distinguished by any of the following characteristics:
Physicians perform biopsies or take X-rays to determine a cancers grade and stage. The stage is based on the size of the primary tumor or the extent it has spread in the body. The grade describes the appearance of the cancer cells and tissue under a microscope: the more abnormal they are, the higher the grade.
What are the main treatment options for people with aggressive or high-risk prostate cancer and can the sequencing, or order in which different treatments are given, make a difference in overall effectiveness of these therapies?
Why Roswell Park for Prostate Cancer?
Find out what makes Roswell Park unique in treating prostate cancer.
Treatment Options For Aggressive Prostate Cancer
There are several different treatment options available for aggressive prostate cancer, and many patients may need multiple treatments. Treatment for aggressive prostate cancer may include radiation therapy, surgery, and hormonal therapy. The type of radiation therapy used will depend on the specific type of prostate cancer that you have. External beam radiation therapy combines several different types of radiation into a single treatment. The benefit of EBR is that it is less invasive than other forms of radiation therapy.
Radiation and surgery can be effective treatments for most types of prostate cancer, though these methods can have some side effects. For instance, hormonal therapy may be an option for patients who do not want or cannot tolerate chemotherapy. Chemotherapy drugs are designed to target fast-growing cells, and are typically reserved for high-risk patients with prostate cancer or recurrences. If you do experience symptoms, however, you may want to consider hormonal therapy to reduce your risks of developing a biochemical recurrence.
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What Treatments Are Available
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:
- chemotherapy with hormone therapy
- clinical trials.
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.
Cases Of Aggressive Prostate Cancer On The Rise Research Finds
Cases of aggressive prostate cancer appear to be on the rise, researchers reported Tuesday.
The good news is its still rare for prostate cancer to spread. Just 3 percent of cases have already started spreading when men are diagnosed and prostate cancer overall has not become more common, the team found.
And the American Cancer Society strongly questioned the findings and the methods used to get them.
The researchers — who were looking for evidence to support a return to widespread prostate cancer screening — found that cases of metastatic prostate cancer the type that has started to spread in the body nearly doubled in men aged 55 to 69 since 2004. The reason is not yet clear.
One hypothesis is the disease has become more aggressive, regardless of the change in screening, said Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine, who led the study.
The other idea is since screening guidelines have become more lax, when men do get diagnosed, its at a more advanced stage of disease. Probably both are true. We dont know for sure, but this is the focus of our current work, Schaeffer continued.
One hypothesis is the disease has become more aggressive, regardless of the change in screening.”
In 2012, the U.S. Preventive Services Task Force recommended against using a blood test called a prostate-specific antigen test to check most healthy men for prostate cancer.
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Can The Gleason Score On My Biopsy Really Tell What The Cancer Grade Is In The Entire Prostate
Because prostate biopsies are tissue samples from different areas of the prostate, the Gleason score on biopsy usually reflects your cancers true grade. However, in about 1 out of 5 cases the biopsy grade is lower than the true grade because the biopsy misses a higher grade area of the cancer. It can work the other way, too, with the true grade of the tumor being lower than what is seen on the biopsy.
What Are Next Steps
Bone metastasis have a profound effect on the long-term outlook for prostate cancer. But its important to remember that the numbers are only statistics.
The good news is that life expectancy for advanced prostate cancer continues to increase. New treatments and therapies offer both longer life and better quality of life. Speak to your doctor about your treatment options and long-term outlook.
Everyones cancer experience is different. You may find support through sharing your treatment plan with friends and family. Or you can turn to local community groups or online forums like Male Care for advice and reassurance.
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About The Prostate And Prostate Cancer
The prostate gland, which grows during puberty, is considered an organ and is made up of several dozen lobules or saclike glands, held together with connective prostate tissue and muscle between them. The glands are called exocrine glands, because they secrete liquid to outside the body.
An enlarged prostate, called benign prostatic hyperplasia , is common in men over the age of 40 and may obstruct the urinary tract. The abnormal prostate cell growth in BPH is not cancerous and doesnt increase your risk of getting prostate cancer. However, symptoms for BPH and prostate cancer can be similar.
A condition called prostatic intraepithelial neoplasia , where prostate gland cells look abnormal when examined under a microscope, may be connected to an increased risk of prostate cancer. Prostate cancer is often caught by a doctor performing a digital rectal exam , through a prostate-specific antigen blood test, through a prostate biopsy or with a CT scan.
Another condition, prostatitis, is the inflammation of the prostate. While not cancerous, it may cause higher PSA levels in the blood.
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Growth Rate Of Aggressive Prostate Cancer
The Gleason score is used to classify different stages of prostate cancer. This score reflects the growth rate of cancer cells. It is divided into localized, regional, and distant stages. Localized prostate cancer has not spread to nearby structures and lymph nodes. Distant stage prostate cancer has spread to other parts of the body and has metastasized. Men diagnosed with localized prostate cancer will live an average of five years after diagnosis.
The researchers tested this computational method using large-scale data. They accessed 33 million PSA test results from 14 million men in the Veterans Affairs Health System. They then analyzed data from 58,523 men ranging in age from 50 to 75. They used an exponential plus constant trend to calculate the cancer-derived PSA over time. As PSA grew, the investigators found that the risk of dying from prostate cancer increased by 2 points.
The growth rate of aggressive prostate cancer is determined by analyzing the size of the tumor under the microscope. While a lower Gleason score indicates a less aggressive tumor, the higher Gleason score means a more aggressive tumor with greater potential for growth and spread. Ultimately, these numbers will help determine the most appropriate treatment for each patient. But if there is no specific test to predict a persons risk of developing aggressive prostate cancer, there is no certainty yet.
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How Important Is The Gleason Score
The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Still, other factors are also important, such as:
- The blood PSA level
- How much of each core is made up of cancer
- The number of cores that contain cancer
- Whether cancer was found in both sides of the prostate
- Whether the cancer has spread outside the prostate