Doctor Visits And Tests
Your doctor visits will usually include PSA blood tests, possibly with digital rectal exams if your prostate hasnt been removed. These will probably begin within a few months of finishing treatment. How often you need follow-up visits and tests might depend to some extent on the stage of your cancer and the chance of it coming back. Most doctors recommend PSA tests about every 6 months or so for the first 5 years after treatment, and at least yearly after that. Bone scans or other imaging tests might also be done, depending on your medical situation and symptoms.
Prostate cancer can recur even many years after treatment, which is why its important to keep regular doctor visits and report any new symptoms .
What Does The Prostate Do Can You Live Without It And What Happens When You Have It Removed
All men have a prostate, yet many know little about what it does or what happens if it is removed. Here’s the lowdown…
- 9:25, 20 Mar 2018
THE prostate is a male reproductive organ which surrounds the neck of the bladder which releases a fluid component of semen.
All men have a prostate, yet many know little about what it does or what happens if it is removed. Here’s the lowdown…
Is Prostate Cancer Curable
Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.
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Who Should Choose Active Surveillance
Some of the characteristics that might qualify you for Active Surveillance include grade group 1 or Gleason 6, a PSA level < 10, cancer that is confined to the prostate, and/or cancer that is very low volume when biopsied.
The ideal candidate for Active Surveillance has low-risk prostate cancer. Learn more about Risk Groups.
What Does The Prostate Do
The prostate is a male gland that releases prostate fluid, one of the components of semen.
The muscles of the prostate gland help propel this fluid into the urethra during ejaculation.
It is a muscular gland that is often described as walnut or small apricot-sized.
An enlarged prostate can be a sign of prostate cancer, the third biggest cancer killer.
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Dry Orgasm And Infertility
Both the prostate and the glands responsible for semen production are removed during surgery, which is a common prostate cancer treatment. If you received this treatment, youd still be able to have an orgasm but youd no longer ejaculate.
This means that youll no longer be fertile. If you plan to have children in the future, you may consider banking your sperm before your surgery.
Talking To Andrews Doctor
For fifteen months, Andrew responded really well to treatment and was feeling reasonably good. But then he developed a very bad spinal cord compression. He was unable to walk and at that point it was clear that things were very serious. He spent nearly a month in hospital and his consultant told us that the cancer was back with a vengeance and that they wanted to fast track him home.
Andrew didnt want to know how long he might have. I know that he knew what the score was but that he just didnt want to speak about it.
Andrew didnt want to know how long he might have.
I asked Andrews doctor how long he might live for. She told me that she could give me some indication of how long Andrew might live for if I wanted to know. I wasnt sure that I wanted to know if Andrew didnt it might have created a barrier between us.
I wanted to know what I should expect. But I wasnt sure that I wanted to know how long Andrew would live for if he didnât know.
But I wanted to know what I should expect. I needed to plan what was going to happen when he came home, the arrangements that would need to be made and whether I needed to speak to other members of our family and friends. At this point I think I felt quite out of control, so speaking to the consultant was my way of regaining some of that control and it helped me to plan for his homecoming.
Its difficult to accept that cancer takes its own route at its own pace.
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What Will Happen After My Treatment
You will have regular check-ups during and after your treatment to check how well it is working. You may hear them called follow-up appointments. Youll have regular PSA blood tests ask the people treating you how often youll have these. If your PSA level goes down this usually suggests your treatment is working.
Tell your doctor or nurse about any side effects youre getting. There are usually ways to manage side effects.
Make sure you have the details of someone to contact if you have any questions or concerns between check-ups. This might be your specialist nurse or key worker. You can also speak to our Specialist Nurses.
Read more about follow-up after prostate cancer treatments.
First Line Treatment For Advanced Prostate Cancer
The established first line approach is to control the progression of the disease by reducing levels of testosterone in the body. This is because testosterone increases the speed at which prostate cancer cells reproduce.
There are two different ways to lower testosterone levels. Hormone therapy lowers the levels of testosterone in the body by taking tablets or having injections. It is sometimes referred to as medical castration. The surgical option involves removing the testicles, known as surgical castration or orchidectomy, although this is now rarely used.
Another approach is called anti-androgen treatment. Androgens have to bind to a protein in the cell called an androgen receptor to work. Anti-androgens are drugs that bind to these receptors so the androgens cant, effectively blocking them. The main side-effects are gynaecomastia breast enlargement and breast pain, although a single radiotherapy dose to the breasts can help this side-effect.
Combining anti-androgens with testosterone reduction is known as Maximum Androgen Blockade and may be used if hormone treatment alone is not working sufficiently.
Treating with chemotherapy at the same time as the start of hormone deprivation was found to increase survival by 13 months in all patients and 17 months in men with high-volume disease.
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Nutrition And Dietary Supplements
Some studies have suggested that eating a healthy diet that is rich in vegetables and lower in animal fats might be helpful, but more research is needed to be sure. However, we do know that a healthy diet can have positive effects on your overall health, with benefits that extend beyond your risk of prostate or other cancers.
So far, no dietary supplements have been shown to clearly help lower the risk of prostate cancer progressing or coming back. In fact, some research has suggested that some supplements, such as selenium, might even be harmful. This doesnt mean that no supplements will help, but its important to know that none have been proven to do so.
Dietary supplements are not regulated like medicines in the United States they do not have to be proven effective before being sold, although there are limits on what theyre allowed to claim they can do. If you are thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that could be harmful.
How Is Hormone Therapy Used To Treat Hormone
Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:
Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.
The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.
Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.
Hormone therapy is sometimes recommended for men who have a “biochemical” recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.
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What Is Localised Prostate Cancer
Localised prostate cancer is cancer thats inside the prostate and hasnt spread to other parts of the body. You may also hear it called early or organ-confined prostate cancer, or stage T1 or T2 prostate cancer.
Most localised prostate cancer grows slowly or doesnt grow at all and has a low risk of spreading. So it may never cause you any problems or affect how long you live. Because of this, localised prostate cancer might not need treatment. You might be able to have your cancer monitored with regular check-ups instead. This is to make sure the cancer isnt growing more quickly than expected.
But some men will have cancer that grows quickly and has a high risk of spreading. This is more likely to cause problems and needs treatment to stop it spreading outside the prostate.
Heres What The Results Showed
After a median follow-up of just over 10 years, 9.7% of men who were treated with radiation and leuporelin for 18 months had died from prostate cancer, compared to 13.3% of the men treated with radiation and leuporelin for six months. Adding zoledronic acid made no difference in either case.
The authors concluded that hormonal therapy is more effective at preventing prostate cancer death when its given for 18 months rather than six. And similar benefits were noted for other endpoints as well. For instance, prostate tumors were less likely to metastasize, or spread, among men in the longer duration treatment group, and it took longer for their cancers to become resistant to hormone therapy if it was reinitiated later.
In earlier clinical research, scientists discovered that hormonal therapy given for three years protects against prostate cancer death more effectively than a six-month treatment regimen. But three years of hormone therapy isnt easily tolerated, and evidence so far shows that 10-year survival rates after either 18 months or three years of hormonal therapy are similar, the authors of the new study claim.
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Outlook For Men With Localised Prostate Cancer
Most localised prostate cancer is slow-growing and may not need treatment or shorten a mans life. For many men who have treatment for localised prostate cancer, the treatment will get rid of the cancer. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment.
Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity
Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.
A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.
While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.
If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.
As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.
And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.
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Changes To Your Sex Life
Sex will be a little different if you have surgery to remove your prostate gland. It means you wonât ejaculate, though you can still have an orgasm. Trouble getting erections or having orgasms is also a risk after an operation or if you have radiation therapy.
You can work with your doctor to cut those risks. Start by asking about “nerve-sparing” surgery and more precise radiation therapy. You can ask about the success they’ve had in protecting other men from these side effects.
If you do end up having problems after treatment, youâre not out of luck. Keep in mind that for many men, the problems go away on their own once the body has time to heal. Medications, devices, penile implants, and couples counseling also can make your sex life satisfying again. But most of all, be patient with yourself.
Things That Can Happen When You Live Without A Prostate
Beyond the oft-reported effects of urinary incontinence and impotence following surgery, there are a number of less widely known possible side effects of prostate removal.
Fun fact number one: Half of all men who die in this country this year will be killed by heart disease, stroke, or cancer. Fun fact number two: Half of all doctors seem to have different ideas about how to prevent the biggest killers of men. We spoke to the best of them, and we’ve simplified, clarified, and prioritized their advice on minimizing the risks of dying before your time. For more tips, . Reporting by Sarah Z. Wexler.
As more men deemed to be at genetic risk of prostate cancer opt to have the organ removed preemptively, lesser-known side-effects of the procedure are coming to the fore. In addition to the oft-reported effects of urinary incontinence and impotence following surgery, here are some symptoms more rarely accounted for:
Shrunken penises. As many men are prescribed antiandrogen treatments to block testosterone effects on advanced prostate-cancer tissue, Dr. Celestia Higano of the University of Washington reports that up to 68 percent of men experience penile shortening after radical prostatectomy surgery.
“Dry orgasm”or, rather, orgasm without ejaculation, which occurs after surgery when retrograde ejaculation sends semen back into the bladder instead of out the penis.
This article originally appeared in Esquire‘s November issue.
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My Tips For Men Family And Friends
- Ask how long someone has left to live if you want to know. The doctor may not always be able to give you an answer. And if they can give you an answer, it wont be exact. And it might not be the answer you want. But if youre ok with that, then you should ask.
- Try to explain why you want to know to the doctor or nurse. It might be that you want to be able to plan care at home, plan a trip, get time off work, or organise some quality time with your family. They might be able to help you work out those things, even if they cant give you exact timings.
What Are My Treatment Options With Advanced Prostate Cancer
The treatments your doctor recommends will depend on factors specific to you, from your overall health to how advanced your cancer was when it was first diagnosed.
Many men receive ADT, a type of hormone therapy, which deprives the body of the male hormones that the cancer needs to keep growing.
For most men, however, hormone therapy stops working at some point. Alternatives to hormone therapy were approved by the Food and Drug Administration in 2018, and Tagawa often starts men on these therapies as soon as theyre diagnosed with bone metastases. Other treatment options may be available through clinical trials.
In addition, chemotherapy, surgery, and immunotherapy as well as radiation treatments, like external beam radiation, which directly target bone problems may be considered. Major cancer centers, such as Memorial Sloan Kettering Cancer Center in New York City and MD Anderson Cancer Center in Houston, have teams of prostate cancer specialists, as well as sophisticated radiation and other treatment equipment consolidated in one place, which can help with the coordination of care.
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What Are Male Sex Hormones
Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.
Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .