What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
How To Check Your Prostate
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article received 11 testimonials and 85% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 1,068,641 times.
What Are The Symptoms Of Prostate Cancer
Early-stage prostate cancer rarely causes symptoms. These problems may occur as the disease progresses:
- Frequent, sometimes urgent, need to urinate, especially at night.
- Weak urine flow or flow that starts and stops.
- Painful urination .
- Painful ejaculation and erectile dysfunction .
- Blood in semen or urine.
- Lower back pain, hip pain and chest pain.
- Leg or feet numbness.
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What Do My Psa Test Results Mean
Once your test results are back, your healthcare provider will let you know if any additional testing is recommended. PSA levels can vary over time for several reasons unrelated to prostate cancer . So, if you have a borderline PSA, your provider may simply recommend another PSA test in six months or so.
How Common Is Prostate Cancer
About one in nine men will receive a prostate cancer diagnosis during his lifetime. Prostate cancer is second only to skin cancer as the most common cancer affecting males. Close to 200,000 American men receive a diagnosis of prostate cancer every year. There are many successful treatments and some men dont need treatment at all. Still, approximately 33,000 men die from the disease every year.
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Recent Trends In Prostate Cancer Incidence By Age Cancer Stage And Grade The United States 20012007
1Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, 4770 Buford Hwy, MS K55, Atlanta, GA 30341, USA
2Department of Urology and Winship Cancer Institute, School of Medicine, Emory University, 1365C Clifton Road, Atlanta, GA 30322, USA
Prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among American men. Each year, approximately 220,000 men are diagnosed with prostate cancer and 29,000 die from it . With the introduction of the prostate-specific antigen testing in the mid-1980s, prostate cancer incidence rate increased drastically, at about 12% per year, and peaked in 1992 . The rate subsequently declined, at about 10% per year for the following three years and then appeared to stabilize from 1995 to 2005 . In 2011, Kohler et al. reported a stable trend of prostate cancer incidence from 1998 to 2007 however, demographic and clinical factors were not examined in this study . With the widespread use of the PSA test, the mean age at diagnosis dropped substantially, from 72.2 years between 1988-1989 to 67.2 years between 2004 and 2005 . Studies using Surveillance, Epidemiology, and End Results Program data have shown that the distribution of prostate cancer stage and grade has also dramatically changed, with localized and moderately differentiated tumors becoming predominant .
2. Patients and Methods
What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening
Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors. Having a small tumor found and treated may not, however, reduce the chance of dying from prostate cancer. That is because many tumors found through PSA testing grow so slowly that they are unlikely to be life threatening. Detecting such tumors is called overdiagnosis, and treating them is called overtreatment.
Overtreatment exposes a person unnecessarily to the potential complications associated with prostate surgery and radiation therapy. These include urinary , gastrointestinal , and sexual side effects .
In addition, finding cancer early may not help someone who has a fast-growing or aggressive prostate tumor that may have spread to other parts of the body before being detected.
The PSA test may give false-positive results. A false-positive test result occurs when the PSA level is elevated but no cancer is actually present. A false-positive test result may create anxiety and lead to additional medical procedures, such as a prostate biopsy, that can be harmful. Possible side effects of biopsies include serious infections, pain, and bleeding.
False-positive test results are common with PSA screening only about 25% of people who have a prostate biopsy due to an elevated PSA level are found to have prostate cancer when a biopsy is done .
Both Tests Are Better Than One
Using these tests together is better than using either test alone. PSA testing together with a DRE may help find a dangerous cancer early when it is easier to treat.
If a problem is found, more tests will be done to find out whether you have prostate cancer or another health problem. Further tests can include:
- a follow-up PSA test
- a transrectal ultrasound a test that uses sound waves to make a picture of the rectum and nearby organs, including the prostate
- a biopsy of the prostate tissue samples of the prostate are looked at under a microscope
If Screening Test Results Arent Normal
If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:
- Waiting a while and having a second PSA test
- Getting another type of test to get a better idea of if you might have cancer
- Getting a prostate biopsy to find out if you have cancer
Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:
- Your age and overall health
- The likelihood that you have prostate cancer
- Your own comfort level with waiting or getting further tests
If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.
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An Abnormal Psa Test: What Comes Next
If your PSA score is in the abnormal range, your doctor may recommend yourepeat the PSA test. If your levels are still high, your doctor mightrecommend one of the newer prostate cancer screening tests available today.
These tests can help better assess your risk for prostate cancer anddetermine whether a biopsy is necessary. Only a prostate biopsy candefinitively diagnose prostate cancer.
For individualized recommendations that suit you, ask your doctor about:
- What age you should start prostate cancer screening
- New blood, urine and imaging tests that are available
- Improved biopsy techniques, if applicable
Economics Cost Of Management Pc
From Europe and USA the costs of management of PC are as follows: in Italy from 6575.31 euro, in UK from 2818 pounds, and in France 12731 euro, and in USA from $12,000., , These costs are very high for low and low middle income countries. There have not been comparable figures from Africa. In Ghana, the head of Urology Unit in KBTH reports individual direct costs for radical prostatectomy or EBRT ranges from GHÂ¢5000 6000 , for Brachytherapy the cost is GHÂ¢30,000 GHÂ¢32,000 i.e. 9000 Euros. For hormonal therapy the cost is from GHÂ¢6400 12400 per year and for Orchidectomy the cost is GHÂ¢2000 .
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Prostate Cancer Screening Patient Version
On This Page
Screening is looking for cancer before a person has any symptoms. This can help findcancer at an early stage. When abnormaltissue or cancer is found early, it maybe easier to treat. By the time symptoms appear, cancer may have begunto spread.
Scientists are trying to better understand whichpeople are more likely to get certain types of cancer. They also study the thingswe do and the things around us to see if they cause cancer. Thisinformation helps doctors recommend who should be screened for cancer, whichscreening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarilythink you have cancer if he or she suggests a screening test. Screeningtests are given when you have no cancer symptoms. Screening tests may be repeated on a regular basis.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
Further Testing For Advanced Cancer
If there’s a significant chance the cancer has spread from your prostate to other parts of the body, further tests may be recommended.
- an MRI scan, CT scan or PET scan these scans build a detailed picture of the inside of your body
- an isotope bone scan, which can tell if the cancer has spread to your bones a small amount of radiation dye is injected into the vein and then collects in parts of the bone where there are any abnormalities
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Psa Test For Prostate Cancer
The prostate gland makes a protein called prostate specific antigen . This protein helps to nourish sperm. Normally, only tiny amounts of it enter the bloodstream.
Cancer cells in the prostate interfere with proper functioning and can cause large amounts of PSA to enter the bloodstream. Therefore, when high levels of PSA are detected in the bloodstream, this may indicate cancer.
Early prostate cancer often has no symptoms. However, high PSA levels can occur five to 10 years before the onset of prostate cancer symptoms. In such circumstances, the PSA test can help to indicate the presence of cancer at an early stage.
Other tests are needed to confirm a diagnosis because an abnormal PSA test can be due to non-cancerous causes. Equally, it is possible for a man to have a normal PSA level when cancer is present.
How Do I Self
Lots of people talk about doing self-checks , to try and spot cancer early.
Its good to be aware of what your body is normally like, so its easier to notice if anything changes. But theres no good evidence to suggest that regularly self-checking any part of your body in a set time or set way is helpful. It can actually do more harm than good, by picking up things which wouldnt have gone on to cause you problems.
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Screening For Prostate Cancer
There is no national screening programme for prostate cancer in the UK. This is because there isnt a reliable test that can pick up prostate cancer that needs treatment at an early stage.
Overall research has shown that current tests dont reduce the number of men dying from prostate cancer. Research is going on to find a new test. Or see if the current test is more effective if used in a different way and can find the cancers that need treatment more accurately.
Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
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What Do The Results Mean
PSA levels may be above the baseline for various reasons other than prostate cancer.
Other factors that can raise PSA levels include:
- an enlarged prostate Ã¢ because of benign prostatic hyperplasia , for example
- prostatitis, which is inflammation and swelling of the prostate
Also, people with obesity may have lower PSA readings.
In addition, some medications may reduce PSA levels, including:
- 5-alpha reductase inhibitors, which can help treat BPH
- aspirin, which some people take regularly as a blood thinner
- statins, which help manage cholesterol levels
- thiazide diuretics, a kind of water pill that can help reduce high blood pressure
Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.
High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.
The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.
Special Types Of Psa Tests
The PSA level from a screening test is sometimes referred to as total PSA, because it includes the different forms of PSA . If you decide to get a PSA screening test and the result isnt normal, some doctors might consider using different types of PSA tests to help decide if you need a prostate biopsy, although not all doctors agree on how to use these tests. If your PSA test result isnt normal, ask your doctor to discuss your cancer risk and your need for further tests.
Percent-free PSA: PSA occurs in 2 major forms in the blood. One form is attached to blood proteins, while the other circulates free . The percent-free PSA is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.
If your PSA test result is in the borderline range , the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy.
Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%. Using these cutoffs detects most cancers and helps some men avoid unnecessary biopsies. This test is widely used, but not all doctors agree that 25% is the best cutoff point to decide on a biopsy, and the cutoff may change depending on the overall PSA level.
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Prostate Cancer Screening Ages 55 To 69
This is the age range where men will benefit the most from screening.Thats because this is the time when:
- Men are most likely to get cancer
- Treatment makes the most sense, meaning when treatment benefits outweigh any potential risk of treatment side effects
Most men will get prostate cancer if they live long enough. Some prostatecancers are more aggressive others can be slow-growing. Doctors will takeyour age and other factors into consideration before weighing the risks andbenefits of treatment.
You should ask your doctor how often he or she recommends you get screened.For most men, every two to three years is enough.
Depending on the results of your first PSA test, your doctor may recommendyou get screened less frequently.
How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is used to monitor men after surgery or radiation therapy for prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before the recurrence causes symptoms.
However, a single elevated PSA measurement in someone who has a history of prostate cancer does not always mean that the cancer has come back. Someone who has been treated for prostate cancer should discuss an elevated PSA level with their doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
A rising trend in PSA level over time in combination with other findings, such as an abnormal result on imaging tests, may lead the doctor to recommend further cancer treatment.
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