How Is Prostate Cancer Treated
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences. At HealthPartners and Park Nicollet, we approach cancer treatment by understanding the impact it has both physically and mentally. So, you and your doctor may decide to manage your cancer with active surveillance or to treat it with surgery or radiation.
If youre over age 80 or have other serious health problems, like heart disease, you may choose not to have treatments to cure your cancer. Instead, you can just have treatments to manage your symptoms. This is called watchful waiting.
If youve already been diagnosed with prostate cancer, choosing treatment for prostate cancer can be confusing. Both urologists and oncologists have the specialty training and expertise to treat prostate cancer. They can work with you develop a treatment plan thats right for you.
What The Results Mean
PSA levels depend on a mans age. As men get older, their PSA levels naturally go up, but PSA can go up and down for many reasons. Doctors have a hard time agreeing on what is a normal PSA level. But some researchers use a cut-off PSA level of around 3 ng/mL to help them decide which men have the greatest risk of developing prostate cancer. Its important for you to discuss your PSA level result and what it means for your risk of prostate cancer with your doctor. Your doctor will help you determine your risk of prostate cancer in relation to your age, family history and other personal information.
A higher than normal PSA level doesnt always mean that a man has prostate cancer. High PSA levels can also be caused by:
- an enlarged prostate due to benign prostatic hyperplasia
- an inflamed or infected prostate
- a urinary tract infection
- a recent medical test or procedure on the prostate, such as a transrectal ultrasound or biopsy
- a urinary catheter
Transgender Women And Their Risk Of Prostate Cancer
It is a well-known fact that prostate cancer is an illness that should be on every mans radar. The American Cancer Society cites that it is the most prevalent cancer among men in the United States .
However, things are a bit incoherent for transgender women. Specialists highlight that trans women should be aware of their risk of having prostate cancer.
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What Are Common Risk Factors For Prostate Cancer
As I mentioned earlier, I most commonly see prostate cancer in men over 60. And like many other types of cancer, prostate cancer risks increase as you get older. Other risk factors can include:
- A family history of prostate cancer If you have a close family member, such as a father or brother, with prostate cancer, youre 2 to 3 times more likely than other men to develop prostate cancer .
- Genetics Many of my patients often ask if prostate cancer is hereditary. Hereditary prostate cancer does exist, but only 5 to 10 percent of all prostate cancers are hereditary due to a single inherited gene mutation.
- Race Black men are at a higher risk of prostate cancer than men of other races, and were not sure why.
- Obesity Obese men who are diagnosed with prostate cancer may be more likely to have an advanced cancer thats more difficult to treat.
What Else Can Cause These Symptoms
As men get older their prostate gland enlarges. It isn’t normally cancer. But instead a condition called benign prostatic hyperplasia . BPH is when the prostate gland grows and presses on the urethra. The urethra is the tube that empties out urine from the bladder.
BPH does not develop into cancer. But you can have an enlarged prostate at the same time as having areas in the prostate gland that contain cancer cells.
See your doctor if you have any of the changes described here.
The changes don’t mean that you have cancer but it is important to get them checked so your doctor can help with you cope with them.
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Latest Men’s Health News
At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.
Recognizing The Risk Factors
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Are There Significant Side Effects Of Treatment
Prostate cancer treatment, whether involving surgery or radiation, can cause a host of short- and long-term side effects. Transient side effects are generally tolerated well. Long-term problems with incontinence and or erectile dysfunction, however, can have a major impact on a mans quality of life. Though estimates vary widely, it is reasonable to assume that such long-term or permanent side effects may occur in significant percentage5 of all patients.
When surgery is performed, a nerve associated with sexual function can be severed. A skilled surgeon may be able to spare the nerve, but there are no assurances. Radiation often damages the nerve, though the onset of symptoms may be delayed by as much as one to two years. You should actively question your physicians about their outcomesspecifically the frequency with which their patients experience long-term problems with incontinence and/or impotency.
How Can Treatment Affect Your Quality Of Life
Your age and overall health will make a difference in how treatment may affect your quality of life.
Both surgery and radiation can cause side effects. Radiation is more likely to cause bowel problems. Surgery is more likely to cause leaking urine or erection problems.
Medicines and mechanical aids may help men who have erection problems after surgery. And there are ways to target the radiation and protect the rectum during radiation.
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How To Know Whether It Is Cancer
If you have any of the mentioned signs, you should see a doctor. They will take the steps to rule out cancer.
However, you can read here the different options :
The doctor checks your prostate through your rectum, with a finger. The prostate is in contact with the rectum so this is the way to palpate it.
Doing so, the doctor can check if it is enlarged, if it has hard nodules
It is detected through a blood test. The more prostatic tissue you have, the higher value of PSA you have.
It is useful if you have a normal PSA value, because that virtually rules out cancer. If your PSA is okey, your prostate is probably ok.
However, if you have a high PSA then you have more prostatic tissue than normal. Maybe you have BPH .
Prostatitis also causes a high PSA, because of the irritated tissue.
So if PSA is normal then everything is good. If PSA is high you probably need some extra tests to find out what is wrong.
An increased PSA can be due to prostate cancer, but also to BPH and prostatitis.
You go inside the MRI machine and stay still for around 30 minutes.
Usually, it also requires intravenous contrast so you will need an IV line.
- This test will tell the doctor if there are any suspiciousnodules inside the prostate. Also, it will show the prostate cancer stage.
- It will also show if it is a large prostate, but with no malignant nodules .
If there are no nodules, everythings fine. If there are you may need a biopsy.
Why Do Women Not Get Prostate Cancer
Why do women not get prostate cancer? The incidence of prostate cancer is second only to lung cancer? Women also have prostate, Why is it only in men?
The prostate is the largest accessory gonad in men, the teacher in the anatomy class had told you that although women also have prostates, but womens prostates have degenerated and do not have any function, let alone pathological changes.
Early screening can get the best treatment time. Screening items include: digital rectal examination, serum PSA examination .
There may be many people who think that cancer is caused by bad luck, and more people are also saying that once they get cancer, they can only wait to die, because not only can they not afford the expensive treatment costs, but also because the cancer itself is fatal. of.
But in fact, many cancers can be detected at an early stage and active treatment can not only prolong life, but also save a lot of costs in treatment.
In recent years, prostate diseases have endangered mens health, and many men have missed the opportunity for treatment because it is difficult to tell.
According to 2020, there will be 10.07 million new cancer cases in men worldwide. In addition to the high incidence of lung cancer in men, prostate cancer is the second most common cancer case.
Prostate cancer is the second largest male tumor in the world. According to statistics, there will be 1.41 million new cases of prostate cancer worldwide and 380,000 deaths in 2020.
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How To Do Active Surveillance Right
After a diagnosis of low-risk prostate cancer, you may be presented with a range of treatment options. Considering the slow progress of most prostate cancer, active surveillance is a reasonable choice for many men. Even if you live a long time after your diagnosis, your cancer may neverbecome aggressive and cause harm. Often, low-risk prostate cancer hardly progresses at all, even over decades.
If you choose to go the active surveillance route, do it the smart way. Dr. Hu recommends that for the first two years after your diagnosis
- Get a PSA test every six months.
- Have an office visit that includes a digital exam every six months.
- Within the first two years after diagnosis, get at least one follow-up biopsy as well as magnetic resonance imaging and precision medicine tests to reduce the risk of missing more aggressive cancer.
What happens next depends on those first two years. If it looks like your cancer is stable and not progressing, your doctor may suggest less frequent follow-ups. But if there is evidence that the cancer is becoming more aggressive, then you can decide at that time whether radiation, surgery, hormone therapy or some combination of these treatments is right for you. You may never need treatment, but if you do, youll get it when its still highly effective.
The Signs Of Prostate Cancer
Prostate cancer can be silent. It usually is, at least while it is small. It doesnt cause any symptoms at that moment.
Thats because it usually grows in the periphery of the prostate, far from the urethra.
After it grows a little, you can start to get some symptoms. These are the most common:
As you can see, all these signs and symptoms are related to urination and ejaculation.
For example, as the prostate surrounds the urethra, prostate cancer may make it harder to pee.
The tumor will narrow the duct and the urine flow will diminish. Thats when we find difficulties to urinate. Either through trouble starting or being unable to stop.
Also, the effort of the bladder against the obstacle can cause a burning sensation or pain
And so on many of these signs are due to this obstacle mechanism.
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Does Prostate Cancer Have Any Symptoms
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
- blood in the urine or semen
- 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.
Can Prostate Cancer Be Prevented
There are no clear prevention strategies for prostate cancer. There is some conflicting evidence that a healthy diet composed of low fat, high vegetables and fruits may help reduce your risk of prostate cancer. Routine screening, with PSA blood test and physical exam, is important to detect prostate cancer at an early stage. A healthy diet and regular exercise are also critical in maintaining good health and preventing disease in general.
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Do Women Have Prostates
Have you ever wondered, do women have prostates? In short, the answer is no. The primary function of the male prostate is to secrete prostate fluid, an important component of semen. However, there is a functional part of your own reproductive system thats very similar.
Small glands, located on either side of your urethra and arising from the urogenital sinus, are called Skene glands. They create a link between your urethra and vagina that actually closes up during gestation. Now, lets take a closer look at the female prostate gland and what it does.
What Are The Side Effects Of Hormone Therapy For Prostate Cancer
Because androgens affect many other organs besides the prostate, can have a wide range of side effects , including:
- loss of interest in sex
Studer UE, Whelan P, Albrecht W, et al. Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer Trial 30891. Journal of Clinical Oncology 2006 24:18681876.
Zelefsky MJ, Eastham JA, Sartor AO. Castration-Resistant Prostate Cancer. In: Vincent T. DeVita J, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenbergs Cancer: Principles & Practice of Oncology, 9e. Philadelphia, PA: Lippincott Williams & Wilkins 2011.
Smith MR, Saad F, Chowdhury S, et al. Apalutamide and overall survival in prostate cancer. European Urology 2021 79:150158.
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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:
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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.