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.
Read Also: Rf Therapy For Enlarged Prostate
Hormone Therapy For Prostate Cancer
Over the last few years, several new approaches to hormone therapy for advanced or metastatic prostate cancer have been approved for clinical use.
Many prostate cancers that originally respond to treatment with standard hormone therapy become resistant over time, resulting in castrate-resistant prostate cancer . Three new drugs have been shown to extend survival in men with CRPC. All three block the action of hormones that drive CRPC:
The survival benefit for these drugs has been seen regardless of whether men have previously received chemotherapy.
In addition, both enzalutamide and the drug apalutamide have all been shown to in men with CRPC that has not yet spread to other parts of the body. Darolutamide has been shown to increase the amount of time men live without their cancer metastasizing.
Abiraterone, apalutamide, and enzalutamide have been shown to improve the survival of men with metastatic castrate-sensitive prostate cancer when added to standard hormone therapy.
Scientists are continuing to study novel treatments and drugs, along with new combinations of existing treatments, in men with metastatic CRPC.
Watchful Waiting And Active Surveillance
Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities.26,27 Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery.26 For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.
Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression.27,28 This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.
Also Check: Brca Gene Prostate Cancer Treatment
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.
Also Check: Laser Ablation For Prostate Cancer
Supporting Someone With Advanced Prostate Cancer
If someone close to you has advanced prostate cancer you might be able to offer them a great deal of support. But looking after someone with advanced prostate cancer can be difficult. Its important to look after yourself and get support if you need it.
- Talk to someone. Sharing your worries and fears can make you feel less alone. You could talk to a family member or a close friend, or someone trained to listen, like your GP or a counsellor.
- Connect with other carers. You might find it helpful to talk to other people in similar situations. You can search for local carers groups on the Carers UK website.
- Take time for yourself. Take time to relax and rest so that you dont get too tired and can cope in the long run.
- Accept help from friends and family. Dont feel that you have to cope with everything on your own. Try to accept help from other people.
- Look after your health. If you feel unwell, tired or low, talk to your GP.
- Ask for help. Practical, financial and emotional support is available from social services and charities. Talk to your GP about what support is available in your area, or speak to our Specialist Nurses.
Macmillan Cancer Support have more information about caring for someone with advanced cancer. You can also read our booklet, When youre close to someone with prostate cancer: A guide for partners and family.
Also Check: Mri Of The Prostate A Practical Approach
Adverse Effects Of Pca Therapies
8.2.1. Surgery
For those undergoing minimally invasive procedures port site hernia has been reported in 0.66% after inserting 12 mm bladeless trocar and can occur more rarely with 8 mm and 5 mm trocars . A key consideration is whether long-term consequences of surgery are reduced by using newer techniques such as RALP. Systematic reviews have documented complication rates after RALP , and can be compared with contemporaneous reports after RRP . From these reports, the mean continence rates at 12 months were 89100% for patients treated with RALP and 8097% for patients treated with RRP. A prospective controlled non-randomised trial of patients undergoing RP in 14 centres using RALP or RRP demonstrated that at 12 months after RALP, 21.3% were incontinent, as were 20.2% after RRP. The unadjusted OR was 1.08 . Erectile dysfunction was observed in 70.4% after RALP and 74.7% after RRP. The unadjusted OR was 0.81 . Further follow-up demonstrates similar functional outcomes with both techniques at 24 months . A single-centre randomised phase III study comparing RALP and RRP also demonstrates similar functional outcomes with both techniques at24 months . Prostatectomy was found to increase the risk of complaints from an inguinal hernia, in particular after an open procedure when compared to minimal invasive approaches .
8.2.2. Radiotherapy
8.2.2.1. Side-effects of external beam radiotherapy
8.2.2.2. Side effects from brachytherapy
8.2.3.1. Cryosurgery
8.2.4. Hormonal therapy
Most Patients Did Not Progress
With active surveillance, the patients had physical exams and PSA tests every six months, with biopsies recommended every one to two years.
Over an average of two and a half years of follow-up, 43 of the study participants showed evidence of cancer progression and received treatment.
In two patients, cancer spread beyond their prostate.
The study is published in the April issue of the Journal of Urology.
The findings support the idea that some men with prostate cancer may not need treatment, American Cancer Society Deputy Chief Medical Officer Len Lichtenfeld, MD, tells WebMD.
He says the addition of a second biopsy should help refine the search for men who are appropriate candidates for active surveillance, but he also agrees that the strategy of watchful waiting is not without its risks.
âThe real advance will be when we have tests that will tell us with a high degree of accuracy when treatment is needed and when it is not,â he says.
A great deal of research is being done to identify genetic tests or tumor markers that can do this, but Lichtenfeld says it will be years before these tests are validated.
Donât Miss: Can Prostate Cancer Spread To The Liver
You May Like: Prostate Biopsy After Age 70
How Prostate Cancer Is Treated
In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.
The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.
Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.
Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:
Impact On Everyday Activities
If you have no symptoms, prostate cancer should have little or no effect on your everyday activities. You should be able to work, care for your family, carry on your usual social and leisure activities, and look after yourself.
However, you may be understandably worried about your future. This may make you feel anxious or depressed and affect your sleep.
If your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, such as radiotherapy or chemotherapy, you’ll probably feel tired and need time to recover.
If you have advanced prostate cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to reduce your working hours or stop working altogether.
Whatever stage your prostate cancer has reached, try to give yourself time to do the things you enjoy and spend time with those who care about you.
Don’t Miss: At What Age Should A Man Get Prostate Exams
Look For Additional Resources And Support
Social support is essential to beat cancer, but sometimes your family and friends do not understand what youre going through.
Webpages such as Cancer Care or Cancer Survivors Unite offer programs, online education, and many resources for cancer patients like you.
You can also find support groups online to talk about your experience with cancer and share opinions and feelings with like-minded people.
Anatomy And Metastasis Of Prostate Cancer
The pudendal nerve innervates the few striated muscles within the prostatic capsule. The parasympathetic nerves emanate from S2 to S4 and form the pelvic nerve. The sympathetic preganglionic nerves, which reside in the thoracolumbar region between T6 and L2, provide the major neural input to the prostate and reach the pelvis through the hypogastric nerve .
Prostate cancer has been shown to metastasize by following the venous drainage system through the lower paravertebral plexus, or Batsons plexus.4,9 Although hematogenous spread of other malignancies is most commonly to the lungs and liver, 90 percent of prostatic metastases involve the spine, with the lumbar spine affected three times more often than the cervical spine. Prostate cancer also spreads to the lungs in about 50 percent of patients with metastatic disease, and to the liver in about 25 percent of those with metastases.4
Epidural metastases are the result of contiguous spread from lesions of the calvaria to the meninges. Because of the protective layer of the dura mater, subdural and intra-parenchymal metastases from prostate cancer are rare .
You May Like: Rock Stars With Prostate Cancer
Read Also: How Do They Remove The Prostate
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.
Stages Of Prostate Cancer
In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.
- T the T category measures the size and extent of the Tumor
- N the N category measures whether and how far the cancer has spread to the Lymph Nodes
- M the M category whether the cancer has spread to other organs in the body (a process called Metastasis
The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.
After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.
Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.
Read Also: Does An Enlarged Prostate Cause Erectile Dysfunction
Death From Other Causes
The mean age at metastatic prostate cancer diagnosis in the study was roughly 71 years. Most of the cohort was White and had a diagnosis of stage M1b metastatic prostate cancer , which means the cancer had spread to the bones.
Among men in the cohort, the rates of death from septicemia, suicide, accidents, COPD, and cerebrovascular diseases were significantly increased compared with the general US male population, the team observes.
Thus, the study authors were concerned with not only with death from metastatic prostate cancer, but death from other causes.
That concern is rooted in the established fact that there is now improved survival among patients with prostate cancer in the US, including among men with advanced disease. âPatients tend to live long enough after a prostate cancer diagnosis for noncancer-related comorbidities to be associated with their overall survival,â they write.
The editorialists agree: prostate cancer âhas a high long-term survival rate compared with almost all other cancer types and signals the need for greater holistic care for patients.â
As noted above, cardiovascular diseases were the most common cause of non-prostate cancer-related deaths in the new study.
As in the management of other cancers, there is concern among clinicians and researchers about the cardiotoxic effects of prostate cancer treatments.
The study had no specific funding. The study authors and editorialists have disclosed no relevant financial relationships.
Understanding Prostate Cancers Progression
To determine the appropriate treatment, doctors need to know how far the cancer has progressed, or its stage. A pathologist, the doctor trained in analyzing cells taken during a prostate biopsy, will provide two starting pointsthe cancers grade and Gleason score.
- Cancer grade: When the pathologist looks at prostate cancer cells, the most common type of cells will get a grade of 3 to 5. The area of cancer cells in the prostate will also be graded. The higher the grade, the more abnormal the cells.
- Gleason score: The two grades will be added together to get a Gleason score. This score tells doctors how likely the cancer is to grow and spread.
After a biopsy confirms prostate cancer, the patient may undergo additional tests to see whether it has spread through the blood or lymph nodes to other parts of the body. These tests are usually imaging studies and may include a bone scan, positron emission tomography scan or computed tomography scan.
Also Check:
Recommended Reading: Is Cinnamon Good For Prostate Cancer
How Prostate Cancer Spreads
Cancer cells sometimes break away from the original tumor and go to a blood or lymph vessel. Once there, they move through your body. The cells stop in capillaries tiny blood vessels at some distant location.
The cells then break through the wall of the blood vessel and attach to whatever tissue they find. They multiply and grow new blood vessels to bring nutrients to the new tumor. Prostate cancer prefers to grow in specific areas, such as lymph nodes or in the ribs, pelvic bones, and spine.
Most break-away cancer cells form new tumors. Many others dont survive in the bloodstream. Some die at the site of the new tissue. Others may lie inactive for years or never become active.