Active Surveillance And Watchful Waiting
If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.
Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.
ASCO encourages the following testing schedule for active surveillance:
A PSA test every 3 to 6 months
A DRE at least once every year
Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years
Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.
Prostate Cancer Is Common With Aging
After skin cancer, prostate cancer is the most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer in their lifetime. And these are just the men who are diagnosed. Among very elderly men dying of other causes, a surprising two-thirds may have prostate cancer that was never diagnosed.
Only 1 in 36 men, though, actually dies from prostate cancer. That’s because most prostate cancers are diagnosed in older men in whom the disease is more likely to be slow-growing and non-aggressive. The majority of these men eventually pass away from heart disease, stroke, or other causes — not their prostate cancer.
Symptoms Of Advanced Prostate Cancer
The symptoms of advanced prostate cancer depend on where the cancer has spread to. Find out about the possible symptoms and when to see your doctor.
Advanced prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. If your cancer has spread you might:
- have bone pain
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Aggressive Treatment For Prostate Cancer Is The Norm
Study Finds Majority of Men Diagnosed With Low-Risk Disease Get Radiation or Radical Surgery
That’s true, the researchers found, even in men with a low level of prostate-specific antigen of under 4 nanograms per milliliter, one of the factors taken into account when treatment decisions are made.
”If we knew for sure everyone with a PSA under 4 would not die of prostate cancer, case closed,” says researcher Mark N. Stein, MD, a medical oncologist at The Cancer Institute of New Jersey and assistant professor of medicine at the UMDNJ-Robert Wood Johnson Medical School, New Brunswick.
But that’s far from true, Stein says. And that makes the balance between overtreatment and undertreatment difficult, he says. The report is appears in the Archives of Internal Medicine.
“The tremendous improvement in survival has been attributed to early detection and treatment,” Stein and his colleagues write. “However, there have been concerns about the potential overdiagnosis and overtreatment of localized prostate cancer.”
In the study, they looked at data from nearly 124,000 men with newly diagnosed prostate cancer from 2004 to 2006 to determine which men received aggressive treatment.
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.
What Stages Have To Do With Cancer Spread
Cancers are staged according to tumor size and how far it has spread at the time of diagnosis. Stages help doctors decide which treatments are most likely to work and give a general outlook.
There are different types of staging systems and some are specific to certain types of cancer. The following are the basic stages of cancer:
- In situ. Precancerous cells have been found, but they havent spread to surrounding tissue.
- Localized. Cancerous cells havent spread beyond where they started.
- Regional. Cancer has spread to nearby lymph nodes, tissues, or organs.
- Distant. Cancer has reached distant organs or tissues.
- Unknown. Theres not enough information to determine the stage.
- Stage 0 or CIS. Abnormal cells have been found but have not spread into surrounding tissue. This is also called precancer.
- Stages 1, 2, and 3. The diagnosis of cancer is confirmed. The numbers represent how large the primary tumor has grown and how far the cancer has spread.
- Stage 4. Cancer has metastasized to distant parts of the body.
Your pathology report may use the TNM staging system, which provides more detailed information as follows:
T: Size of primary tumor
- TX: primary tumor cant be measured
- T0: primary tumor cant be located
- T1, T2, T3, T4: describes the size of the primary tumor and how far it may have grown into surrounding tissue
N: Number of regional lymph nodes affected by cancer
M: Whether cancer has metastasized or not
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.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for prostate cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead it groups cancers into localized, regional, and distant stages.
- Localized: There is no sign that the cancer has spread outside the prostate.
- Regional: The cancer has spread outside the prostate to nearby structures or lymph nodes.
- Distant: The cancer has spread to parts of the body farther from the prostate, such as the lungs, liver, or bones.
Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will recommend a specific treatment plan for you based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
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What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
The Stages Of Prostate Cancer: What You Need To Know
After a prostate cancer diagnosis, your oncologist will refer to the stage of your cancer. All cancers are categorized into four distinct stages, each of which identifies the progress of the growth of cancerous cells within clinically defined standards. These stages help doctors determine the most appropriate care for each patient based on his or her condition, and can also provide easy-to-understand context for your diagnosis. Learn more about the stages of prostate cancer, how each stage will affect your treatment plan and the survival rates for each stage, then contact Regional Cancer Care Associates to schedule a consultation.
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Predicting Aggressive Prostate Cancer
If you are diagnosed with prostate cancer, your doctor will probably evaluate several factors to determine how aggressive it is. These “markers” identify whether the cancer is low risk, intermediate risk, or high risk. Low-risk prostate cancer is slow growing and not likely to spread quickly. High-risk prostate cancer is aggressive, meaning it is likely to spread quickly outside the prostate. Understanding the risk level of your cancer will help your doctor advise you about possible treatments. Your doctor will look at key “markers” for aggressive cancer, as well as the “stage” of your specific cancer.
Commonly used markers for prostate cancer include:
The stages of prostate cancer refer to the cancer size and how far it has spread. The stages are:
- Localized Prostate Cancer is stage I to stage IIIA. At this stage, the tumor is confined to the prostate.
- Regional Prostate Cancer, also known as local extension, is stage IIIB to IVA. The tumor has grown through the prostate capsule, either into the seminal vesicles or into nearby muscles and organs.
- Metastatic Prostate Cancer is referred to as stage IVB. The tumor has spread to the distant lymph nodes or more distant parts of the body.
Attention to the general health of a patient as well as the patient’s wishes are also an important part of treatment decisions.
What Kind Of Treatment Will I Need
There are many ways to treat prostate cancer. The main kinds of treatment are observation, active surveillance, surgery, radiation, hormone therapy, and chemo. Sometimes more than one kind of treatment is used.
The treatment thats best for you will depend on:
- Your age
- Any other health problems you might have
- The stage and grade of the cancer
- Your feelings about the need to treat the cancer
- The chance that treatment will cure the cancer or help in some way
- Your feelings about the side effects that might come with treatment
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After A Diagnosis Of Prostate Cancer
After finding out you have prostate cancer, you may feel shocked, upset, anxious or confused. These are normal responses. Talk about your treatment options with your doctor, family and friends. Ask questions and seek as much information as you need. It is up to you as to how involved you want to be in making decisions about your treatment.
After non-melanoma skin cancer, prostate cancer is the most common cancer in Australia. In 2016, 19,305 Australian men were diagnosed with prostate cancer.
Prostate cancer is unusual in that it is slow growing in some men and not a threat, but for others the cancer can be aggressive. Cure rates for prostate cancer are improving, however side-effects of treatment may affect your lifestyle including sexual function and continence.
To ensure that you receive the best care, your specialist will arrange for a team of health professionals based on your needs and preferences
Learn more about the best prostate cancer care for each step of your treatment:
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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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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Call Joe Hall at 844-863-5518 to learn more about his prostate cancer journey. Joes an 11-year prostate cancer survivor and has talked to thousands of men about their prostate cancer.
Veterans, call us at and well help you navigate through the VA system to receive prostate cancer treatment here at Radiotherapy Clinics of Georgia.
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Learn More About Prostate Cancer Care At Rcca
If youve been diagnosed with prostate cancer or are concerned about potential symptoms, contact RCCA today. Our team of cancer care specialists will assess the stage of your cancer using the latest diagnostic methods and work with you to design a fully individualized care plan that includes advanced treatment options, the potential for clinical trials, and support that addresses physical and emotional well-being. To speak with a representative right away, please call 844-474-6866.
Survival Rates For Prostate Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. These rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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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.