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National Cancer Institute Prostate Cancer

There Are Three Ways That Cancer Spreads In The Body

Prostate Cancer Statistics – Did You Know?

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Community Prostate Cancer Screenings

Northside Hospital Cancer Institute holds multiple prostate cancer screenings for community members each year at several convenient locations throughout Georgia.

Men who meet the following criteria are eligible to register and attend NHCI community prostate cancer screenings:

  • Men who are between the ages of 45-75
  • Men who do not have a prostate cancer diagnosis
  • Men who have not had a PSA blood test within the past year

To register for an upcoming Northside Hospital community prostate cancer screening, please call . Qualified interpreters are available to assist you at each screening event. Please inform registration staff members of your language preference.View upcoming dates for our prostate cancer screening events on our Classes & Event Calendar.

Men are encouraged to make an informed decision with their health care provider regarding the appropriateness of prostate cancer screening.

Ajcc Stage Groupings And Tnm Definitions

The AJCC has designated staging by TNM classification.

Table 1. Definition of Histologic Grade Groupa

Grade Group Gleason Score Gleason Pattern
aAdapted from AJCC: Prostate. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp. 71526.
4+4, 3+5, or 5+3
5 4+5, 5+4, or 5+5
Table 2. Definitions of TNM Stage Ia

Stage Gleason Score Gleason Pattern g Illustration
T = primary tumor N = regional lymph nodes M = distant metastasis cT = clinical T PSA = prostate-specific antigen pT = pathological T.
aAdapted from AJCC: Prostate. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp. 71526.
The explanations for superscripts b through g are at the end of Table 5.
I cT1ac, cT2a, N0, M0 cT1 = Clinically inapparent tumor that is not palpable. < 10
cT1a = Tumor incidental histologic finding in 5% of tissue resected.
cT1b = Tumor incidental histologic finding in > 5% of tissue resected.
cT1c = Tumor identified by needle biopsy found in one or both sides, but not palpable.
cT2 = Tumor is palpable and confined within prostate.
cT2a = Tumor involves 1/2 of one side or less.
N0 = No positive regional nodes.
M0 = No distant metastasis.
Gleason Score, 6 Gleason Pattern, 3+3 .
N0 = No positive regional nodes.
M0 = No distant metastasis.

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Treatment Option Overview For Prostate Cancer

In This Section
  • Bicalutamide
  • Local treatment modalities are associated with prolonged disease-free survival for many patients with localized prostate cancer but are rarely curative in patients with locally extensive tumors. Because of clinical understaging using current diagnostic techniques, even when the cancer appears clinically localized to the prostate gland, some patients develop disseminated tumors after local therapy with surgery or radiation.

    Treatment options for each stage of prostate cancer are presented in Table 6.

    Table 6. Treatment Options by Stage for Prostate Cancer

    Stage Standard Treatment Options
    EBRT = external-beam radiation therapy LH-RH = luteinizing hormone-releasing hormone PARP = poly polymerase TURP = transurethral resection of the prostate.
    Stage I Prostate Cancer
    PARP inhibitors for men with prostate cancer and BRCA1, BRCA2, and/or ATM mutations

    Advances In Prostate Cancer Research

    NCI National Cancer Institute Logo

    Nanoparticles are tested as a means to deliver drugs to prostate cancer cells.

    NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat prostate cancer. Most men diagnosed with prostate cancer will live a long time, but challenges remain in choosing the best treatments for individuals at all stages of the disease.

    This page highlights some of the latest research in prostate cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.

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    What Is The Psa Test

    Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.

    The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.

    PSA testing is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem.

    In addition to prostate cancer, several benign conditions can cause a persons PSA level to rise, particularly prostatitis and benign prostatic hyperplasia . There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.

    Whole Exome And Genome Sequencing

    Stephen Thibodeau presented pilot studies in whole exome sequencing in ICPCG families. They selected families with a large number of affected individuals and available first cousins. He described advances in sequencing and target capture technology and indicated that they are currently obtaining high-quality data containing up to 150 million reads, > 70% of the sequences having > 40x coverage, identifying ~35,000 filtered on-target SNPs of which ~16% were novel, including an average of ~30 splice and ~100 nonsense changes per individual. The remaining changes were missense and synonymous changes. He emphasized the need for considerable QC and bioinformatics support for these projects. To identify candidate targets, they filter the data initially at sharing across family members for nonsense and splice variants.

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    Institute For Prostate Cancer Research

    The Institute for Prostate Cancer Research is a collaborative effort between Fred Hutch and UW Medicine. Together, we create a team of more than 40 scientists and scientist-clinicians in multiple disciplines. Our mission is to understand the causes of prostate cancer and its progression, develop new prevention strategies, devise innovative diagnostics and improve survival and quality of life.

    Weâve been awarded more than $40 million in research grants from the National Institutes of Health and other federal agencies. This includes one of only 9 prostate cancer Specialized Program of Research Excellence grants nationwide from the National Cancer Institute to study prostate cancer progression. Faculty members also have received individual grants to study numerous aspects of prostate cancer.

    Through cutting-edge research, scientists and clinicians provide hope for men with prostate cancer and their families in the Northwest and the world. Weâve already identified and/or assembled up to 80 percent of the genes expressed in prostate cancer, developed one of the largest serum and tissue banks in the world, undertaken some of the most advanced studies of bone biology and skeletal metastases, assembled information and genotypes for more than 300 families with hereditary prostate cancer and developed many new therapeutic strategies.

    Our 2021 Report to the Community can be downloaded below.

    There Are Different Types Of Treatment For Patients With Prostate Cancer

    New NCI Director, Early Release of Prostate Cancer Data, Disappointing Findings in RCC, and More

    Different types of treatment are available for patients withprostate cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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    Studying Early Detection For Men At High Risk

    Men with certain inheritedgenetic traits are at increased risk for developing prostate cancer. Examples of such traits include inherited BRCA gene mutations and Lynch syndrome. No clear guidelines exist for when or howor ifto screen men at high genetic risk for prostate cancer.

    NCI researchers are using magnetic resonance imaging of the prostate in men at high risk to learn more about how often and how early these cancers occur. Theyre also testing whether regular scans in such men can detect cancers early, before they spread elsewhere in the body .

    Why Choose Lci For Care

    • Prostate cancer specialists. Our prostate cancer patients are cared for by fellowship-trained urologic oncologists. These doctors received years of extra training in treating diseases like prostate cancer. While some urologists treat many different conditions, our team is solely dedicated to helping cancer patients like you.
    • A team approach. At LCI, youll have a comprehensive team by your side. This group of experts includes prostate cancer surgeons, medical oncologists, radiation oncologists, radiologists, geneticists and more. Theyll meet regularly to discuss your condition and work together to create a custom treatment plan just for you.
    • Proven experience. We help hundreds of prostate cancer patients every year. We have some of the regions highest volumes for both local and metastatic prostate cancers. We also treat rare prostate cancers like small cell prostate cancer and sarcomas in the prostate. Our deep experience allows us to choose the most effective therapies for your specific condition.

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    Genetics Of Pc Progression

    William Isaacs emphasized that accumulation of mutations in key genes is a critical aspect of our current views of PC progression. The importance of somatic gene fusions has emerged as paramount , and understanding germline factors that predispose to fusion events could be important for initiation or for early events in the carcinogenic process.

    Family history is a known risk factor, and studies have reported familial concordance in PC survival. Isaacs cited studies in families that identified several chromosomal regions linked to PC aggressiveness . An important association with aggressiveness is found in carriers of BRCA1 and BRCA2 mutations . Therefore, even though rare variants may account for a small fraction of PCs, they may be more important determinants of aggressive disease. Isaacs and other speakers suggested that most of the PC susceptibility loci identified so far probably modulate early stages of disease rather than disease progression.

    Cancer Support And Survivorship Programs

    PCR joins the NCRI as a new partner!

    Cancer care can be overwhelming for you and your family. Thats why we offer many resources to help you stay well during and after treatment, including:

    • Individual and group counseling to help you keep a positive outlook.
    • Nurse navigators who can help you with everything from understanding your diagnosis to arranging transportation.
    • Integrative oncology services that promote wellness through services like acupuncture, massage therapy, yoga and more.
    • Nutritional support from registered dietitians who can help you find foods that keep your body strong during treatment and recovery.
    • Survivorship services that help you thrive long-term by addressing the issues you face after successful cancer treatment.

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    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 .

    The Grade Group And Psa Level Are Used To Stage Prostate Cancer

    The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen test and the Grade Group. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2 to 10 and describes how different the cancer cells look from normal cells under a microscope and how likely it is that the tumor will spread. The lower the number, the more cancer cells look like normal cells and are likely to grow and spread slowly.

    The Grade Group depends on the Gleason score. See the General Information section for more information about the Gleason score.

    • Grade Group 1 is a Gleason score of 6 or less.
    • Grade Group 2 or 3 is a Gleason score of 7.
    • Grade Group 4 is a Gleason score 8.
    • Grade Group 5 is a Gleason score of 9 or 10.

    The PSA test measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer.

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    In The Early Stages There Are No Noticeable Symptoms Of Prostate Cancer

    Prostate cancer grows slowly, and many people don’t have symptoms in early stages. As prostate cancer progresses, the disease can cause:

    • Urination problems, such as pain, burning, difficulty stopping or starting, weak flow, and/or increased frequency
    • Blood in the urine or semen
    • Frequent pain in the lower back, hips, or upper thighs
    • Difficulty getting or maintaining erections
    • Painful ejaculation
    • Loss of appetite or weight

    Moffitts Approach To Prostate Cancer Treatment

    Oligometastatic Disease – 2021 Prostate Cancer Patient Conference

    Having earned the prestigious Comprehensive Cancer Center designation from the National Cancer Institute , Moffitt Cancer Center has distinguished itself as one of the nations premier cancer centers. Through our extensive research, bench-to-bedside approach and robust clinical trials program, our patients have opportunities to be among the first to benefit from promising new prostate cancer treatments that are unavailable elsewhere.

    The renowned Urologic Oncology Program at Moffitt features a multispecialty team that includes board-certified surgeons, radiologists, radiation oncologists, nurses, supportive care specialists and other medical professionals. Working together, these diverse experts develop a tailored treatment plan for each patient. Moffitt also holds weekly tumor board meetings to assess and monitor complex cases. These are just some of the ways in which we provide outstanding cancer care.

    If you would like more information about prostate cancer, you are welcome to talk with a specialist in the Urologic Oncology Program at Moffitt Cancer Center. To request an appointment, please call or submit a new patient registration form online.

    Recommended Reading: What Is A High Psa Level For Prostate Cancer

    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 .

    Nonprofit And Governmental Organizations

    These groups are a good place to start for more information on prostate cancer.

    American Cancer Societyâs information on prostate cancer:

    Cancer.Netâs information on prostate cancer:

    Cancer Careâs information on prostate cancer:

    CDCâs information on prostate cancer:

    National Cancer Instituteâs information on prostate cancer:

    Prostate Cancer Foundation:

    Us TOO:

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