Further Treatments To Control The Cancer
Your first treatment may help keep your cancer under control. But over time, the cancer may change and start to grow again. If this happens you might be offered other treatments, including:
- more hormone therapy
- clinical trials
More hormone therapy
Your prostate cancer may respond well to other types of hormone therapy, such as abiraterone , enzalutamide , steroids or oestrogens, or to a combination of treatments.
More chemotherapy
If youve had hormone therapy on its own as a first treatment, you might be offered a chemotherapy drug called docetaxel . This may help some men to live longer, and can help to improve and delay symptoms. If youve already had docetaxel, you might be offered more docetaxel or another chemotherapy drug called cabazitaxel .
Radium-223
This is a type of internal radiotherapy that may be an option if your cancer has spread to your bones and is causing pain. A radioactive liquid is injected into your arm and collects in bones that have been damaged by the cancer. It kills cancer cells in the bones and helps some men to live longer. It can also help to reduce bone pain and delay some symptoms, such as bone fractures. Read more about radiotherapy for advanced prostate cancer.
Are There New Techniques That Reduce The Chance Of Becoming Incontinent
When removingthe prostate, surgeons try to save as much of the area around the bladder and the sphincter muscles around the urethra as possible, thus limiting damage to the sphincter. Doctors have also fine-tuned the process of placing radioactive seed implants, using sophisticated computer projections that allow the seeds to destroy the prostate while limiting damage to the bladder.
Still, at this point, any man who is undergoing radiation or surgery to treat prostate cancer should expect to develop some problems with urinary control. With newer techniques, some men will have only temporary problems controlling their urine, and many will regain full control of their bladder in time.
Continued
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Causes And Symptoms Of Benign Prostatic Hyperplasia
Changes in hormones that occur through aging are what contribute to BPH. Genetics, too, can be a possible cause for BPH. The prostate continues to grow from the age of 25, but when the prostate becomes too enlarged it can cause complications in older men.
Symptoms of BPH include:
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What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
Bph Treatment After Radiation Therapy For Prostate Cancer: 73
SL is a 63-year-old man with a diagnosis of prostate cancer treated with external beam radiation therapy with IMRT 2 years ago.
He complains of a slow urine stream, a need to urinate frequently and urge to urinate. He was previously treated with multiple medications including Rapaflo, tamsulosin, and Myrbetriq without significant benefit. He was advised TURP . He is hesitant to have TURP and wants to explore alternatives.
AUA symptom score of 19.
A thorough evaluation was performed which included bladder and prostate ultrasound, uroflow measurement, and bladder post-void residual urine volume measurement. The patient was found to have a large prostate, 73 ml peak urinary flow of 6 ml/sec, and a mean flow of 3 ml/sec. He had an elevated post-void residual of 186 ml.
Cystoscopyrevealed lateral lobe hypertrophy of the prostate and a small but obstructive median lobe Urodynamic studies revealed very high-pressure voiding and small bladder capacity.
The patient decided to undergo a Urolift procedure.
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What Are The Symptoms And Signs
The location of the prostate gland is fairly low in the pelvic region, below the urinary bladder and in front of the rectum. It lies in very close proximity to the urethra. The urethra is the tube that conveys urine from the bladder to the external environment. When the prostate gland swells, it tends to exert pressure on the urinary bladder as well as the urethra. Initially, there may be no significant disturbance. Eventually, however, the individual will notice certain changes in patterns of urination. The following symptoms are common manifestations of enlargement of the prostate gland:
- The individual may find it difficult to initiate urination and may need to strain to force urine out.
- There may be a reduced flow of urine.
- The urine stream may pause intermittently.
- Frequent urge to urinate, particularly at night.
- The bladder is not voided completely upon urination.
- Sudden, unexpected urges to urinate.
- Urinary incontinence.
- Exercise. When this is the cause, hematuria will usually go away in 24 hours.
Radiotherapy To The Prostate
Some men who have just been diagnosed with advanced prostate cancer may be offered external beam radiotherapy as part of their first treatment. This is where high-energy X-ray beams are directed at the prostate from outside the body. The X-ray beams damage the cancer cells and stop them from dividing and growing. Read more about radiotherapy for advanced prostate cancer.
Radiotherapy to the prostate isnt suitable for all men with advanced prostate cancer. If it isnt suitable for you, you might be offered a type of radiotherapy to help manage symptoms instead.
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What Are The Symptoms Of Prostate Cancer
If you have any symptoms that worry you, be sure to see your doctor right away. They may be caused by conditions other than prostate cancer.
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.
If you have any of the following symptoms, be sure to see your doctor right away
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Urinating often, especially at night.
- Trouble emptying the bladder completely.
- Pain or burning during urination.
- Pain in the back, hips, or pelvis that doesnt go away.
Keep in mind that these symptoms may be caused by conditions other than prostate cancer.
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How Is Advanced Prostate Cancer Diagnosed
If youve previously been diagnosed with prostate cancer, be sure to tell your doctor if you have any new symptoms, even if youve completed treatment.
To determine if prostate cancer has returned or has spread, your doctor will likely order some imaging tests, which may include:
You probably wont need all of these tests. Your doctor will choose the tests based on your symptoms and physical exam.
If any of the images reveal abnormalities, it doesnt necessarily mean that you have cancer. Additional testing may be necessary. If they find a mass, your doctor will probably order a biopsy.
For a biopsy, your doctor will use a needle to remove samples from the suspicious area. A pathologist will then analyze the removed cells under a microscope to see if theyre cancerous. The pathologist can also determine if you have an aggressive form of prostate cancer.
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Urological Complications After Radiation Therapynothing Ventured Nothing Gained: A Narrative Review
Joanna Chorbiska^, Wojciech Krajewski^, Romuald Zdrojowy^
Department of Urology and Oncologic Urology , , Poland
Contributions: Conception and design: W Krajewski, J Chorbiska Administrative support: R Zdrojowy Provision of study materials or patients: R Zdrojowy Collection and assembly of data: J Chorbiska, W Krajewski Data analysis and interpretation: J Chorbiska, W Krajewski Manuscript writing: All authors Final approval of manuscript: All authors.
^ORCID: Joanna Chorbiska, 0000-0001-9792-4450 Wojciech Krajewski, 0000-0003-1727-2283 Romuald Zdrojowy, 0000-0002-1634-3556.
Correspondence to:
Keywords: Radiotherapy urological complications pelvic malignancy radiation cystitis
Submitted Jul 24, 2020. Accepted for publication Nov 20, 2020.
doi: 10.21037/tcr-20-2589
Blood In Urine After Prostate Cancer Treatment: What You Need To Know
There are a number of reasons men with prostate cancer develop bleeding in urine. Hematuria can occur in patients with newly diagnosed prostate cancer as a result of cancer overgrowth that causes symptoms such as a urinary infection or difficulty voiding. More commonly, blood in the urine can occur during radiation treatment for prostate cancer.
Bleeding from Prostate
A small amount of bloody urine can be expected after a prostate biopsy that is performed to diagnose prostate cancer. In addition, blood in urine is expected after surgery for prostate cancer. Typically the amount of blood should be small and should resolve within a week after surgery. However, you might see a small amount of blood in urine on and off for a few weeks after surgery.
Blood in the urine can also be expected after radiation brachytherapy for prostate cancer. One may also experience blood in urine after external beam radiation to the prostate, such as IMRT.
After radiation therapy, blood in urine typically starts within a few weeks after treatment initiation it is usually minor and intermittent and resolves within the first few months after radiation therapy. In patients at risk, such as smokers and the elderly, a full evaluation should be performed. Persistent bloody urine after radiation therapy should be fully evaluated due to increased risk of bladder cancer in men with prostate cancer as well as increased risk of secondary bladder cancer after radiation therapy.
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Urine Test May Spot Aggressive Prostate Cancer
THURSDAY, Nov. 4, 2021
A urine test might one day be able to tell which prostate cancer patients need immediate treatment and which dont, British researchers report.
Prostate cancer can be divided into low and high risk the low-risk men rarely require treatment, and the high-risk certainly do, said study author Jeremy Clark, a senior research associate at Norwich Medical School at the University of East Anglia in Norfolk. However, there is a third group, called intermediate risk, which falls between these extremes, and the treatment pathway for these men is less clear.
Prostate cancer is common over 40% of 50-year-old men will have prostate cancer but not everyone is dying of it, so deciding which men to treat is not always easy, Clark said.
We have developed a simple urine test that can measure the presence of aggressive cancer and also how much aggressive cancer is present, he said.
The test appears to be able to assess how much aggressive cancer is present in these intermediate-risk men, and so could be used to identify a group of intermediate-risk men that could avoid immediate treatment, which includes surgery and radiotherapy, and instead, these men could be monitored by active surveillance by being retested yearly to see if their disease is stable or not, Clark said. Around a quarter of the intermediate-risk men could fall into this group.
The report was published Nov. 3 in the journal Life.
More information
How Is Hematuria Treated
The treatment will depend on the cause. Infections are likely treated with antibiotics. Prescription medications may be used for particularly painful kidney stones, or they may be broken down using extracorporeal shock wave lithotripsy . An enlarged prostate could be treated using alpha blockers, or surgery depending on the severity.
Methods to prevent and avoid future issues with urine in the blood include drinking plenty of water, urinate immediately after sex, practice good hygiene and stop smoking. Some dietary changes can help such as reduced salt intake limiting certain foods like spinach and rhubarb.
So if youre dealing with blood in your urine make an appointment to let the doctors at Urology Center of Florida give you the treatment you need.
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Mutation Allele Frequencies Are Significantly Higher In The Plasma Of Patients With Pca And Are Related To Metastasis
Next, we compared MAFs between PCa and BPH in plasma DNA sequencing. We observed a trend that patients with PCa have higher MAFs detected , although it does not reach statistical significance . Further, statistical analysis showed that there was no difference in MAF between PCa and BPH.
Further analysis demonstrated that the MAF was associated with metastasis status. MAFs were significantly higher in metastatic PCa and lower in treatment naïve PCa patients . MAF was not associated with Gleason score , tumor stage , PSA , or age . Patients with PCa at stage IV tended to have higher MAFs .
Furthermore, we found that the number of mutations was associated with metastatic status and tumor stage. The number of mutations was significantly higher in metastatic PCa . Furthermore, the number of mutations was significantly associated with the tumor stage , being the highest frequent in patients with PCa at stage IV. However, the number of mutations was not associated with treatment naïve status , PSA , Gleason score , or age .
Your Psa Is Going Up Whats Going On With Your Prostate Good News: Second
Your PSA is going up. Whats going on with your prostate? Do you need a biopsy? Or, maybe youve already had a biopsy that didnt find cancer, but your urologist is wondering whether you need another one. Whats the next step?
Good news: You dont have to move directly to having needles stuck in your prostate! Its not the Monopoly bad-case-scenario of Do not pass Go, do not collect $200! There is a next step! Its a second-line test: a blood or urine test that can provide other layers of information beyond the basic PSA test. There are several good ones out there. Which one do you need? Well, as Marlon Brando said in the classic 1953 movie, The Wild One: Whadya got?
Theres no shortage of options! There are blood tests that provide more nuanced information than the basic PSA test, plus urine tests and even, if youve already had a biopsy, molecular biomarker tests, which arent done on body fluids but on tissue samples. These tests can be helpful, not only in diagnosing cancer, but in risk stratification predicting which cancer is more likely to be aggressive, and which cancer is less likely to need immediate treatment.
Now, about those other blood tests: In addition to the free PSA test, here are two more that include free and total PSA, but look for other factors, as well:
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Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
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What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life, making healthy choices and feeling as good as you can.
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