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Refusing Treatment For Prostate Cancer

If You And Your Family Do Not Agree

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Family members, friends, and caregivers might have different ideas about your treatment. They might want you to have more aggressive treatment. Or they might try to keep you from having certain treatments.

If this happens, your health care team can help you talk with your family and friends. Sometimes, it is best if your family and closest friends meet with you and your doctor to talk about the best treatment plan. Remember that you always have the right to make your own treatment decisions.

Cancer Treatment Options For Older Adults

You may have just one type of treatment or a combination of treatments. The main cancer treatments for people of all ages are:

  • Radiation therapy

How cancer surgery can affect older adults

Like other treatments, surgery has risks. The risks can be higher when you are older because your body does not always work as well as it did. Before surgery, you and your doctor should think about the following:

Heart function. Surgery may make heart problems worse. It is important to consider your heart function before you have surgery. Older adults have heart disease or an irregular heartbeat more often than younger people. Also, your heart might not tolerate changes in blood pressure as well. This can happen during surgery.

Kidney function. Surgery can involve many drugs. You might also get a lot of fluids to keep your body working. Your kidneys need to process the drugs and fluids. If your kidneys do not work as well as they used to, surgery can cause problems.

Liver function. As you get older, less blood flows to your liver to help it work. Your liver breaks down drugs. If it does not work as well as it should, you are more likely to have a reaction to the drugs needed for surgery.

Considering surgery risks and benefits

It is important to talk with your health care team about the risks and benefits of cancer surgery. If surgery is risky for you, talk about other treatments.

Learn more about cancer surgery.

Planning for after surgery

How chemotherapy can affect older adults

Is Breast Cancer Curable

Breast cancer is well studied, frequently diagnosed, and if detected early, potentially curable. Conventional treatment for early breast cancer is surgical resection of the tumor, followed by radiation and chemotherapy to reduce the risk of disease recurrence, by killing any residual cancer cells that remain.

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What Happens When You Ignore Prostate Cancer

by DWM | Sep 22, 2021 | urology news

When you have prostate cancer, most people choose to arrange for treatment, but not everyone does. It might seem crazy to refuse treatment for prostate cancer, but thats exactly what some folks choose to do.

Some people ignore prostate cancer because they are more afraid of surgery than the disease itself. While such a sentiment is understandable, it can result in great tragedy. Heres what happens when you ignore prostate cancer.

Why Your Decisions Matter

it wasnt a shame to me to have prostate cancer lakeland regional

In the past, doctors sometimes made decisions without talking with patients. Today, the situation is different. Your health care team wants to know your concerns and answer your questions. They also believe that you have the right to make your own decisions. Working with your health care team to make a treatment plan can help you feel more in control.

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What Happens If I Decide Not To Treat My Prostate Cancer

Should I treat my prostate cancer or leave it alone? The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present. But let’s take a look at the natural history of prostate cancer if it is not treated…

While most men undergo some form of treatment for their prostate cancer, some men today choose to not be treated for their prostate cancer. Instead, they may choose to have their doctors monitor their cancer, especially if it’s expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small. This is called active surveillance, meaning doctors will initiate cancer treatment only if the cancer starts growing.

Others choose no cancer treatment because of a short life expectancy or other serious medical problems. They may feel that the risks or side effects of cancer treatment outweigh their potential benefits. This option is certainly OK and reasonable in the right circumstances — requiring a careful and thoughtful discussion with your doctor and family.

What happens if prostate cancer is ultimately left untreated?

Where does prostate cancer spread?

Most cases of diagnosed prostate cancer, however, if left untreated, will grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.

Choosing Not To Undergo Treatment

After my dad carefully considered his treatment options and all the various advice, he made a decision. Due to his age and life expectancy, he opted to do nothing other than monitoring his PSA. If he were younger, he would consider and seek treatment. But at his age, he doesnt want to risk impacting the quality of his remaining years.

In his case, I believe he made the right decision. Not all prostate cancer needs treatment, particularly low-grade. Or in the case of my dad, age and life expectancy are important factors. Its a personal decision.

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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.

An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.

Factors Associated With Patient’s Refusal

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Among the 29,932 patients with recommended but unperformed surgery, 11,221 patients were due to refusal and 18,711 patients were due to other unspecific reason. The demographic and clinical characteristics of the 29,932 patients were presented in Table 1.

Table 1. Demographic and clinical characteristics of patients with recommended but unperformed cancer surgery.

As shown in Table 2, in patients with recommended but unperformed surgery, black patients were more likely to refuse recommended surgery than white patients . API patients were more likely to refuse recommended surgery than white patients . Those black-white and API-white disparities in surgery refusal narrowed after additionally adjusting for insurance type and marital status. Patients who refused recommended surgery were more likely to have worse CSS than those who unperformed recommended surgery due to other unspecific reason . In addition, surgery refusal probability significantly increased along with age increase. Female patients were more likely to refuse surgery than male patients . Patients with high cancer stage were less likely to refuse surgery than those with early cancer stage . Uninsured/Medicaid patients were more likely to refuse surgery than insured patients . Unmarried patients were more likely to refuse surgery than married patients .

Table 2. Factors associated with patient’s refusal of recommended cancer surgery .

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What Happens If You Leave Prostate Cancer Untreated

If prostate cancer is left untreated, it may grow and possibly spread out of the prostate gland to the local tissues or distant sites such as liver and lungs. If prostate cancer is left untreated, it may grow and possibly spread out of the prostate gland to the local tissues or distant sites such as liver and lungs.

Coping With Changesafter Treatment

Your body will go through many changes because of prostate cancer and treatment. Let yourself feel upset. Donât bottle up your feelings.

Here are some strategies to keep in mind, as you work through recovery.

  • Find trusted people to support you.

  • Talk about how you feel.

  • Do not be afraid to share feelings of grief.

  • Stay active and engaged in your usual activities.

  • Stay connected with your partner through affection and activities you enjoy.

  • Give yourself permission to focus on the pleasure of touch, and not as much on performance.

  • Remember that sex is about more than an erection.

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Prognosis Following The Use Of Complementary And Alternative Medicine In Women Diagnosed With Breast Cancer

This analysis, by Saquib et al, was a secondary analysis of the Womens Healthy Eating and Living study. It looked at 2562 breast cancer survivors and surveyed for rejection of systemic treatment and use of CAM following surgical resection. All women had to be aged 18-70 and had operable Stage I-IIIa breast cancer. In this group, 177 women were identified who declined systemic treatment. 80% of this group used CAM. Compared to women that took chemotherapy, women that declined systemic treatment had a 90% greater risk of an additional breast cancer event, and the risk of death increased by 70%. CAM use had no effect on this finding. In addition, the lack of effect was consistent between high supplement users and low supplement users. The authors concluded that women that decline systemic treatment are at greater risk for subsequent recurrence and death due to breast cancer. The use of CAM had no measurable effect on the recurrence of breast cancer or on the risk of subsequent death.

Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation

Minimally invasive procedure to treat enlarged prostate now available ...

Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.

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Where Prostate Cancer Spreads

If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.

The cancer can spread down the blood vessels, lymphatic channels, or nerves that enter and exit the prostate, or cancer could erode directly through the capsule that surrounds the prostate.

The seminal vesicles are a site of particularly common early spread. More extensive local spread can occur with cancer invading the nearby bladder or rectum.

Further advancement of cancer can occur when cancer cells enter the blood vessels and lymphatic channels. Once cancer has entered into these vessels, prostate cancer cells can seed into virtually any other part of the body.

Prostate cancer is known to have a particular affinity for spreading or metastasizing to the bones especially the lower spine, pelvis, and femur. Other organs such as the liver, brain, or lungs can also be the sites of spread, but these are much rarer.

Your Cancer Treatment Goals

Your cancer treatment goals depend on many factors. For example, the type of cancer and whether it has spread will factor into your goals.

Treatment goals include:

  • Living longer, even with cancer

  • Having fewer symptoms from cancer and side effects from its treatment

  • Maintaining physical and emotional strength

  • Having a certain quality of life

Your goals might be different from a younger persons. For example, a healthy younger person’s goal might be to cure the cancer even if treatment is very difficult. Some people are able to have aggressive treatment. This might not be true for you.

Depending on your age and general health, you might care more about feeling well than curing cancer permanently. This might be especially true if you have a chronic health condition or you feel that your quality of life is poor.

But if you are very healthy and enjoy many activities, you might want aggressive treatment. You might have plans many years in the future. If so, you might want your health care team to do everything possible for a cure.

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Can Prostate Cancer Spread To The Liver

If prostate cancer is left untreated, it may grow and possibly spread out of the prostate gland to the local tissues or distant sites such as liver and lungs. Unchecked prostate cancer may spread to: ONLY if the cancer is in its initial stage, the physician might recommend active surveillance or watchful waiting.

What Should Patients Know About Msks Approach To Treating Prostate Cancer

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At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.

Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.

The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.

We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.

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Prostate Cancer Patients Refusal Of Cancer

K. M. IslamAcademic Editor: Received

Abstract

Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. . Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients well-being.

1. Introduction

2. Materials and Methods

2.1. Data Source
2.2. Socioeconomic Indicators

3. Results

3.1. Year Trend for Recommendation and Refusal of Prostate Cancer-Directed Surgery
3.3. Adjusted Odds Ratios of Refusing Recommended Surgery

Choosing The Best Treatment

It can be difficult to choose the best treatment for you. Your doctor and specialist nurse will explain the different treatment options and help you make a decision. The Predict Prostate tool can also help you decide between monitoring and radical treatment. We have more information about this tool further down this page.

A UK trial showed that there can be very little difference in survival between the treatments especially if you are diagnosed with early prostate cancer.

The table below shows how many men survive different treatments for CPG 1, 2 and 3 localised prostate cancer after 10 years.

Treatment

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What Is The Life Expectancy Of A Man With Prostate Cancer

The life expectancy of a man with prostate cancer is favorable. Most of the aged men detected of prostate cancer die of other comorbidities. The life expectancy is as follows:

  • Almost 100% of men who have early-stage prostate cancer will survive more than 5 years after diagnosis.
  • Men with advanced prostate cancer or whose cancer has spread to other regions have lesser survival rates. About one-third will survive for 5 years after diagnosis.

The longer-term survival rates for early-stage prostate cancer include:

  • The relative 10-year survival rate is 98%.
  • The relative 15-year survival rate is 96%.

The Initial Causes Refusing Treatment For Prostate Cancer

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One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

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