Finding Out If The Cancer Has Spread
To find out if cancer has spread outside of the prostate, doctors may perform the imaging tests listed below. Doctors are able to estimate the risk of spread, called metastasis, based on PSA levels, tumor grade, and other factors, but an imaging test can confirm and provide information about the cancers location.
Imaging tests may not always be needed. A CT scan or bone scan may not be necessary for those with no symptoms and low-risk, early-stage prostate cancer, as determined with information from the PSA test and biopsy. Learn more about when these tests are recommended to find out if the cancer has spread.
For people with advanced prostate cancer, ASCO recommends that 1 or more of the imaging tests below be done to provide more information about the disease and help plan the best treatment. This includes when there is a newly diagnosed, high-risk cancer if metastasis is suspected or confirmed if the cancer has returned following treatment or when the cancer grows during the treatment period. Learn more about this guideline on the ASCO website.
Magnetic resonance imaging . An MRI scan uses magnetic fields, not x-rays, to produce detailed images of the body. An MRI can be used to measure the tumors size, and a scan can focus specifically on the area of the prostate or on the whole body. A special dye called contrast medium is given before the scan to create a clearer picture, which is injected into a patients vein.
Current Psa Screening Recommendations
PSA-based screening refers to testing healthy men without symptoms.
Until recently, physician societies disagreed on screening recommendations, but with the publication of the U.S. Preventive Services Task Force Guideline in May 2018, all the major physician groups are broadly in agreement, including the American College of Physicians , the American Cancer Society , American Urological Association , and American Society of Clinical Oncology :
- They advise supporting men so that they make informed decisions about screening that reflect their personal preferences and values.
- Routine screening is not recommended in men between ages 40 and 54 of average risk.
- For men ages 55 to 69 years, the U.S. Preventive Services Task Force concluded with moderate certainty that the net benefit of PSA-based screening is small for some men, making the decision up to the judgment of the physician and the values of the patient.”
- For men 70 years and older, they recommend against routine screening because the expected harms are thought to outweigh the benefits.
- Your doctor should not screen you unless you express a preference for it.
- A discussion of the benefits and harms of screening should include a family history of prostate cancer, race or ethnicity, any medical conditions that affect your overall health and lifespan, and your values about risk and benefit.
- If you have less than a 10-year life expectancy, screening is not recommended.
What Is Metastatic Cancer
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
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My Decision To Do Nothing About Prostate Cancer
What are the early signs of prostate cancer? Absolutely none, as it turns out. By the time this common, slow-growing scourge is giving you trouble, its probably far advanced. It may already be threatening your life.
Prostate cancer is an odd one. If its caught early, your chances of survival are very high but so are your chances of having your prostate removed, a solution as crude as it is effective.
A guy with no prostate has no prostate cancer , but he may not have a lot of sex either. He may also have urinary incontinence.
Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the:
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
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Complementary And Alternative Medicine
There is an important distinction between complementary therapies and alternative therapies.
- Complementary therapies, such as exercise and diet changes, are undertaken in addition to conventional medical treatments. Health care providers are often supportive of complementary therapies, depending on your particular situation.
- Alternative therapies are undertaken instead of conventional medical treatments. Some of these may be helpful for some people, but most are not well-studied and none are well-regulated. Misleading websites and false advertising abound. You should be extremely careful about choosing nonstandard treatments instead of treatments that have been evaluated in clinical trials with published results.
Many therapies can fall into either category. Some interfere with standard medical treatment or cause serious side effects, so be sure to inform your doctor if you are considering any of these therapies. Lifestyle changes are likely to be helpful in both reducing the risk of getting prostate cancer and controlling its progression. UCSF is a leader in coordinating clinical trials of diet, exercise and stress in patients with prostate cancer. In addition, every prostate cancer patient treated at UCSF receives access to a nutritionist or dietitian to help in planning a healthy diet and to address dietary issues that may arise during treatment.
Surgery To Remove Your Prostate Gland
You might have surgery to remove your prostate gland if:
- your cancer hasnt spread outside the prostate gland
- you are younger and have a fast growing tumour
- as part of treatment for locally advanced or high risk localised prostate cancer
The aim of a radical prostatectomy operation is to cure prostate cancer. It is major surgery with some possible side effects. If youre an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. This is because your cancer might grow so slowly that youre more likely to die of old age or other causes than from prostate cancer.
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What Should I Do If I Have Prostate Cancer Symptoms
If you are displaying one or more signs of prostate cancer, be sure to promptly consult with a physician. Even benign prostate conditions like prostate enlargement warrant timely medical attention, so dont delay seeking treatment. And, like most other malignancies, prostate cancer is usually more easily treated when it is detected at an early stage.
Who Is At Risk Of Stage 4 Prostate Cancer
Each year almost 200,000 American men are diagnosed with prostate cancer. Obesity and smoking are linked to a higher risk of prostate cancer, but most prostate cancers happen to men over 55. The risk increases as you get older about 60% of prostate cancers are diagnosed in men over 65 years old.
Stage 4 prostate cancer happens when cancer becomes aggressive and spreads to other parts of your body. Some genetic mutations have been connected to an increased likelihood of developing aggressive prostate cancer, so men with family histories of the disease are at greater risk. Men with family members who have had pancreatic, breast, or ovarian cancers might also have a higher risk of prostate cancer.
Black or African-American men are also more likely to have aggressive forms of prostate cancer than men from other races.
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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.
After Prostatectomy: What To Expect
At the hospital : You should expect to be in the hospital for one night. At Johns Hopkins, all rooms on the urology floor are private. Here, nurses help patients get moving shortly after surgery to prevent blood clots and other postoperative risks.
First few days at home : After youre sent home, you might find that regular ibuprofen or acetaminophen will be sufficient pain management for the first few days. If over-the-counter medications arent enough, your doctor can help you with alternatives.
One week after surgery : After your surgery site heals, your catheter will be removed. This is usually seven to 10 days after surgery. This can easily be done at your doctors office. Some people decide to take out their catheter at home. If thats the case, ask your doctor for instructions first.
This is also about the time your surgeon will call you with the final pathology results. He or she will discuss what you should know and whether further treatment is necessary.
One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery. Most people take off work for three to four weeks. If you work from home, you could return to work sooner.
- Urinary incontinence
- Erectile dysfunction
Recovery from surgery takes time. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help.
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Experiments With Tissue Culture & Animal Models Of Prostate Cancer
Experiments with tissue culture and animal models of prostate cancer have revealed the mechanisms of the synthesis of lymphangiogenic growth factors in prostate cancer and their important contribution to lymphangiogenesis in prostate cancer lymph node metastasis.
Signaling pathways for VEGF-C synthesis in 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:
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Genetic And Genomic Tests For Localized Prostate Cancer
A mans inherited genes predict his prostate cancer risk. For a long time, we have known that there is a family risk in prostate cancer. If your father or brother has prostate cancer, or your mother or sister has breast or ovarian cancer, you are at higher risk of being diagnosed with prostate cancer. To partially quantify that genetic risk, a germline test can be performed before a biopsy. This test of DNA from healthy cells can determine whether you have inherited genetic mutations, such as BRCA1 and BRCA2, known to increase prostate cancer risk. If the test shows youre low risk, you may be able to avoid a biopsy even if you have a slightly elevated PSA, while still being actively monitored for prostate cancer.
If already diagnosed with prostate cancer, you may undergo another type of test for assessing your genetic risk. A genomic test of tissue from your biopsy or prostatectomy can look for somatic mutations, alterations in the DNA of the cancer cells themselves. Genomic tests measure expression of various genes that relate to how aggressive a cancer is likely to be. They indicate how rapidly cancer cells are growing and how genetically abnormal they are relative to normal cells.
Symptoms Of Metastatic Prostate Cancer
Metastatic prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. It is also called advanced prostate cancer.
If your prostate cancer has spread you might:
- feel generally unwell
- have weight loss for no known reason
You might have specific symptoms depending on where the cancer has spread to. These symptoms can also be caused by other medical conditions so might not be a sign that the cancer has spread.
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What Is Prostate Cancer
Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.
Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.
Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.
Ask your doctor to use this picture to show you where your cancer is.
The prostate is a gland found only in men, so only men can get prostate cancer.
The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.
There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.
Hormone Therapy With Radiation
Prostate cancer cells need testosterone to grow. Hormone therapy aims to drastically lower testosterone levels to slow the cancer’s progression. Although it does not cure the cancer on its own, hormone therapy improves the effectiveness of radiation for high-risk disease and is often recommended in conjunction with radiation therapy for men with intermediate- or high-risk localized disease. However, hormone therapy may have significant side effects. These include loss of libido , hot flashes , changes in mood or memory, loss of bone and muscle density, body fat gain, and adverse effects on sugar or cholesterol metabolism. When offered as short-term therapy in conjunction with radiation, it is often well tolerated. How long a patient should receive hormone therapy remains controversial and depends on how aggressive his cancer is.
Learn more about hormone therapy.
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What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
What Happens If Your Psa Scores Double In 3 Years
Therefore it may signify the aggressiveness of any prostate abnormalities, whether its an enlarged prostate, prostatitis, or prostate cancer. If your average PSA readings double in less than three years your doctor will most likely order a biopsy, to look in to the problem further and discuss possible prostate cancer treatment options.
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Definitions Of Disease Categories
ICD codes used in the disease categories were the following : myocardial infarction , other coronary heart disease , cerebrovascular accident , arterial disease , heart failure , pneumonia , chronic lower respiratory disease , external causes , complications of diagnostic or surgical procedures , complications of therapeutic drug or vaccine usage , suicide , traffic accident , falls , other heart disease , gastrointestinal disease , dementia , diabetes , complications of heart disease , urinary system disease , symptoms , pulmonary circulation , nervous system disease , hypertensive disease , other bacterial disease , psychic disease , anemia , tumors other than prostate cancer , and prostate cancer .
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Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.
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