Functional Outcomes And Quality Of Life After Treatment For Localized Prostate Cancer
At 15 years after treatment of localized prostate cancer diagnosed in 1994-1995, declines in urinary, sexual, and bowel function were common. These functional declines in quality of life occur to a significantly greater extent among those that undergo treatment for prostate cancer as compared to a normative aging population without a diagnosis of prostate cancer, and symptom distress is more common among men with prostate cancer that are treated compared to those not treated. In a contemporary study of quality of life after treatment for localized prostate cancer, the authors reported that a substantial proportion of men did not return to baseline function in the domains of bowel, sexual, and urinary function that changes in quality of life domains were treatment specific and that patient and partner outcome satisfaction were closely associated with changes in quality of life after treatment. Thus, treatment for prostate cancer commonly results in quality of life changes that affect both the patient and his partner.
I What Every Physician Needs To Know
Prostate cancer, an adenocarcinoma, is the second most common cause of cancer deaths among men, as well as the most common solid tumor in men, overall. In the past, serial serum PSAs and DREs were used as screening, but recently these tests have become controversial.
Diagnosis is based on prostate biopsy. Prognosis is multifactorial dependent on the histological Gleason Score, serum PSA, and the clinical staging categorizing localized cancer patients as low-, intermediate-, or high risk. The cure rates for localized prostate cancer range from 30-70% with appropriate therapy and 5-year survival rates are around 100%.
Androgen deprivation is the best initial therapy for metastatic prostate cancer. Most men develop resistance within 48 months, known as castration-resistant prostate cancer. Combination hormone and Docetaxel therapy is being considered as a treatment option as well. The next line of therapy consists of chemotherapy, immunotherapy, or androgen-modulation. Castration-resistant bone metastases can be treated with zoledronic acid and denosumab, a RANK-ligand inhibitor.
If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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What Is Prostate Cancer
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells, and can then spread to other areas of the body. To learn more about cancer and how it starts and spreads, see What Is Cancer?
Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen.
The prostate is below the bladder and in front of the rectum . Just behind the prostate are glands called seminal vesicles that make most of the fluid for semen. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate.
The size of the prostate can change as a man ages. In younger men, it is about the size of a walnut, but it can be much larger in older men.
Types Of Prostate Cancer
Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells .
Other types of cancer that can start in the prostate include:
- Small cell carcinomas
- Neuroendocrine tumors
- Transitional cell carcinomas
- Sarcomas
These other types of prostate cancer are rare. If you are told you have prostate cancer, it is almost certain to be an adenocarcinoma.
Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.
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Questions To Ask Your Doctor
Asking questions of your doctor may help you make more informed decisions about your care. Open communication between a patient and his doctor is extremely important. Here are answers to some common questions prostate cancer patients should ask their doctors:
What is a prostate-specific antigen level?
PSA is a substance produced by the prostate. It is mostly found in semen. The levels of PSA in the blood may be higher in men who have prostate cancer or other conditions. A PSA test is used primarily to screen for prostate cancer. A PSA test measures the amount of prostate-specific antigen in your blood. Small amounts of PSA ordinarily circulate in the blood. The PSA test may detect high levels of PSA that could indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, may also increase PSA levels.
What is a Gleason score?
A Gleason score of seven means the cancer is likely to grow and spread at a modest pace. If the cancer is small, several years may pass before it becomes a problem. To prevent problems, treatment is needed.
A Gleason score between eight and 10 signifies the cancer is likely to grow and spread fast. If the cancer is small, a few years may pass before the cancer becomes a problem. To prevent problems, treatment is needed now.
How much experience do you have treating my type and stage of prostate cancer?
About Rare Prostate Cancers
Although prostate cancer is a common cancer in men, there are different types of prostate cancer, and some of these are rare. Because they are rare, we dont know as much about them. If you are diagnosed with one of the cancers mentioned here, speak to your doctor or nurse about what that means and what treatments are suitable for you.
Like most things in our body, the prostate is made up of different types of cells . The type of cancer that develops depends on the cell it starts in.
The most common type of prostate cancer starts in some of the cells that line the prostate, called glandular epithelial cells. There are two types of gland cells basal cells and luminal cells . Prostate cancer can develop in either of these cells.
When we talk about common prostate cancer here, we mean this type of prostate cancer. You may hear it called adenocarcinoma or acinar adenocarcinoma or see this written in your biopsy results .
Rarer types of cancer can also develop from gland cells, or from other types of cells in the prostate.
Some men have more than one type of prostate cancer. For example, they may have some common prostate cancer as well as a rare cancer.
Some of the rare cancers may be more aggressive than common prostate cancer. This means they may grow faster and are more likely to spread outside the prostate.
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C History Part : Competing Diagnoses That Can Mimic Prostate Carcinoma
Since the symptoms of prostate cancer over lap benign prostatic hyperplasia, it can be mistaken as prostate cancer. Prostatitis, BPH, recent transurethral catheterization, and a DRE can elevate serum PSA. Metastatic Paget Disease and other causes of pelvic adenopathy such as lymphoma should be considered.
Most commonly prostate cancer is adenocarcinoma, but can develop into other histopathological types, including transitional carcinoma, neuroendocrine carcinoma, small-cell carcinoma, signet-ring carcinoma, squamous cell carcinoma, as well as a sarcoma of the prostate.
The Most Common Prostate Cancer: Adenocarcinoma
These cancers start in the gland cells of the prostate. Gland cells make prostate fluid. This fluid combines with sperm to make semen. When you get cancer in these cells, you could have one of two types:
Acinar adenocarcinoma. Most people get this type. It develops in the gland cells that line the prostate gland.
Ductal adenocarcinoma. This kind starts in the cells that line the ducts of the prostate gland. Itâs usually more aggressive than the other type. That means it grows and spreads more quickly.
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About The Prostate And Prostate Cancer
The prostate gland is part of the male reproductive system and produces fluid that mixes with semen during ejaculation to help sperm travel. The prostate is a walnut-sized, rubbery organ that surrounds the urethrathe urinary duct that carries urine from the bladder out of the bodyand sits directly below the bladder.
The prostate gland, which grows during puberty, is considered an organ and is made up of several dozen lobules or saclike glands, held together with connective prostate tissue and muscle between them. The glands are called exocrine glands, because they secrete liquid to outside the body.
An enlarged prostate, called benign prostatic hyperplasia , is common in men over the age of 40 and may obstruct the urinary tract. The abnormal prostate cell growth in BPH is not cancerous and doesnt increase your risk of getting prostate cancer. However, symptoms for BPH and prostate cancer can be similar.
A condition called prostatic intraepithelial neoplasia , where prostate gland cells look abnormal when examined under a microscope, may be connected to an increased risk of prostate cancer. Prostate cancer is often caught by a doctor performing a digital rectal exam , through a prostate-specific antigen blood test, through a prostate biopsy or with a CT scan.
Another condition, prostatitis, is the inflammation of the prostate. While not cancerous, it may cause higher PSA levels in the blood.
Talk With Your Doctor
Prostate cancer is a risk for all men as they age, but if its caught and treated early, the outlook is generally very good. So as you get older, be sure to have open conversations with your doctor about your risk.
If you have any symptoms you think might be prostate cancer, talk to your doctor right away. And even if you dont have symptoms, consider adopting a healthy lifestyle to decrease your risk.
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What Is Carcinoma Of The Prostate
Carcinoma of the prostate is a type of prostate cancer that occurs when normal prostate cells begin to grow uncontrollably.
Carcinomas begin in the epithelial tissuethe thin tissue, like skin, that covers the linings of internal organs. Other cancers typically form in the bodys connective or supportive tissues , blood-forming tissue like bone marrow , or within the immune system .
Carcinomas are the most common type of cancer and they can be broken down into multiple subgroups: squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma, and basal cell carcinoma.
How commonare carcinomas of the prostate?
The most common carcinoma of the prostate is an adenocarcinoma they make up about 95% of all prostate carcinomas. Adenocarcinomas are a type of cancer that are produced by glandular cells, such as those of the prostate gland. They are most commonly found in men over the age of 70.
Othercarcinomas of the prostate are less common and only make up about 5% of totalprostate carcinomas. Transitional cell carcinomas form in the cells that coverthe urethra. This cancer typically begins in the bladder and then spreads tothe prostate. Some carcinomas, like squamous cell or small cell carcinomas, arerare, malignant tumors of the prostate. In contrast to most prostate cancersthat are slow growing, and these types of carcinomas are usually aggressive.
Treatment Options At Rcca
No matter which type of prostate cancer you or a loved one has been diagnosed with, Regional Cancer Care Associates is there to fight the battle with you. Our team of experts will determine the best combination of the most advanced treatments and methods, which can include chemotherapy, radiation, hormone therapy or surgery, to help you achieve the best possible outcome. For more information or to find an RCCA location near you, contact us today at 844-346-7222.
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Enhancing Healthcare Team Outcomes
Prostate cancer diagnosis and treatment can be complex and is often controversial. an interprofessional team of specialty-trained nurses, nurse practitioners, physician assistants, primary care providers, and urologists must work to manage:
These and many more issues continue to challenge clinicians who deal with prostate cancer patients and men at risk for this common, potentially lethal male malignancy.
The interprofessional team can optimize the treatment of these patients through communication and coordination of care. Primary care providers, urologists, oncologists, radiation oncologists, and nurse practitioners provide diagnoses and care plans. Specialty care urologic nurses should work with the team for coordination of care and are involved in patient education and monitor compliance. The interprofessional team can thus improve outcomes for patients with prostate cancer.
Prostate Cancer Symptoms Young : What’s The Difference Between Carcinoma And Sarcoma
The earlier the detection of prostate cancer, the better the patient’s chance of survival is. Getting a diagnosis of bladder cancer can be a difficult time. Although screenings for prostate cancer are one tool for early detecti. Prostate cancer is a common type of cancer in men, according to the mayo clinic. There are a number of different treatments doctors recommend.
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Risk Factors You Cant Control
Age: The risk of developing prostate cancer increases with age. One in 10,000 men younger than 40 will be diagnosed with prostate cancer, but one in 15 men in their 60s will be diagnosed with the disease.
Family history: Being born with a gene mutation is one of the unavoidable risks of prostate cancer. Two of them include the BRCA1 and BRCA2 gene mutations. BRCA and other inherited mutations, including HOXB13 and DNA mismatch repair genes, may explain why prostate cancer runs in families. Having a father or brother with prostate cancer may double a mans risk, especially if that relative was diagnosed before age 55.
Hormones: The level of male sex hormones, called androgens, may be higher in some men than others. Higher levels of androgensmainly testosteronehave been linked to a higher risk of prostate cancer. Men who use testosterone therapy are at a higher risk of developing prostate cancer, as an increase in testosterone stimulates the growth of the prostate gland.
Prostatic intraepithelial neoplasia : This condition may be associated with increased risk of prostate cancer. PIN is a condition in which prostate gland cells look abnormal when examined with a microscope. Its not necessarily linked with any symptoms. Nearly half of men will be diagnosed with PIN before age 50.
Race: Studies show that African-American men are about 70 percent more likely to develop prostate cancer in their lifetime than Caucasian or Hispanic men.
Prostate Cancer Surveillance And Clinical Trials
Men who are older or who have other life-threatening illnesses may be candidates for watchful waiting. With watchful waiting, you do not undergo frequent, invasive testing. One of the reasons for watchful waiting is a slow-growing prostate tumor can behave more like a chronic disease rather than a fatal condition. Watchful waiting is an acceptable option for any man with a low-grade prostate tumor. Your will only recommend treatment if the tumor causes bothersome symptoms, such as difficulty urinating.
Although treatment is similar for the different types of prostate cancer listed above, knowing what type and you have is important for treatment success. It helps you understand the treatment plan your doctor designs for you, and may help identify if you are eligible for a clinical trial. Trials look at new and better ways to treat prostate cancer. Many trials are specific for a particular stage, such as early stage prostate cancer or advanced prostate cancer. The trial may also consider the type of prostate cancer, such as neuroendocrine prostate cancer.
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Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
Early Signs Of Prostate Cancer
While any of the above symptoms can be your first indication that you have prostate cancer, urinary symptoms are more likely than other symptoms to appear early.
Its important to keep in mind that most of these symptoms can also be caused by other conditions that arent cancer. These conditions include benign prostatic hyperplasia and prostatitis.
So, while its important to keep tabs on any symptoms you may have, remember that theres a good chance theyre not caused by cancer.
That said, neither of these conditions causes blood to appear in your urine. If you have this symptom, call your doctor right away.
Centers for Disease Control and Prevention .
Its also because the results from the prostate-specific antigen test, which can be part of the screening, may lead to a misdiagnosis of cancer. For both of these reasons, screening could cause unnecessary worry and unneeded treatment.
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