What Percentage Of Men Will Get Prostate Cancer

What Are The Stages Of Prostate Cancer

Cancer staging is first described using what is called a TNM system. The T refers to a description of the size or extent of the primary, or original, tumor. N describes the presence or absence of, and extent of spread of the cancer to lymph nodes that may be nearby or further from the original tumor. M describes the presence or absence of metastases usually distant areas elsewhere in the body other than regional lymph nodes to which the cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patients PSA score at presentation as well as their Gleason score in assigning a final stage designation.

The American Joint Commission on Cancer system for prostate cancer staging is as follows:

Traditionally, advanced prostate cancer was defined as disease that had widely metastasized beyond the prostate, the surrounding tissue, and the pelvic lymph nodes and was incurable. However, a more contemporary definition includes patients with lower grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.

The National Cancer Institute and the National Comprehensive Cancer Network guidelines on prostate cancer version 2.2017 indicate the following:

What Are The Statistics For Prostate Cancer

• The rate of prostate cancer is higher in African-American men than white men. African-American men are also more than twice as likely to die from prostate cancer. The reasons why are not known. But some risk factors may play a part, such as differences in genes.

• About 164,690 men in the U.S. will get prostate cancer in 2018. It is the most common cancer in men, not including skin cancer. Nearly 2 out of 3 of these men will be age 65 or older.

• Prostate cancer is the second leading cause of cancer death in men in the U.S. after lung cancer. About 29,430 men will die of prostate cancer in 2018.

Tests To Predict Prostate Cancer

The PSA test was carried out in a standard fashion at the clinical laboratory of the Erasmus University Medical Centre. The PCA3 test was done at the laboratory of experimental urology at Radboud University Nijmegen Medical Centre. Measurements of the 4k-panel, consisting of four markers , were performed in the Department of Laboratory Medicine at Lund University on stored serum samples . Separate marker values as well as an overall 4k-panel predictor were derived using a prespecified formula . The formula was a mix of linear terms and nonlinear spline transformations of the four markers. A specialised pathologist handled the histologic examinations of the biopsy specimens.

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Everyone Older Than 60 Has Cancer

Doctors are finally realizing that most people have cancer in their body. But its latent or hidden cancer. Latent cancers are so well contained by the immune system that they never get large enough to cause problems. As a result, doctors rarely discover them, unless they discover them by accident. Most of the cancers they discovered in this autopsy study were latent cancers. And, as you can see, they are very common.

Autopsy studies on women, for example, show that by the time a woman is 40 years old, the chance of her having a latent breast cancer is 40 percent.

That sounds terrible, doesnt it? Its really not terrible. In fact, the existence of latent cancers is very reassuring. They clearly demonstrate how effective a healthy immune system can be in stopping cancer.

Its so effective that the great majority of latent cancers never go on to become full-blown cancers. Thats good news. When you start to add up all of the various autopsy studies that are published, you soon realize that every single one of us over the age of 60 has cancer. Actually, we have at least two of these cancers already living in our bodies. But the really important thing about latent cancers is that they can teach us a lot.

The first thing they teach us is that by maintaining a healthy immune system, we can dramatically decrease our chances of dying from cancer.

Whats the best way to do this?

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Types Of Prostate Surgery

There are several different approaches to prostate cancer surgery and they can be performed in a variety of ways. The type and extent of your surgery will depend on how aggressive your cancer is and whether it has spread beyond your prostate.

Radical prostatectomy is when your surgeon removes the whole prostate gland. If cancer has spread, your surgery may extend beyond your prostate and include the surrounding lymph nodes.

There are several types of surgery available when you need to have your prostate gland cut, partially removed or removed, each with its own benefits.

Open retropubic surgery

Your surgeon makes a 10cm incision in your abdomen, then removes the entire gland. If you have very aggressive prostate cancer, some of the surrounding lymph nodes may also be removed for testing. Your surgeon may not continue the surgery if they discover that your cancer has already spread.

Keyhole surgery

Your surgeon accesses your prostate gland by inserting instruments through several small incisions in your abdomen. Keyhole prostate surgery is usually done robotically: miniature robotic arms, controlled by your surgeon, are inserted through the incisions. It has similar benefits to traditional non-robotic surgery, but the procedure tends to cost more because of substantial out-of-pocket costs from your surgeon.

Nerve-sparing surgery

Other surgeries for prostate cancer

Open perineal surgery

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How To Choose Between Different Types Of Prostate Cancer Surgery

I frequently see patients who have been diagnosed with prostate cancer, have decided on surgery, but are struggling with the choice of different types of surgery. Increasingly, there can be a choice, especially if patients seek opinions from two or three different urologists . A common scenario might be: the patient sees a doctor who argues robotic prostate cancer surgery is superior to other approaches. He might see another specialist who argues that a laparoscopic prostatectomy remains the gold standard the best minimally invasive approach. A third consultant might advise him that his best chance of maintaining his usual erections would be open surgery. Who to believe?

The only way to understand this variety of approaches and the marketing behind them is to look at how they each developed. In the UK, up until 2000, the only prostatectomy on offer was via open surgery. Thereafter, a small number of surgeons, myself included, started to carry out prostatectomies using a laparoscopic approach. The number of surgeons was relatively small because this is a technically difficult operation to perform. Compared with, for example, removing a gall bladder, reaching and safely removing a prostate laparoscopically is very challenging. However, I felt there were clear benefits of keyhole surgery for patients in terms of post-operative recovery and performed many hundreds of laparoscopic operations.

What Determines Erection Recovery After Surgery

The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.

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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.

The Decision Was Easier After The Test

One of the patients who underwent an “oncotype prostate” test after being diagnosed with the disease is Dr. Petar Yosifov. An orthopedic surgeon by profession, 60 years old, who lives in Kiryat, married and the father of three grown children. Yosifov discovered the disease last March randomly after his fever rose and the family doctor sent him For blood tests that also included diagnosing prostate cancer markers, the results clearly showed that he had the disease.

“After the results arrived, I began an investigation, including an MRI and a biopsy, and after that I came to Dr. Dekel, who recommended performing a prostate oncotype test because, according to the test, a more accurate decision can be made regarding continued treatment,” says Petar, who, as mentioned, is a doctor in his profession and understands the importance of the in-depth investigation. “According to the result of the test, we decided that it would be better to do a radical prostatectomy, because the chance of finding an aggressive tumor was high.

After I received results from the biopsy of the surgery to remove the entire tumor and the prostate, which was conducted only about two weeks ago, we saw that the situation was even more serious and the prostate oncotype test correctly predicted the prostate situation.”

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Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a persons quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

• A PSA test every 3 to 6 months

• A DRE at least once every year

• Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

Why Does It Take So Long To Recover Erections After The Very Best Surgery

A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.

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Prostate Cancer In Central America/caribbean

Among the Central American countries, Costa Rica leads with an ASR of 53.8 cases per 100,000 people, followed by Mexico and Cuba with 28.9 and 24.3 cases per 100,000 people respectively . Unfortunately, epidemiological data are scarse for those regions. Trends are available only for Costa Rica which showed an annual increase in incidence of 3.8% per annum over the period 19972008. ASR on mortality put Belize at first place with 28.9 cases per 100,000 people followed by Cuba and Mexico with 24.1 and 17.0 cases per 100,000 people for the period 20032010, respectively. Costa Rica stops at 14.8 cases per 100,000 people . The most recent data on Central America published by GLOBOCAN 2020 shows an ASR incidence of 43.8 and mortality of 11.0 cases per 100,000 people . No active screening program are currently in place in Central America. Between 2004 and 2006, in Monterrey a screening program was run, using PSA and DRE screening of 973 men, 40 years of age, showed that only 44% of the men who had an abnormal result underwent prostate biopsy, and 27% of these were diagnosed with prostate cancer, mostly with high grade lesions .

See Your Doctor Regularly

Prostate cancer screening recommendations differ depending on whether youre in a high-risk or average-risk group.

High-risk men should consider getting screened for prostate cancer starting at age 40. Men at normal risk can delay screenings until age 55.

The bottom line? A healthy lifestyle can greatly decrease your risk of developing prostate cancer. Eat right, stay active and see your doctor for early detection.

One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. Send questions to [email protected], call 321-751-6771 or visit One Senior Place, The Experts in Aging.

Lisa Conway is a Registered Nurse and a Certified Care Manager for Senior Partner Care Services, Viera.

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Management Of Erectile Dysfunction

About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.

Who Gets This Cancer

Prostate cancer occurs only in men, and it is more common in older men than younger men. It is more likely to occur in men with a family history of prostate cancer and men of African American descent. The rate of new cases of prostate cancer was 112.7 per 100,000 men per year based on 20152019 cases, age-adjusted.

Rate of New Cases per 100,000 Persons by Race/Ethnicity: Prostate Cancer

Males

SEER 22 20152019, All Races, Males

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Myth: If The Cancer Comes Back It Cant Be Treated Again

Fact: Recurrence of prostate cancer can be wrenching. But just because a cancer comes back doesnt mean you cant reach remission again. What it does mean is that youll likely have to try another approach to treatment.

Your first cancer cure is always the best, says Sartor. But you do have a possibility for cure if it comes back particularly if youve had an initial radical prostatectomy, in which case if you catch early, you can radiate and get a pretty good cure rate.

Sartor adds that one of the reasons he often recommends surgery before radiation is for this reason so that people get a second chance at cure if the cancer comes back and they monitor their condition appropriately.

Prostate Cancer Treatment Options: What Are They

Prostate cancer is, most often, a slow-growing cancer.

For some men, prostate cancer causes no symptoms or long-term issues, so treatment isnât necessary.

In these cases, doctors may recommend active surveillance. That is, theyâll keep an eye on the development of the tumor using various tools and tests, including:

• Digital rectal exams
• Transrectal ultrasounds
• Prostate biopsies

Men who require treatment for their condition are most often treated with surgery, radiation therapy, hormone therapy, or a combination of these modalities.

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Risk Of Prostate Cancer

About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.

Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men at diagnosis is about 66.

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The findings leave little doubt about the importance of informed decision making and the need for physician-patient discussions prior to deciding a course of action for early-stage prostate cancer, said Dr. Otis Brawley, chief medical officer for the American Cancer Society in Atlanta.

I think that this whole paper is a huge cry that we need to make sure that people are informed and are taking part in their treatment decisions, Brawley told MedPage Today.

The lower rate of regret among men on active surveillance might also reflect on the informed decision-making process, although the study did not specifically examine that issue, he added.

In the United States, its almost impossible to put someone on observation, after you have told them they have cancer, and not inform them, the way I think someone should be informed, said Brawley. Its very easy to tell someone you have cancer and were going to do a radical prostatectomy next Monday and not inform them. It may very well be that the people who got observation were more fully or better informed and better understood what they were facing, compared with the people who got aggressive therapy.

A study reported earlier this year reinforced the need for informed decision making based on physician-patient discussions about treatment options. The study showed high rates of regret among men who relied primarily on internet-based information about prostate cancer treatment to decide how their own disease should be treated.

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