Prostate Cancer: Signs And Symptoms To Look Out For
The changes in the USPSTF guidelines were less of a problem for urologists than primary care physicians because the American Urological Association came up with its own guidelines that suggested using the PSA to screen men 55 to 69 who had an average risk for prostate cancer, Haywood said.
Its likely that primary care physicians who need to screen for a host of different cancers werent checking the AUA guidelines.
We think some men were not getting screened, Haywood said, adding that its possible that some of those men are now being diagnosed with advanced cancer.
The solution isnt to go back to the days when men with slow-growing cancers were receiving treatments that adversely affected their quality of life, Tewari said.
We need to be smarter in using imaging, we need to minimize the number of biopsies, we need to recruit more patients for active surveillance and work together in minimizing this trend of more death and possibly more metastatic diseases at the time of diagnosis, he said.
The good news is that there have been spectacular advances in treatments, even for those with advanced cancers, said Dr. Hank Ng, a clinical assistant professor at NYU Langone Health who specializes in medical oncology. Even those with advanced cancers are living for years.
Dealing With Treatment Side Effects
Often there are unwanted and unexpected side effects that result from the various treatments for prostate cancer. These are not from the cancer itself, but from the surgery, radiation or hormone therapy or chemotherapy that are typically used to treat the disease.
All treatments will have some side effects, some short term, and some are long term. Short-term side effects tend to be common and reversible or diminishing. Long-term side effects are less common and are not always fully reversible.
Those side effects vary from person to person and as well as physical, they can also effect men psychologically and emotionally. Men about to undergo treatment should seek out information on what the potential side effects might be from their upcoming treatment.
Urinary Problems
Surgery can affect the ability to control the bladder. It can lead to incontinence or leaking urine when coughing or with a sudden movement. Radiation treatment can lead to other problems with urination.
Sometimes men who have had surgery or radiation therapy can experience a slowing of their urine stream and a feeling they are not able to completely empty their bladder. In rare cases, men who have had radiation therapy may also experience blood in the urine. Sometimes it can be due to the prostate cancer treatment, but it can also be a sign of other health issues that should be investigated.
It is important to report any changes or concerns about your urinary symptoms to your healthcare team.
Bowel Problems
Precancerous Cells And Pin
Sometimes, the results will show that precancerous cells, or prostatic intraepithelial neoplasia , are present.
If these PIN are low grade, the doctor will not consider this a matter of concern. Many males have low grade PIN. However, if the PIN are high grade, there is a chance that cancer may develop. In these cases, a doctor may suggest further tests.
If a person already has prostate cancer, the grade of the PIN does not matter, as it does not affect the severity or the Gleason score of the cancer.
Carcinoma in situ refers to cells that have the potential to become cancerous. They can occur almost anywhere in the body.
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What Happens After A Prostate Ultrasound And Biopsy
When the procedure is finished, you may resume your normal meals and daily activities, unless otherwise instructed. Some urologists may prescribe an antibiotic after the biopsy to prevent any infections, but given antibiotics only prior to the biopsy. Some men may have soreness for a few days after the procedure, which is normal. Your provider will contact you when your results are available
Comparing Mri Strategy Vs Trus Bx
For the study, 453 patients with suspicion of PCa were involved. 226 were assigned to the MRI arm, and 227 to the TRUS bx arm. This chart summarizes the findings:
Performance of MRI-guided biopsy for prostate cancer
| Mean number of positive biopsy cores per patient | 4.4 | 4.4 |
While the MRI arm had a higher detection rate of Grade group 2, it was not statistically significant. This means that the strategy of first having an MRI, and, if indicated, a follow-up targeted biopsy produced positive findings comparable to a randomized, blind 12-needle TRUS biopsy. Technically, this is called non-inferior results.
However, heres where the key differences come in. First, the average number of needles used was 6.3 for the MRI-targeted biopsy vs. 11.4 for the TRUS biopsy. Ouch! Also, the MRI biopsies picked up a far greater percent of significant PCa vs. TRUS biopsy . Another way of saying it is, TRUS biopsy missed dangerous PCa more often, while picking up many cancers that would qualify for AS.
Most important in terms of this blogs topic, MRI reduced the rate of biopsies by nearly 40%! The authors point out, Eighty-three of 221 men who underwent MRI-TB had a negative MRI result and avoided biopsy. Just think about it: their MRI scores showed they did not need biopsy. On the other hand, just over 63% of men in the MRI arm had imagine scores that warranted a biopsy, but their biopsies used far fewer needles than the standard TRUS method.
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Eating And Drinking And Taking Medicines
Having the biopsy under local anaesthetic means you can eat and drink normally before the test.
Having the biopsy under general anaesthetic means that you wont be able to eat or drink for a number of hours beforehand. You usually stop eating at least 6 hours before the biopsy and stop drinking at least 4 hours beforehand. Your team will give you instructions.
Take your usual medicines as normal, unless you have been told otherwise. If you take warfarin to thin your blood, you should stop this before your biopsy. Your doctor will tell you when to stop taking it. This is usually for 5 days before
Tell your doctor if you also take drugs that stop cells in the blood called platelets from sticking together and forming a clot. These are antiplatelets. You need to stop taking these drugs for a few days before your biopsy.
Prostate Biopsy Procedure: What You Should Know
If your doctor suspects that you have prostate cancer, they may advise you to undergo a prostate biopsy procedure. A biopsy is a standard cancer screening test that involves the careful removal of small tissue samples, which are then examined in a laboratory to determine whether they contain cancer cells or any other abnormal cells.
Here is what you should know about a prostate biopsy, including when you might need this procedure and how often it may lead to a cancer diagnosis.
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Day After The Prostate Biopsy
After your biopsy, you will have to drink many fluids so that you may provide us with two separate urine samples from two separate voids. The most common complication is blood in the urine after the biopsy. We would like to make sure that your urine is in the process of clearing before we send you home for the day. It is normal to see blood in the urine and bowel movements for 1-2 weeks after the procedure. It should progressively diminish over that time-period. If you find that, you cannot urinate or if you are passing a large number of blood clots, then report to the office or nearest emergency room for evaluation. A physician may have to insert a catheter into the bladder for a few days to allow you urine to be drained. You should continue to drink more than your usual intake of fluids to keep your urine diluted and to prevent formation of blood clots within the bladder.
If you have fever or chills, please take your temperature with an oral thermometer and call your physician if it reads above 100.8 F.
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The Importance Of Prostate Massage
Prostate massage is a treatment that addresses the root cause of most prostate issues. Treatments like surgery and medications only provide temporary relief by treating the symptoms and not the cause.
> > > Prostate Massage for Optimal Prostate Health
On the other hand, regular prostate massages encourage the gland to work without problems. A man will not be subjected to dangerous side effects from medication or complications from surgery. Massage also helps make the prostate stronger and more resistant from disease and infection.
Advantages Of Prostate Massage
Although regular prostate massage can help to eliminate or reduce the severity of any symptoms a man may have, it can also offer other benefits especially with improved sexual enjoyment and function.
It is a fact that modern medicine has not been able to determine the causes and treatments for many conditions related to the prostate. Even though prevention is the best medicine, prostate massage will help improve your prostateâs health and prevent existing conditions from becoming worse.
However, in the case of bacterial prostatitis, left untreated, can cause intense inflammation and increased bacterial growth.
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What Is Prostate Cancer Screening
The diagnosis of prostate cancer usually follows a biopsy prompted by a significantly elevated initial PSA level, an increase in PSA levels over time, or an abnormal digital rectal examination. According to JAMA, patients with a prostate cancer history benefit from extended PSA monitoring. Elevated PSA levels may help determine when to go in for a prostate MRI and hopefully avoid unnecessary or repeat prostate biopsies.
The American Journal of Mens Health reports that prostate cancer diagnosis occurs most often in men older than 50. Other factors influencing the rate of prostate cancer are ethnicity and family history. Screening is vital because localized prostate cancer sometimes causes no symptoms or warning signs.
Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
Gleason score
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What Is The Prostate Gland
The prostate gland is about the size of a walnut and surrounds the neck ofa mans bladder and urethrathe tube that carries urine from the bladder.Its partly muscular and partly glandular, with ducts opening into theprostatic portion of the urethra. Its made up of three lobes, a centerlobe with one lobe on each side.
Researchers dont know all the functions of the prostate gland. However,the prostate gland plays an important role in both sexual and urinaryfunction. Its common for the prostate gland to become enlarged as a manages, and its also likely for a man to encounter some type of prostateproblem in his lifetime.
Many common problems that dont require a radical prostatectomy areassociated with the prostate gland. These problems may occur in men of allages and include:
Cancer of the prostate is a common and serious health concern. According tothe American Cancer Society, prostate cancer is the most common form ofcancer in men older than age 50, and the third leading cause of death fromcancer.
There are different ways to achieve the goal of removing the prostate glandwhen theres cancer. Methods of performing prostatectomy include:
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Prepping Before The Procedure
At least a week before your prostate biopsy procedure, you should discuss your medications with your doctor. You may need to temporarily stop using blood thinners or nonsteroidal anti-inflammatory drugs, as these types of medication can raise the risk of bleeding complications during the procedure.
You may need to do an enema the night before your biopsy and possibly a second enema an hour or two before the procedure.
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Prostate Biopsy: How It Works
The instrument used to perform most prostate biopsies today is a spring-loaded device that pokes a hollow needle through the rectal wall to collect small samples of prostate tissue, guided by an ultrasound or MRI.
The samples are quite smalljust several times the diameter of the lead in a mechanical pencil. Later, a pathologist checks the samples under a microscope for signs of cancer.
Prostate biopsy comes with certain risks. For example, when the biopsy needle passes through the rectal wall to reach the prostate, it can spread a bacterial infection to the prostate gland or bloodstream.
How Should You Prepare For A Prostate Ultrasound And Biopsy
Preparation for a prostate ultrasound and biopsy is simple. You shouldnt take any blood-thinning medications such as warfarin , clopidogrel , aspirin or ibuprofen before a prostate biopsy because blood thinner increase the risk of bleeding. If you are already taking blood thinners, your doctor will discuss with you how many days prior to the biopsy they should be held.
Most healthcare providers dont ask you to follow any type of special diet before a biopsy. However, they suggest eating lightly before the procedure and drinking only clear liquids. Check with your providers office to see if you need to do anything additional to prepare for the test.
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When Is A Prostate Biopsy Done
Physicians may order a prostate biopsy in a few situations:
- Abnormalities in a rectal examination: General practicioners perform these physical prostate exams–during which they use a gloved, lubricated finger inserted into the rectum to look for unusual tissue growth–as part of a man’s annual check-up. When doctor feel a lump or something else abnormal during a rectal exam, they typically order a prostate biopsy.
- Elevated blood levels of prostate-specific antigen : PSA is a protein produced by the prostate. Historically, physicians believed that high PSA levels may indicate the presence of prostate cancer and ordered it as a routine screening test. However, a growing body of research has shown that high levels of PSA may be associated with other conditions, such as prostatitis. If elevated PSA is accompanied by other symptoms, a biopsy can determine whether prostate cancer is present.
Sexual Activity After A Prostate Biopsy
You may also want to wear condoms for a week or two to help prevent bacteria or other substances from irritating the areas around your rectum, perineum, or urethra.
Here are some ways you can help reduce your recovery time before and after your prostate biopsy:
- Stop taking blood thinners like aspirin or warfarin to help promote blood clotting during healing.
- Take any antibiotics a doctor instructs you to take before and after the biopsy.
- Use any enemas that a doctor instructs you to take to clean out your rectum and reduce your risk of infection.
- Consider giving a urine sample before the biopsy so that the doctor can ensure you dont have a urinary tract infection.
- Rest for a few days after the biopsy and try to stay off your feet to prevent irritation at the biopsy site.
- Consider taking a few days off work or other activities to reduce stress and movement.
- Reduce stress or anxiety to keep your body calm and promote your immune system function.
- Drink about 64 ounces of water a day to hydrate and promote healing.
- Avoid caffeine and alcohol, which can thin your blood, interfere with antibiotics, and make you pee more frequently.
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How To Prepare For The Test
Your provider will inform you about the risks and benefits of the biopsy. You may have to sign a consent form.
Several days before the biopsy, your provider may tell you to stop taking any:
- Anticoagulants such as warfarin, , clopidogrel , apixaban , dabigatran , edoxaban , rivaroxaban , or aspirin
- NSAIDs, such as aspirin and ibuprofen
- Herbal supplements
Continue to take any prescription medicines unless your provider tells you not to take them.
Your provider may ask you to:
- Eat only light meals the day before the biopsy.
- Do an enema at home before the procedure to cleanse your rectum.
- Take antibiotics the day before or on the day of your biopsy.
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Transperineal Biopsy For Prostate Cancer
A transperineal biopsy is a needle biopsy to look for cancer cells in the prostate. This helps to diagnose prostate cancer.
Your doctor puts a needle into the prostate through the skin behind the testicles . They take a number of samples, which are sent to the laboratory. In the laboratory, a specialist doctor looks at the samples under the microscope.
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