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What You Need To Know About Prostate Cancer

What Do Other Groups Think

What you need to know about prostate cancer screening

The American Cancer Society is also in the talk to your doctor camp.

Because research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment, it says, men should discuss the pros and cons of PSA screening starting at age 50 .

Even the American Urological Association, which practically accused the task force of killing men with its not recommended conclusion of 2012, says routine PSA screening is not advised for men younger than 54 or older than 70. For those 55 to 69, it recommends shared decision making talk to your doctor, understand the risks and benefits and the odds that youll be better off and biannual rather than yearly screening for men who opt in.

How Common Is Prostate Cancer

About 1 in every 8 men in the United States will be diagnosed with prostate cancer.

Prostate cancer accounts for 14% of all new cancer cases in the United States.

The incidence rates for prostate cancer declined in the late 2000s and 2010s, partly due to screening guidelines that resulted in less testing. From 2014 to 2018, the incidence rates remained steady for widespread and local-stage diseases but increased by 4% to 6% each year for advanced-stage prostate cancer.

Why Did The Task Force Back Off Its 2012 Thumbs

Dr. James Eastham, a prostate cancer surgeon at Memorial Sloan Kettering Cancer Center, welcomed that. This is a reasonable step back from the previous we dont recommend routine PSA screening,’ he said. But its true that everyone shouldnt be tested, and that many men with an elevated PSA dont have cancer at all or, if they do, that cancer doesnt pose a risk to his life.

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Genetic Testing For Prostate Cancer

You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.

Terms You May Become Familiar With Will Include:

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  • staging, as doctors look to identify the stage of prostate cancer or how far it has spread
  • watchful waiting, which is essentially delaying potentially invasive treatment to see if the cancer or symptoms actually develop
  • active surveillance, to find any signs of progression as early as possible via undergoing regular PSA tests, MRI scans and biopsies

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Screening And Early Detection

Screening is performed to detect cancer before it causes symptoms. Catching prostate cancer early can result in a more favorable outlook. Healthcare providers may be able to treat the cancer before it spreads to other places in the body.

Some methods used to screen for prostate cancer include:

  • Prostate-specific antigen test: This test measures the level of PSA, a substance made by the prostate, in the blood. Men with prostate cancer may have higher PSA levels than those without. Healthcare providers may recommend a biopsy if a mans PSA is elevated or abnormal.
  • Digital rectal examination : During a DRE, healthcare providers insert a lubricated, gloved finger into a mans rectum to feel the prostate to detect any abnormalities.

Recommendations about prostate cancer screening include:

  • Men between the ages of 55 and 69 should make an individual decision about being screened with a PSA test.
  • Before the screening, men should talk to their healthcare providers about the benefits and risks.
  • Men 70 years or older should not be screened for prostate cancer on a routine basis.

Whats The Purpose Of A Transrectal Ultrasound

A transrectal ultrasound is a procedure that produces an image of the prostate. Its usually ordered after an abnormal PSA and DRE. For the test, a small probe is inserted into the rectum. The probe then uses sound waves to produce a picture on a computer screen.

The test is uncomfortable, but not painful. It can be done in your doctors office or on an outpatient basis in about 10 minutes. It can help estimate the size of the prostate and spot abnormalities that may indicate cancer. However, a TRUS cant confirm the diagnosis of prostate cancer.

A TRUS can also be used to guide a biopsy.

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With Psa Testing Cancer

Google keeps track of what is searched most frequently. Since prostate cancer is common, its hardly surprising that people who research aches or pains down there in the lower part of the abdomen search for symptoms of prostate cancer.

The most commonly googled question related to prostate cancer is, What are the symptoms? Given whats published online, however, you would think that prostate cancer has all sorts of symptoms: urinary problems, pain, sexual difficulties, even rectal problems. The truth is that in this modern era of PSA testing, prostate cancer has no symptoms whatsoever! Prostate cancer is a totally silent process unless it is very advanced.

Treating Prostate Cancer At Washington University

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Prostate cancer is one of many cancers actively treated by Washington University Physicians at Alvin J. Siteman Cancer Center, where our mission is to prevent cancer in the community and transform cancer patient care through scientific discovery. The combined expertise and experience of our researcher-physicians reduces the cancer burden regionally and nationally. Our program has developed from an intimate partnership with Washington University School of Medicine and Barnes-Jewish Hospital, institutions recognized for their medical excellence.

Patients who come to the Siteman Cancer Center for treatment of prostate cancer are seen by a team of Washington University Physicians surgical, medical and radiation oncologists often during the same visit.

Siteman Cancer Center has an online tool that helps patients assess their cancer risk and suggest ways to lower it. This tool is available at

Contact us for an appointment by filling out the appointment request form. Newly diagnosed patients also may call the registered nurses in our Patient Care Coordination Center, toll-free at 800-600-3606 from 8 a.m.-4:30 p.m. weekdays.

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What About Other Treatments I Hear About

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

How Serious Is My Cancer

If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.

The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.

If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.

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You Can Take Action Now To Reduce Your Risk Of Prostate Cancer Later On

You cant control your genes or what the future may hold. But you can take steps to reduce your risk of prostate cancer through lifestyle choices. For starters:

  • Maintain a healthy diet. A diet full of fruits, vegetables, whole grains, lean proteins and healthy fats can contribute to your overall health.
  • Exercise regularly. Exercise not only improves your physical health, but also your mood and mental health. Plus, there is some evidence that men who exercise are at a lower risk of developing prostate cancer.
  • Try to maintain a healthy weight. Obesity is a risk factor for prostate cancer.
  • Talk proactively with your doctor about your risk for prostate cancer. If youre over 40 and havent discussed your risk level with your doctor or urologist, I suggest you make an appointment. Depending on your risk factors, you and your doctor can work together to create an action plan that works best for you, which may include a prostate cancer screening.

Also, if youve been experiencing any unusual urinary or erectile symptoms, dont ignore them. Make a primary care appointment, for starters.

Your doctor will talk with you about your symptoms, answer your questions and recommend treatment next steps if needed. They may also recommend you see a urologist like me. Urologists are experts in urinary and male reproductive health, including prostate cancer diagnosis and treatment.

When Should I See My Doctor

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See your doctor if you notice any unusual or ongoing changes in your toilet habits . Most often, these wont mean you have cancer, but finding cancer early improves the odds of treating it successfully.

If you dont have any symptoms but are concerned about your risk, your doctor can also explain the risks and benefits of prostate cancer screening, such as having a PSA test.

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Prostate Cancer Is Slow

Sometimes. Other times, prostate cancer spreads quickly and can kill. And it’s hard to predict what a man’s cancer will do.

Because experts can’t always tell if a man’s cancer will be aggressive, many men who are diagnosed face a difficult choice: a treatment that might not be needed and could leave them with life-changing side effects, or to watch and wait and hope the cancer doesn’t spread and need treatment. And men often have to make a choice between other treatments, which each have different pros and cons.

Our Specialist Nurses support men facing tough treatment decisions, and we produce award-winning health information to help them navigate complex medical issues.

You can help us be there for men when they need support by volunteering, donating, or marching with us.

What To Expect With A Screening

The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early. There are two tests that are commonly used to screen for prostate cancer: a blood test called a prostate specific antigen test measures the level of PSA in the blood and a digital rectal examination. A biopsy of a small piece of tissue that is removed from the prostate may be indicated for diagnosing prostate cancer.

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A Suggested Psa Screening Protocol

Its reasonable to start checking PSA yearly in men over the ages of 45. Men with a family history of prostate cancer or men who are African-American should start annual testing at age 40. Men over age 75 who are in good health should continue screening.

So what is the trigger level of PSA that should lead to performing a scan? As noted above, younger men who have small prostate glands should consider doing a scan if the PSA is over 2.5. In an older man, particularly if the prostate gland as determined by the finger exam is big, a PSA over 4.0 is a reasonable threshold for obtaining imaging . The PSA blood test has far surpassed the wildest dreams of the doctors who discovered it. Like any powerful tool, however, misuse can lead to over-treatment and unnecessary harm.

So much of the misinformation on the internet implies that every ache, pain, or problem located near the prostate could be caused by cancer. The fact that the most frequently asked question related to prostate cancer is about prostate cancer symptoms indicates that the public is being led into all kinds of unnecessary anxiety.

Know this: As long as the PSA is in the normal range, in general, men can rest assured that any prostate-related symptoms they are experiencing are most likely originating from something unrelated to cancer. PSA testing detects early stage prostate cancer so reliably that when the PSA is normal, one can be sure that any prostate-related symptoms are due to some other cause.

What To Do If You Are Diagnosed With Prostate Cancer

What you need to know about prostate cancer

Aforementioned is evidence that cancer of this kind may not be detected until it starts causing ultimate damage. It is important to know your options. Be sure to consult your doctor as soon as you suspect that you or a loved one may have cancer. Having routine checkups are of immense importance, as they can help you catch the disease early.

If you are in the late stages of prostate cancer, let All American Hospice shoulder some of your burden. We offer 24/7 home service and palliative care to help ease the draining process of being diagnosed with cancer.

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Are There Complications Of Prostate Cancer And Treatment

Treatments can cause side effects, including:

  • Erectile dysfunction: More than 3 in every 4 men have problems with getting and keeping an erection after surgery. However, this can be minimised using nerve-sparing surgery techniques. Erectile dysfunction is also common after radiation therapy and ADT. There are effective treatments for erection problems.
  • Poor bladder control : 5% to 10% of men have problems with urine leakage within one year after prostate removal.
  • Urinary urgency: Radiation therapy can cause damage around the prostate, making you feel like going to the toilet more often.

Men who take ADT may also experience a reduced sex drive and hormone-related effects such as hot flushes, tiredness and sweating, loss of body hair and osteoporosis. ADT can also result in reduced muscle strength, an increased risk of getting heart disease and memory loss.

Can Prostate Cancer Treatment Affect Your Quality Of Life

Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before youre treated, especially urinary, bowel or sexual function problems, will affect how you recover. Men can experience urinary incontinence or erectile dysfunction as a result of surgery or radiation therapy.

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What Are Common Risk Factors For Prostate Cancer

As I mentioned earlier, I most commonly see prostate cancer in men over 60. And like many other types of cancer, prostate cancer risks increase as you get older. Other risk factors can include:

  • A family history of prostate cancer If you have a close family member, such as a father or brother, with prostate cancer, youre 2 to 3 times more likely than other men to develop prostate cancer .
  • Genetics Many of my patients often ask if prostate cancer is hereditary. Hereditary prostate cancer does exist, but only 5 to 10 percent of all prostate cancers are hereditary due to a single inherited gene mutation.
  • Race Black men are at a higher risk of prostate cancer than men of other races, and were not sure why.
  • Obesity Obese men who are diagnosed with prostate cancer may be more likely to have an advanced cancer thats more difficult to treat.

What Is Prostate Cancer

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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

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.

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