How Is Prostate Cancer Diagnosed
Screenings are the most effective way to catch prostate cancer early. If you are at average cancer risk, youll probably have your first prostate screening at age 55. Your healthcare provider may start testing earlier if you have a family history of the disease or are Black. Screening is generally stopped after age 70, but may be continued in certain circumstances.
Screening tests for prostate cancer include:
- Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum and feels the prostate gland, which sits in front of the rectum. Bumps or hard areas could indicate cancer.
- Prostate-specific antigen blood test: The prostate gland makes a protein called protein-specific antigen . Elevated PSA levels may indicate cancer. Levels also rise if you have BPH or prostatitis.
- Biopsy: A needle biopsy to sample tissue for cancer cells is the only sure way to diagnose prostate cancer. During an MRI-guided prostate biopsy, magnetic resonance imaging technology provides detailed images of the prostate.
Read Also: How Do You Massage Your Prostate
Locally Advanced Prostate Cancer
Locally advanced prostate cancer is cancer that has started to break out of the prostate, or has spread to the area just outside the prostate.
What are my treatment options?
Treatments for locally advanced prostate cancer will aim to get rid of the cancer, or to keep it under control, depending on how far the cancer has spread.
The treatment options for locally advanced prostate cancer are:
A small number of men may be offered high dose-rate brachytherapy on its own, but this isnt very common.
Choosing a treatment
Depending on how far your cancer has spread, you may have a choice of treatments. If so, your doctor or nurse will talk you through your treatment options and help you choose the right treatment for you. You might not be able to have all of the treatments listed above.
Radiation Therapy For Prostate Cancer
If your care team is considering radiation therapy as part of your treatment regimen, youll work directly with a radiation oncologist. He or she will explain the specific type of radiation therapy recommended for your cancer and answer any questions you have.
Some prostate cancer patients wonder about the safety of this treatment. Thanks to scientific advances, radiation therapy techniques have improved over the years. More precise radiation delivery techniques are designed to help spare normal tissue from exposure and reduce the severity of side effects. In addition to the external delivery of radiation, we now also have internal delivery options. In some cases, courses of radiation treatment may be more intense and shorter in duration.
The development and use of hydrogel spacersgel thats inserted between the prostate and the rectummay also reduce damage to tissue surrounding the prostate during radiation, which in turn helps to reduce treatment-associated side effects.
You May Like: Prostate Cancer And Sexless Marriage
Being Diagnosed With Prostate Cancer
Bob was diagnosed with two aggressive prostate tumours when he was 70 years old, although luckily the cancer had not spread from his prostate. His doctor recommended radiation therapy. Derek was in his late sixties when he received his diagnosis, and was thankful to know it had been diagnosed while the cancer was still contained in the prostate.
Phil had aggressive prostate cancer when he was diagnosed at just 52 years of age. In addition to hormone and radiotherapy, he was also prescribed chemotherapy. The treatment was successful and he went into remission but said that four years later, I had a scan which revealed the cancer had returned and spread to two ribs and my right thigh bone. I recommenced hormone therapy and soon went into remission again, but within nine months or so my PSA levels started rising rapidly. I again recommenced hormone therapy until the levels dropped. This time however it was decided that I would continue with my therapy despite being in remission.
The Grade Group And Psa Level Are Used To Stage Prostate Cancer
The stage of the cancer is based on the results of the staging and diagnostic tests, including the prostate-specific antigen test and the Grade Group. The tissue samples removed during the biopsy are used to find out the Gleason score. The Gleason score ranges from 2 to 10 and describes how different the cancer cells look from normal cells under a microscope and how likely it is that the tumor will spread. The lower the number, the more cancer cells look like normal cells and are likely to grow and spread slowly.
The Grade Group depends on the Gleason score. See the General Information section for more information about the Gleason score.
- Grade Group 1 is a Gleason score of 6 or less.
- Grade Group 2 or 3 is a Gleason score of 7.
- Grade Group 4 is a Gleason score 8.
- Grade Group 5 is a Gleason score of 9 or 10.
The PSA test measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer.
Recommended Reading: Life Expectancy After Prostate Cancer Treatment
Signs And Symptoms Of Prostate Cancer
Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:
- Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
- Trouble getting an erection
- Pain in the hips, back , chest , or other areas from cancer that has spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord
Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
What Affects My Treatment Options
Your treatment options will depend on whether your cancer is contained within the prostate gland , has spread just outside of the prostate or had spread to other parts of the body .
You may have a choice of treatments. Your doctor or specialist nurse will explain all your treatment options, and help you to choose the right treatment for you.
Your treatment options and which treatment you choose may depend on several things, including:
- how far your cancer has spread
- how quickly your cancer may be growing
- the advantages and disadvantages of each treatment
- what each treatment involves
- the possible side effects of each treatment
- practical things, such as how often you would need to go to hospital, or how far away your nearest hospital is
- your own thoughts about different treatments
- how the treatment you choose now could affect your treatment options later if your cancer comes back or spreads
- your general health
- how long youre expected to live for.
The first treatment you have may affect which treatments you can have in the future, if you need further treatment. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. And to take someone to appointments, such as your partner, friend or family member.
Listen to a summary of this page
Technically Challenging Procedure Offers New Option
Doctors perform prostate artery embolization by inserting a catheter into the femoral artery in the thigh. They direct this tube to the prostate artery on both sides of the enlarged gland.
The doctors then inject a fluid containing thousands of tiny particles into the catheter. These block the small blood vessels of the prostate and starve it of its blood supply.
The procedure itself is technically challenging. As a result, its carried out by interventional radiologists, who have experience using small catheters and other techniques for blocking arteries.
According to the researchers, accessing the prostate through the femoral artery may be the reason for the low number of side effects.
Also, currently used techniques may not be available to all men.
Many men have benign prostatic hyperplasia that cannot be treated by traditional methods, said Bagla, such as when the BPH is smaller than 50 cubic centimeters or larger than 80 cubic centimeters.
Prostate artery embolization offers these patients an effective treatment that results in reduced risk of bleeding, urinary incontinence or impotence, compared to other BPH therapies, offering patients a better quality of life, he added.
Earlier studies of prostatic artery embolization included two presented at the Society of Interventional Radiologys Annual Scientific Meeting in 2012 and one study in 2014. All three of those studies showed that the technique was effective with few side effects.
You May Like: Proton Therapy For Advanced Prostate Cancer
What Is Proton Beam Radiation Therapy
This type of therapy treats tumors with protons instead of X-ray radiation. It may be able to deliver more radiation specifically to a prostate cancer tumor with less damage to normal tissue.
Proton beam therapy might be a safe treatment option when a doctor decides that using X-rays could be risky for a patient. But so far, research hasnât shown that it works better than traditional radiation therapy against solid cancers in adults.
The side effects of proton beam therapy are similar to the ones that other types of radiation treatment bring on. But since proton therapy may be less damaging to normal tissue, the side effects might be milder.
After treatment, you may gradually have ones like:
- Fatigue or low energy
- Sore, reddened skin around the area where you got treated
- Hair loss around the treatment spot
One of the disadvantages of proton therapy is that it might not be covered by all insurance companies. Youâd need to check with your health plan to find out.
Proton therapy also isnât widely available. You can get it only at certain centers in the U.S.
Ideas For Future Studies Of Proton Therapy
Despite the studys limitations, these intriguing findings raise questions that should inform future prospective phase 3 trials, Dr. Buchsbaum said, although there are barriers to large studies of proton therapy.
For instance, it is particularly encouraging that proton therapy appeared to be safer in a group of older and sicker patients who typically experience more side effects, Dr. Baumann noted.
Dr. Buchsbaum agreed that proton therapy may be especially helpful for older and sicker patients, but he noted that ongoing phase 3 trials were not designed to analyze this group of patients.
And because proton therapy may cause fewer side effects, future trials could also explore whether combining proton therapy with chemotherapy might be more tolerable for patients, the authors wrote.
For example, both chemotherapy and traditional radiation for lung cancer can irritate the esophagus, making it painful and difficult for patients to eat. But proton therapy might limit damage to the esophagus, making it easier for a patient to tolerate the combination, Dr. Baumann explained.
Future studies could also explore whether combining proton therapy with higher doses of chemotherapy might increase cures without causing more side effects, he added.
Dr. Buchsbaum agreed, saying that it would be worthwhile to explore this possibility. Just asking the question: Is more effective? might not be giving it a fair opportunity to demonstrate its benefit to society, he said.
Recommended Reading: Can Advanced Prostate Cancer Be Cured
What Are The Results Of Using Proton Therapy In Patients
For patients facing prostate cancer, treatments and side effects present unique challenges in choosing a therapy. Proton radiation for prostate cancer treats the disease with successful outcomes and a low risk of side effects.
For thousands with cancer of the prostate, proton therapy has offered an effective, virtually painless option for prostate cancer treatment. Since the University of Florida Health Proton Therapy Institute opened in 2006, thousands have undergone proton therapy for prostate cancer, and prostate cancer patients at the UF Health Proton Therapy Institute enjoy a close-knit community of fellow patients, caregivers and spouses. Today, prostate cancer is one of many types of cancer treated at the Institute.
Prognosis For Prostate Cancer
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each persons individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of prostate cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.
Prostate cancer often grows slowly and even more aggressive types tend to grow more slowly than other types of cancer. If diagnosed early, prostate cancer has one of the highest five year survival rates.
You May Like: Does Not Ejaculating Cause Prostate Cancer
Side Effects Of Suppressing The Male Hormone Testosterone
Phil, Bob and Derek all started their prostate cancer treatment with hormonal therapy to reduce their testosterone levels. My doctor explained that before I could commence radiation therapy they had to reduce the size of my prostate which would be done with two lots of hormone therapy that starved the prostate of testosterone, Derek said.
Testosterone is fertiliser for prostate cancer, so I needed injections to reduce my testosterone levels before I could start radiotherapy, said Bob. I was given two injections of a testosterone-suppressant before I started radiotherapy. I had the first injection in August 2013 and the second in late November 2013. During this time my testosterone levels halved.
Testosterone is the male hormone and plays an important role in developing the characteristics we associate with male bodies, things like body and facial hair and a deep voice. It also regulates mens sex drive and sperm production. So reducing testosterone levels often causes changes in sex drive, body shape and male features.
Although Phil, Bob and Derek were given similar testosterone suppressing medications, they all experienced very different side effects.
The hot flushes mostly occurred first thing after waking in the morning. They were similar to a rush of perspiration over my whole body. As they occurred after I woke up the discomfort went away very quickly. Although I have noticed that I still sometimes break out in perspiration after my first morning coffee.
After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body
The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.
The following tests and procedures also may be used in the staging process:
Read Also: Psa In Bph And Prostate Cancer
Don’t Miss: Best Thing For Healthy Prostate
Questions To Ask Your Doctor Or Nurse
You may find it helpful to keep a note of any questions you have to take to your next appointment. If youre choosing a treatment, you might find it helpful to ask your doctor or nurse some of these questions.
- What treatments are suitable for me?
- How quickly do I need to make a decision?
- What are the advantages and disadvantages of each treatment? What are their side effects?
- How effective is my treatment likely to be?
- Can I see the results of treatments youve carried out?
- Is the aim to keep my prostate cancer under control, or to get rid of it completely?
- If the aim of my treatment is to get rid of the cancer, what is the risk of my cancer coming back after treatment?
- If the aim of my treatment is to keep the cancer under control, how long might it keep it under control for?
- What treatments and support are available to help manage side effects?
- Are all of the treatments available at my local hospital? If not, how could I have them?
- After treatment, how often will I have check-ups and what will this involve? How will we know if my cancer starts to grow again?
- If my treatment doesnt work, what other treatments are available?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?