Monitoring And Pharmacologic Therapy
Ordinarily, in patients in whom only a single focus of PIN, particularly HGPIN, has been identified, therapy may not be necessary. In patients with multiple areas of HGPIN or ASAP on the initial biopsy or on subsequent biopsies, therapy may be considered, as the risk of cancer in these patients is 15 times that in patients without these entities. Prostate cancerprevention studies indicate that 5-alpha reductase inhibitors, antiandrogens, and selective estrogen receptor modulators are usually not effective in eliminating HGPIN and ASAP,. .
Figure 1 Location Of The Prostate Gland
This location creates challenges in both diagnosis and treatment. During a digital rectal exam, for example, a doctor is able to feel only the back portion of the prostate. If cancer has developed in the apex, base, or deep inside the prostate, it may not be palpable.
As you evaluate treatment options, Id suggest that you think not only about your situation today, but also about where you expect to be in five or 10 years because chances are, youll still be alive. And you need to be sure that you would make the same treatment decision five or 10 years from now as you will right now.
Will you be able to deal with impotence if it occurs? What about incontinence ? How will the possible side effects of treatment affect your relationship with your wife or significant other and your very sense of self? Its vital to really think about these issues: In my experience, truly informed patients are much better able to deal with adverse consequences than patients who are uninformed or rush into making a decision.
Its also important to understand the limits of current medical knowledge about prostate cancer.
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What Causes A Prostate Nodule
A nodule is a lump or area of hardness under the surface of the prostate. In some cases, a prostate stone, which is similar to a kidney stone, can be felt under the surface. It may seem like a nodule, but its really a tiny formation of calcified minerals. A stone is usually harmless. A true prostate nodule is an abnormal growth of cells that may or may not be cancerous.
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
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Has The Radiotracer Used In Psma Pet Scans Been Approved By The Fda
The radiotracer piflufolastat, also known as Pylarify, is safe and FDA-approved. Side effects are rare and temporary and may include headache and a change in taste. Piflufolastat is a radionuclide dye, so it contains a small amount of radiation. The amount is similar to the exposure you receive during a CT scan and the tracers radioactive element is entirely gone from your body within a few days.
Is Prostate Cancer Curable
Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.
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What Is Intermediate To High
Although surgery is an effective treatment option for early stage prostate cancer, it becomes less effective as the risk of cancer having spread beyond the prostate increases. It is difficult for surgeons to completely remove the cancer once it has grown beyond the confines of the prostate gland. Several factors can potentially identify patients who are at a higher risk for having cancer outside the prostate.
These can include any of the following:
- A nodule felt to occupy half of the prostate gland or more on physical exam
- A biopsy showing a more aggressive tumor, with a Gleason score > 6
- A biopsy showing cancer invading around the small nerves in the prostate
- Multiple positive prostate biopsies
What Is Prostate Cancer
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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Figure 2 Why Understaging May Occur
When the prostate is removed, a pathologist examines slices of the gland for evidence of cancer. A. Under a microscope, the pathologist can distinguish tiny tumors, consisting of clumps of visibly abnormal cells. B. With current imaging technology, it is not yet possible for a pathologist to identify micrometastases individual cancer cells shed from the primary tumor that have gone on to seed adjacent tissue. In this image, for example, cancer cells have already penetrated the capsule and migrated to adjacent tissue, even beyond the margin of tissue removed during surgery.
Individual prostate cancer cells can spread to more remote areas of the body in three ways . Whats more, they can do so without being detected with our current technology, essentially escaping under the radar. So its always possible even if you are diagnosed with early-stage prostate cancer that the cancer has already spread and will manifest in the coming years. How likely is it that an early-stage prostate cancer will become active without treatment? A small study provides some clues .
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is very common in men above the age of 40 and can cause the urinary tract to be obstructed. Unlike prostate cancer, BPH is not cancerous nor is it fatal. As you age, your testosterone levels increase, which, in turn, causes your prostate to grow in size or become enlarged.
During a physical exam, if you have BPH, your doctor will notice your prostate feels larger than it should be. Your PSA tests will also come back elevated. Whereas in prostate cancer, the sides of the prostate are usually affected, in BPH the central portion of the prostate is usually affected. Also, unlike cancer, BPH cannot spread.
The most common symptoms of BPH include urinary symptoms such as frequency of urination, hesitancy, dribbling, and frequent nighttime urination. Depending on the severity of your symptoms, treatment can range from nothing to medication to shrink the prostate, or surgery to remove the central part of the prostate to allow better flow of urine.
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When Is A Prostate Nodule A Nodule And Do Nodules Always Mean Prostate Cancer
Question: I have a 70 yo friend with a strong fam hx of prostate cancer his father died of it. Despite a psa of 1.2, he recently had a nodule felt by his family doctor and his urologist on dre, which was followed by a biopsy that was negative no cancer, and nothing else unusual found. His urologist told him yearly exams were all he needed at this point. Would you be more aggressive? Please explain.
The term nodule is used a bit broadly and even I in yesterdays video with Penelope spoke of a nodule in broad strokes.
So what to do?
In the above case the likelihood is that the palpable abnormality was something other than cancer and the negative biopsy is very encouraging. Now that we have a normal PSA, a normal biopsy and a slightly atypical exam the goal is to monitor and consider repeating a biopsy if any of the parameters change. Whether this is done on a six month basis or yearly depends on several factors to include the age and health of the patient, the anxiety mentality, and the comfort level of the urologist. In this case the patient could easily ask his family doctor to get a PSA at six months to assure that it is not changing dramatically and to provide comfort that the plan is adequately checking on things.
What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
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How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects everyone in different ways. Some men can manage mild symptoms and dont need treatment. Others find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
What Is A Prostate Nodule
The prostate nodule is defined as a lump or area of hardness under the surface of a mans prostate.
In some instances, a patient can have prostate stone under the surface of the skin, and although it may seem like a nodule, its not the same thing as nodules are more like tissue masses.
While prostate stone is harmless, even though its uncomfortable, nodule represents an abnormal growth of cells, which may or may not be cancerous in nature.
Understanding there is a lump on the prostate is a primary source for concern among men, but you shouldnt panic. Instead, schedule an appointment to see your doctor who will perform specific diagnostic tests to see whats going on.
The best way to stay on top of everything is to go to regular checkups even if you have the normal prostate.
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Are Prostate Nodules A Sign Of Cancer
Curated by Claudia Shannon / Research Scientist / ishonest
Overview
If your doctor tells you that your prostate exam revealed a nodule on your prostate, your first thought may be that its a sign of cancer. But a nodule or other changes to your prostate dont necessarily mean you have cancer. Keep reading to learn more about prostate nodules.
What causes a prostate nodule?
A nodule is a lump or area of hardness under the surface of the prostate. In some cases, a prostate stone, which is similar to a kidney stone, can be felt under the surface. It may seem like a nodule, but its really a tiny formation of calcified minerals. A stone is usually harmless. A true prostate nodule is an abnormal growth of cells that may or may not be cancerous.
Nodule vs. tumor
You may hear the terms nodules and tumors used interchangeably. For the most part, they mean the same thing: an abnormal growth of cells.
A nodule is typically used to describe a very small mass of cells, while tumor generally refers to a larger growth. Doctors also tend to use tumor when describing a cancerous growth, though the phrase benign tumor is also used sometimes. If youre ever unsure about a phrase your doctor uses, stop and ask for clarification.
Benign vs. malignant
A malignant prostate nodule is cancerous. That means that cells in a malignant nodule or tumor can spread into nearby tissue and organs.
Will a prostate nodule cause symptoms?
Additional tests
Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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The Initial Causes Prostate Nodules Always Cancer
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
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Prostate Cancer Treatment Side Effects
If you happen to be diagnosed with intermediate or high risk prostate cancer, ask carefully about treatment side effects such as incontinence and impotence. Your personal preferences with consideration to age and other health factors play an important role when making your final decision about treatment.
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Diagnostic Tests Are Limited
We always knew that prostate cancer is common and that, until recently, it often went undiagnosed: Autopsies of men who died of other causes have shown that about one-third of men over age 50 have some cancerous cells in their prostate, while 90% of men over age 90 have such cells.
As PSA screening has grown more widespread, we are finding more tumors that otherwise would have escaped detection. Yet current diagnostic technology does not always enable urologists to determine which tumors will lie dormant and which will become active, spreading elsewhere in the body.
Studies estimate that anywhere from 16%56% of men diagnosed with prostate cancer, generally because of an abnormal PSA test, have tumors that might never have caused problems had they not been found. And the landmark Prostate Cancer Prevention Trial unexpectedly yielded data that early-stage prostate tumors are incredibly common, even at PSA levels considered normal.
The PCPT was a randomized controlled study the type considered to be the gold standard in research . The study, which involved almost 19,000 healthy men, was designed to evaluate whether the drug finasteride could prevent prostate cancer from developing. Finasteride is a hormonal medication originally approved to treat benign prostatic hyperplasia , but which has also been investigated as a potential treatment for prostate cancer.