As Screening Falls Will More Men Die From Prostate Cancer
In active monitoring, men with localized prostate cancer do not get surgery or radiation right after theyre diagnosed. Instead, they have regular biopsies, blood tests, and MRIs to see if their cancer is progressing. If it is, they can receive treatment.
Although some oncologists advise men with early, low-grade prostate cancer to choose active surveillance and professional groups such as the American Society of Clinical Oncology recommend it many patients recoil at what sounds like lets just wait for your cancer to become really advanced. A decade ago fewer than 10 percent of men diagnosed with prostate cancer chose monitoring, UCLA researchers found. But that is changing. Now at least half of men do.
That made sense to Garth Callaghan, author of the best-selling Napkin Notes, a book of missives he tucked into his daughters lunch box. Diagnosed with early prostate cancer in 2012, he said, none of the choices seemed particularly attractive to a 43-year-old man who dreaded the possibility of side effects of surgery or radiation, including incontinence and impotence. I was completely torn. My previous experience was, just get it out of my body. But after his doctor explained that prostate cancer is grossly overtreated in the United States, I did a complete 180 and chose active monitoring.
Neurologic Complications Of Prostate Cancer
RAMSIS BENJAMIN, M.D., M.P.H., Keck School of Medicine of the University of Southern California, Los Angeles, California
Am Fam Physician. 2002 May 1 65:1834-1841.
This article exemplifies the AAFP 2002 Annual Clinical Focus on cancer: prevention, detection, management, support, and survival.
Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batsonâs plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord compression. Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy. Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis. Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important. Physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age. Spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.
More Common Neurologic Complications in Patients with Metastatic Prostate Cancer*
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Treatments To Help Manage Symptoms
Treatments to help manage symptoms caused by advanced prostate cancer include:
- pain-relieving drugs
- complementary therapies
There are lots of different types of pain-relieving drugs, such as tablets, patches and injections. Your doctor or palliative care nurse will help you find whats best for you.
Some men worry about becoming addicted to pain-relieving drugs. But this is uncommon in men with prostate cancer. Read more about managing pain in advanced prostate cancer.
Radiotherapy can help control symptoms by slowing down the growth of the cancer. Radiotherapy to help control symptoms is sometimes called palliative radiotherapy.
The most common type of radiotherapy used to reduce symptoms is external beam radiotherapy. This is high-energy X-ray beams targeted at the area being treated from outside the body. It can help to manage symptoms such as pain, blood in your urine or discomfort from swollen lymph nodes. Its also used to treat metastatic spinal cord compression.
You might have slightly more pain during treatment, and for a few days afterwards, but this should soon get better. It can take a few weeks for radiotherapy to have its full effect.
If your prostate cancer is causing bone pain, you may be offered radium-223 to help reduce the pain and delay some other symptoms.
Read more about radiotherapy for advanced prostate cancer.
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Quick Answer: How To Lower Risk Of Prostate Cancer
Researchers dont completely understand the relationship between diet and prostate cancer prevention, but studies suggest that certain eating habits may help. Reduce fat intake. Eat less trans fats and saturated fats. Eat more fruits and vegetables. Add green tea and soy. Avoid charred meat.
How May My Constipation Be Treated
Constipation is a common side effect or unwanted change in your body when you have chemotherapy treatment. Constipation can make you feel very uncomfortable. The most important thing for you to remember is to not let your constipation go on for days and days, but to get help right away. If you do not have a bowel movement for two days, you should tell your health care team right away. There are medicines that your doctor or health care team can give to you that will make your constipation better.
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What Are The 5 Early Warning Signs Of Prostate Cancer
Early prostate cancer symptoms Burning or pain during urination. Difficulty urinating, or trouble starting and stopping while urinating. More frequent urges to urinate at night. Loss of bladder control. Decreased flow or velocity of urine stream. Blood in urine Blood in semen. Erectile dysfunction.
Kidney Disease After Radiation Exposure
Radiation exposure on earth is usually at a very low dose. Diagnostic x-rays are essential for modern medical care and pose little or no radiation risk. High dose radiation is much less common than diagnostic x-ray, but it is also very useful, because it can cure cancer. But those high doses pose a risk of injury to the surrounding normal tissues, with both early and late side effects. Depending on dose and site of irradiation, these normal tissue side effects can include injury to the blood-forming bone marrow, gastrointestinal tract, lungs, brain, heart, and kidneys. To these is added the delayed risk of radiation-induced cancer, but that is five years or more after exposure.
The typical doses for some common radiation exposures.
The range of doses in question is shown on the adjoining figure. Note that background radiation is more than that of a diagnostic chest x-ray. The added cancer risk becomes significant at single doses of 30 mSv, i.e. ten times those of yearly background exposure. Early gastrointestinal effects such as nausea or vomiting may occur after single exposures of 1000 mSv or more , and hematopoietic marrow suppression will occur after single doses of 3000 mSv or more.
Dr Eric P Cohen
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Metastatic Spinal Cord Compression
Metastatic spinal cord compression happens when cancer cells that have spread from the prostate grow in or near to the spine, and press on the spinal cord. MSCC isnt common, but you need to be aware of the risk if your prostate cancer has spread to your bones or has a high risk of spreading to your bones. The risk of MSCC is highest if the cancer has already spread to the spine. Speak to your doctor or nurse for more information about your risk.
MSCC can cause any of the following symptoms.
- Pain or soreness in your lower, middle or upper back or neck. The pain may be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, go to the toilet, or lie down. It might get worse when you are lying down. It may wake you at night or stop you from sleeping.
- A narrow band of pain around your abdomen or chest that can move towards your lower back, buttocks or legs.
- Pain that moves down your arms or legs.
- Weakness or loss of control of your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
- Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest, that doesnt go away.
- Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.
It is very important to seek medical advice immediately if you think you might have MSCC.
Can Hematuria Go Away On Its Own
Hematuria is a condition in which blood is present in the urine. Its presence can be seen in urine by the patient himself, and then it is called gross hematuria. However in some cases, it is present in the urine but not seen by naked eyes, it is called microscopic hematuria. The causes of hematuria can be trauma, infection in the urinary tract, vigorous exercises, and medicines like aspirin, antibiotics, etc, kidney stones, and many more. Most of its cases are without sign or symptom. Its symptoms involve pinkish or reddish-brown discoloration of the urine, pain in the back or bladder.
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Drugs To Treat Cancer Spread To Bone
If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab. Sometimes, radiation, radiopharmaceuticals, or pain medicines are given for pain control.
Side effects of bone medicines
A serious side effect of bisphosphonates and denosumab is damage to the jaw, also called osteonecrosis of the jaw . Most people will need to get approval from their dentist before starting one of these drugs.
Radiotherapy To The Prostate
Some men who have just been diagnosed with advanced prostate cancer may be offered external beam radiotherapy as part of their first treatment. This is where high-energy X-ray beams are directed at the prostate from outside the body. The X-ray beams damage the cancer cells and stop them from dividing and growing. Read more about radiotherapy for advanced prostate cancer.
Radiotherapy to the prostate isnt suitable for all men with advanced prostate cancer. If it isnt suitable for you, you might be offered a type of radiotherapy to help manage symptoms instead.
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Cancers Can Vanish Without Treatment But How
- Read in app
By Gina Kolata
But as a paper in The Journal of the American Medical Association noted last week, data from more than two decades of screening for breast and prostate cancer call that view into question. Besides finding tumors that would be lethal if left untreated, screening appears to be finding many small tumors that would not be a problem if they were left alone, undiscovered by screening. They were destined to stop growing on their own or shrink, or even, at least in the case of some breast cancers, disappear.
The old view is that cancer is a linear process, said Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health. A cell acquired a mutation, and little by little it acquired more and more mutations. Mutations are not supposed to revert spontaneously.
So, Dr. Kramer said, the image was an arrow that moved in one direction. But now, he added, it is becoming increasingly clear that cancers require more than mutations to progress. They need the cooperation of surrounding cells and even, he said, the whole organism, the person, whose immune system or hormone levels, for example, can squelch or fuel a tumor.
Cancer, Dr. Kramer said, is a dynamic process.
It was a view that was hard for some cancer doctors and researchers to accept. But some of the skeptics have changed their minds and decided that, contrary as it seems to everything they had thought, cancers can disappear on their own.
Is Prostate Cancer A Death Sentence
Its bad news, but it isnt likely to be a death sentence. Thanks to widespread screening, nearly 90 percent of prostate cancers are detected before they spread beyond the gland. At this point, the disease is highly curable, meaning that after five years men who have undergone treatment remain cancer-free.
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Symptoms Of Advanced Prostate Cancer
The symptoms of advanced prostate cancer depend on where the cancer has spread to. Find out about the possible symptoms and when to see your doctor.
Advanced prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. If your cancer has spread you might:
- have bone pain
- have weight loss for no known reason
Diagnosing Back Pain And Prostate Cancer
A doctors first step in finding out the cause of back pain typically is to take an image, usually an X-ray or CT scan.
For men who have early stage or localized prostate cancer, that it would spread to the bone is very unusual, says Chris Filson, a doctor at the Atlanta Veterans Administration Medical Center. However, if a patient has more advanced prostate cancer, we have to do additional tests to ensure theres no involvement of the cancer in the bone.
A doctor who suspects or already has diagnosed prostate cancer will look for characteristic changes in the bone. The X-ray or CT scan also can indicate how much of your spine is affected and where.
In addition, an MRI can detect problems that an X-ray or CT scan cant.
Chiropractors are often the ones who first spot or suggest the presence of prostate cancer. Joint pain, especially back pain, often sends people to chiropractic care when they dont have any other symptoms of prostate cancer.
Whether youre seeing a chiropractor or medical doctor, be sure to provide your complete medical history. This can help your doctor diagnose your back pain. Its especially important to mention any personal or family history of cancer.
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External Beam Radiation Therapy
After completing external beam radiation therapy , urinary and bowel side effects may persist for two to six weeks, but they will improve over time. You may need to continue some medications.
Some patients report continued, though lessening fatigue for several weeks after treatment. Other minor problems may include dry itchy skin, a sensation of heaviness in the perineum, anal and rectal irritation, and flare-up of hemorrhoids. However, patients are usually well enough to continue with normal daily activities.
Prostate Cancer: No Treatment Ok For Some
Outcomes Good With Active Surveillance, New Study Suggests
March 19, 2009 — The best treatment may be no treatment at all for some younger men with early stage, good-prognosis prostate cancer, new research suggests.
Known as active surveillance or watchful waiting, the strategy of intensive monitoring instead of treatment is mostly reserved for elderly patients with other health problems who are likely to die of some other cause before their prostate cancer spreads.
The thinking has been that the approach may be too risky for younger men who may live with prostate cancer for decades instead of a few years.
But a new study shows active surveillance to be a viable option for carefully selected prostate cancer patients, regardless of their age, as long as they are closely followed to make sure their disease does not progress.
Of the 262 men in the study who were initially observed but not treated after being diagnosed, 43 ended up needing treatment over an average follow-up of about 30 months and one patient died after his cancer spread to his bones.
âThere is definitely a risk to this strategy,â University of Chicago urologist and lead researcher Scott E. Eggener, MD, tells WebMD. âWhat we were able to do in this study was quantify this risk, and it appears to be very low.â
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Further Treatments To Control The Cancer
Your first treatment may help keep your cancer under control. But over time, the cancer may change and start to grow again. If this happens you might be offered other treatments, including:
- more hormone therapy
- clinical trials
More hormone therapy
If youve had hormone therapy on its own as a first treatment, you might be offered a chemotherapy drug called docetaxel . This may help some men to live longer, and can help to improve and delay symptoms. If youve already had docetaxel, you might be offered more docetaxel or another chemotherapy drug called cabazitaxel .
This is a type of internal radiotherapy that may be an option if your cancer has spread to your bones and is causing pain. A radioactive liquid is injected into your arm and collects in bones that have been damaged by the cancer. It kills cancer cells in the bones and helps some men to live longer. It can also help to reduce bone pain and delay some symptoms, such as bone fractures. Read more about radiotherapy for advanced prostate cancer.
General Prostate Cancer Survival Rate
According to the American Cancer Society:
- The relative 5-year survival rate is nearly 100%
- The relative 10-year survival rate is 98%
- The 15-year relative survival rate is 91%
Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.
Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology
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Study Finds New Way To Pinpoint Dangerous Prostate Cancer
Researchers say theyve found a new way to tell if a mans prostate cancer will come back and kill him after treatment.
If a blood test called a PSA doesnt fall to low enough levels after treatment, it means the cancers not all gone and will likely come back and spread, the team at Brigham and Women’s Hospital and Harvard Medical School reported.
PSA tests look for prostate specific antigen, a protein made only by prostate cells. Higher PSA levels suggest that prostate cells are growing often because of cancer, but sometimes if the prostate is inflamed or because of the harmless enlargement of the prostate that comes with aging.
The important number to know: PSA should fall to 0.5 nanograms or lower.
That gives doctors a chance to act right away, said Dr. Anthony DAmico, the senior oncologist on the study.
Instead of waiting to see if PSA has gone up, this can tell you that somebody has not only failed treatment, but failed so badly that they are going to die of prostate cancer, DAmico told NBC News.
You should know what your PSA is after your treatment. You need to know once it stops going down if that low point is above half a point .”
“By identifying and enrolling these men in clinical trials immediately, the hope is to take a prostate cancer that appears to be incurable and make it curable” added Dr. Trevor Royce, who led the work on the study.
Its an important question.