How Can I Prevent Prostate Cancer
The best way to try and prevent prostate cancer is to modify the risk factors for prostate cancer that you have control over. Eat a low-fat diet that is rich in fruits and vegetables and low in animal fats. It is always a good idea to maintain a healthy weight, get plenty of exercise and not to smoke or to quit smoking.
What Treatments Are Available
If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms.
If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments:
- chemotherapy with hormone therapy
- clinical trials.
Research has found that having radiotherapy together with one of the main treatments listed above can help some men with advanced prostate cancer to live longer. But radiotherapy isnt suitable for all men with advanced prostate cancer.
If you live in Scotland, you may also be offered a type of hormone therapy called abiraterone acetate together with standard hormone therapy. In the rest of the UK, abiraterone is currently only given to men with advanced prostate cancer that has stopped responding to other types of hormone therapy. The National Institute for Health and Care Excellence is currently deciding whether to make it available for men who have just been diagnosed with advanced prostate cancer.
Before you start treatment
Before you start any treatment, make sure you have all the information you need. Its important to think about how you would cope with the possible side effects. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. It may also help to take someone with you, such as your partner, a family member or friend.
If you have any questions, speak to our Specialist Nurses.
What Stages Have To Do With Cancer Spread
Cancers are staged according to tumor size and how far it has spread at the time of diagnosis. Stages help doctors decide which treatments are most likely to work and give a general outlook.
There are different types of staging systems and some are specific to certain types of cancer. The following are the basic stages of cancer:
- In situ. Precancerous cells have been found, but they havent spread to surrounding tissue.
- Localized. Cancerous cells havent spread beyond where they started.
- Regional. Cancer has spread to nearby lymph nodes, tissues, or organs.
- Distant. Cancer has reached distant organs or tissues.
- Unknown. Theres not enough information to determine the stage.
- Stage 0 or CIS. Abnormal cells have been found but have not spread into surrounding tissue. This is also called precancer.
- Stages 1, 2, and 3. The diagnosis of cancer is confirmed. The numbers represent how large the primary tumor has grown and how far the cancer has spread.
- Stage 4. Cancer has metastasized to distant parts of the body.
Your pathology report may use the TNM staging system, which provides more detailed information as follows:
T: Size of primary tumor
- TX: primary tumor cant be measured
- T0: primary tumor cant be located
- T1, T2, T3, T4: describes the size of the primary tumor and how far it may have grown into surrounding tissue
N: Number of regional lymph nodes affected by cancer
M: Whether cancer has metastasized or not
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What Does It Mean If Theres Cancer In My Lymph Node
If cancer is found in one or more lymph nodes, it could mean that more tests are needed to know how far the cancer has spread. This information is used to determine the stage of your cancer and the best treatment options.
For more information on staging, see Cancer Staging, or find your cancer type for more detailed information.
Diagnosing Cancer Of The Lymph Nodes
In addition to a biopsy, the TNM system is commonly used to issue a diagnosis and determine which type of treatment is best. The T refers to the size of the tumor or cancerous growth. The N refers to the number of lymph nodes that contain cancerous cells. And, the M is for metastasis, which refers to cancer thats spread to areas far from the originating tumor.5
This categorization is used in addition to other diagnostic tests and tools to determine the cancer stage such as:
- Imaging tests X-rays, CT scans, MRIs, and other types of imaging tests can provide a clearer picture and more information about where the cancer is located and how much is present.
- Endoscopy exams An endoscope is a thin, lighted tube with a video camera attached that looks around on the inside of the body for cancerous areas.
In general, cancers assigned as Stage I are less advanced and have a better prognosis and response to treatment. Whereas, a higher stage indicates that the cancer has spread further and requires a more intense or multiple types of treatment. Other factors that affect treatment are:
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Day Of Your Simulation
Once you arrive
A member of your radiation therapy team will check you in. You will be asked to state and spell your full name and birth date many times. This is for your safety. People with the same or a similar name may be having care on the same day.
Your radiation therapist will greet you. They will take a photograph of your face. This picture will be used to identify you throughout your treatment.
Your radiation therapist will then explain what to expect during your simulation. If you havent already signed a consent form, your radiation oncologist will review everything with you and ask for your signature.
During your simulation
You will need to change into a hospital gown for your simulation. You should keep your shoes on. If you wear a head covering , you may need to remove it.
After you change, your radiation therapists will bring you to the simulation room and help you lie down on the table. They will do everything they can to make sure youre comfortable and have privacy.
The table will have a sheet on it, but its hard and has no cushion. Also, the room is usually cool. If you feel uncomfortable at any time, tell your radiation therapists. If you havent taken pain medication and think you may need it, tell your radiation therapists before your simulation starts.
Once your simulation starts, dont move. Moving may change your position. However, if youre uncomfortable or need help, tell your radiation therapists.
Positioning
Imaging scans
Skin markings
How Will My Cancer Be Monitored
Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management.
You will have regular PSA tests. This is often a useful way to check how well your treatment is working. Youll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones.
You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading.
Your doctor or nurse will also ask you how youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these.
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Preparing For Your Simulation
- During your simulation, you will be lying in one position for a long time. If you think you will be uncomfortable lying still, you can take acetaminophen or your usual pain medication before your simulation.
- If you think you may get anxious during your procedure, ask your doctor if medication may be helpful.
- Wear comfortable clothes that are easy to take off. You will need to change into a hospital gown.
- Dont wear jewelry, powder, or lotion.
- If your dentist made a mouth guard for you, bring it to your simulation.
To help pass the time during your simulation, your radiation therapists can play music for you.
You may need to follow additional instructions to prepare for your simulation. If you do, your nurse will give you more information.
If you dont need any special preparation, you can eat and drink like usual on the day of your simulation.
For people having a positron emission tomography-computed tomography scan
- Starting 6 hours before your simulation appointment time, dont eat or drink anything except water. This includes gum, hard candy, cough drops, and mints. If you eat or drink anything except water, your PET-CT scan may need to be rescheduled.
- You may get intravenous contrast during your PET-CT scan. If youre allergic to IV contrast, tell your nurse. They will give you special instructions.
Chances Of Developing Metastatic Prostate Cancer
About 50% of men diagnosed with local prostate cancer will get metastatic cancer during their lifetime. Finding cancer early and treating it can lower that rate.
A small percentage of men aren’t diagnosed with prostate cancer until it has become metastatic. Doctors can find out if it’s metastatic cancer when they take a small sample of the tissue and study the cells.
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Detecting Prostate Cancer Spread To Lymph Nodes Using Choline
By: Dan Sperling, MD
Advanced imaging is finding new uses in prostate cancer detection, and potentially contributing to saving lives in cases previously thought untreatable. An interesting example is the use of C-Choline-PET/CT scans to identify prostate cancer that has spread to the nearby lymph nodes.
Lets begin by understanding what lymph nodes are, and why they are a likely target for the early spread of prostate cancer that has left the gland. Just as your body has a network of arteries and veins that move blood around, it also has a separate network of vessels that contain a clear watery fluid called lymph. Lymph bathes cells, providing oxygen and nutrients, and it carries away waste. It also contains white blood cells that fight infection. Scattered throughout the lymph vessels are hundreds of filter points, called nodes, that hold substances picked up in the lymph fluid. After the fluid is cleansed it slowly continues on its way to the chest where it rejoins the bloodstream, leaving the offending substances in the nodes.
One area rich in lymph nodes is the region in the pelvic cavity, close to the prostate gland. If prostate cancer is left untreated, or if treatment misses some of the cancer, as cancer cells infiltrate beyond the edge of the capsule they will be picked up in the lymph and carried to regional nodes that try to combat them. Thus, a single lymph node or group of nodes in that area may swell or enlarge as they work to filter out the bad cells.
Lymph Nodes And What They Do
Lymph vessels send lymph fluid through nodes throughout the body. Lymph nodes are small structures that work as filters for foreign substances, such as cancer cells and infections. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid. Lymph nodes are located in many parts of the body, including the neck, armpit, chest, abdomen , and groin. They contain immune cells that can help fight infection by attacking and destroying germs that are carried in through the lymph fluid.
There are hundreds of lymph nodes throughout the body. Each lymph node filters the fluid and substances picked up by the vessels that lead to it. Lymph fluid from the fingers, for instance, works its way toward the chest, joining fluid from the arm. This fluid may filter through lymph nodes at the elbow, or those under the arm. Fluid from the head, scalp, and face flows down through lymph nodes in the neck. Some lymph nodes are deep inside the body, such as between the lungs or around the bowel, to filter fluid in those areas.
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What Is The Lymph System
The lymph system is a part of your bodys immune system. It includes a network of lymph vessels and lymph nodes. Lymph vessels are a lot like the veins that collect and carry blood through the body. But instead of carrying blood, these vessels carry the clear watery fluid called lymph. Lymph fluid also contains white blood cells, which help fight infections.
Lymph fluid would build up and cause swelling if it were not drained in some way. Lymph vessels draw up the lymph fluid from around the cells to send it towards the chest. There, lymph fluid collects into a large vessel that drains into a blood vessel near the heart.
What Are The Treatments For Prostate Cancer
There are many different ways to treat prostate cancer. For prostate cancer, it is important that you get a second opinion and you will most likely be consulting multiple types of healthcare providers before making a final decision. You should talk to both urologists and radiation oncologists to hear about the benefits and risks of surgery, hormonal therapy and radiation in your particular case. If your prostate cancer has already spread at the time of diagnosis, you will also need a medical oncologist to talk about chemotherapy. The most important thing is to review your options and make a decision that best suits your lifestyle, beliefs and values.
Active Surveillance
Surgery
Surgery is a common form of treatment for men with prostate cancer. Surgery attempts to cure prostate cancer by removing the entire prostate and getting all of the cancer out of the body. An attempt at a surgical cure for prostate cancer is usually done with early stage prostate cancers. However, sometimes surgery will be used to relieve symptoms in advanced stage prostate cancers.
Talk to your surgeon about their complication rates before your operation. With surgery, urinary incontinence and impotence are often most severe right after the operation and generally get better with time. There are things that your providers can recommend to help you with either of these problems. Talk to your urologist about your options.
Radiation
Hormonal Deprivation Therapy
Chemotherapy
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Metastatic Squamous Neck Cancer With Occult Primary Is A Disease In Which Squamous Cell Cancer Spreads To Lymph Nodes In The Neck And It Is Not Known Where The Cancer First Formed In The Body
Squamous cells are thin, flat cells found in tissues that form the surface of the skin and the lining of body cavities such as the mouth, hollow organs such as the uterus and blood vessels, and the lining of the respiratory and digestive tracts. Some organs with squamous cells are the esophagus, lungs, kidneys, and uterus. Cancer can begin in squamous cells anywhere in the body and metastasize through the blood or lymph system to other parts of the body.
When squamous cell cancer spreads to lymph nodes in the neck or around thecollarbone, it is called metastatic squamous neck cancer. The doctor will try to find the primary tumor , because treatment for metastatic cancer is the same as treatment for the primary tumor. For example, when lung cancer spreads to the neck, the cancer cells in the neck are lung cancer cells and they are treated the same as the cancer in the lung. Sometimes doctors cannot find where in the body the cancer first began to grow. When tests cannot find a primary tumor, it is called anoccult primary tumor. In many cases, the primary tumor is never found.
What Screening Tests Are Used For Prostate Cancer
There are two tests used for prostate cancer screening:
The American Cancer Society recommends that men make an informed decision on whether or not they should be screened after talking about the risks and benefits of screening with their healthcare provider. Screening is not recommended in men without symptoms of prostate cancer if they have a life expectancy of less than ten years. Men at average risk of developing prostate cancer should begin this conversation at age 50. African American men and men with one relative with prostate cancer should talk with their healthcare provider about screening beginning at age 45. Men at the highest risk, those with more than one first degree relative with prostate cancer at an early age should begin talking about screening at age 40. Repeat screening is based on baseline PSA results, but typically occurs every 1-2 years.
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Magnetic Resonance Lymphography With Ultrasmall Superparamagnetic Iron Oxide
MR imaging can be improved by the use of contrast agents containing USPIO nanoparticles, which are taken up by subcapsular macrophages within LNs. The iron oxide within the USPIO turns normal lymph nodes dark on T2- and T2*-weighted MRI. This allows for the detection of early histological changes caused by microscopically infiltrating tumor cells, even before the LNs enlarge in size . The lympho-graphic properties of USPIOs have been known for over 15 years. In 1999 Harisinghani et al. investigated USPIO lymphography in 19 patients with primary abdominal and pelvic malignancies .
MRL with ferumoxtran-10 has several limitations, including the need to perform imaging pre-contrast and 24â36 h post-contrast due to the slow accumulation of the contrast agent within lymph nodes. Furthermore, the USPIO agent ferumoxtran-10 must be administered slowly through a filtered needle over 15â30 min to minimize infusion reactions including hypersensitivity and back pain. Approximately one fourth of patients participating in phase 3 clinical trials using ferumoxtran-10 reported headache, back pain, vasodilation, or urticaria as adverse events . As mentioned, the agent is currently only available at one center in Europe on a research basis. Thus, there has been interest in other candidate USPIO agents with wider availability and better side effect profiles .