Weighing Your Options For Treatment
If you test positive for prostate cancer, you have some options as to what youd like to do about it. Until recently, nearly everyone opted for surgery or radiation, while some patients choose not to undergo treatment, instead opting for active surveillance, during which the cancers are left alone but regularly monitored to be certain that theyre not growing.
Certainly, screening can lead to earlier prostate cancer detection, and with earlier detection, youre eligible for multiple different treatments or active surveillance, said Sia Daneshmand, MD, associate professor of urology at Keck School of Medicine of USC and director of urologic oncology at the USC Institute of Urology at Keck Medicine of USC. So we encourage patients who are candidates for screening to discuss it with their urologist and/or primary care physician so that we can determine whats the best course of treatment for them.
There also is a new option for those seeking prostate cancer treatment. Its called High-Intensity Focused Ultrasound , which uses ultrasound beams to non-surgically destroy prostate tumors.
If you are in the Los Angeles area, schedule an appointment with one of our urologists by calling;;or by visiting;Urology.KeckMedicine.org/request-an-appointment.
What Kind Of Doctor Will I See For A Dre
A primary care doctor or a gynecologist usually does a DRE. A gynecologist is a doctor who specializes in the health of women’s reproductive system. Other types of doctors, including gastroenterologists, surgeons, and oncologists may do DREs. A gastroenterologist is a doctor who specializes in the gastrointestinal tract. An oncologist is a doctor who treats cancer.
American Cancer Society Recommendations For Prostate Cancer Early Detection
The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information. The discussion about screening should take place at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
After this discussion, men who want to be screened should get the prostate-specific antigen blood test. The digital rectal exam may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the mans general health preferences and values.
If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
- Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
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To Screen Or Not To Screen
Due to concerns about over treatment and raising unnecessary anxiety, there has been increased debate over the importance of annual screenings for prostate cancer using the prostate-specific antigen test and a digital rectal exam . This past March the New England Journal of Medicine published two conflicting papers on the value of screening, based on studies conducted in North America and England. Following much analysis, many medical experts agree that the larger study, conducted over a much longer time span supports the idea that early detection and treatment does indeed save lives. The PSA test, even with its limitations, remains an important tool in the diagnosis and the treatment of prostate cancer.
In a follow-up commentary, Patrick C. Walsh, MD, of Johns Hopkins Medical Institutions wrote: What is the take-home message? If you are the kind of person who doesnt wear a seatbelt nor goes regularly to the dentist or your family doctor for a
checkup and are not worried about dying from prostate cancer, do not undergo PSA testing. On the other hand, if you are a healthy man age 55 to 69 who does not want to die from prostate cancer, the European trial provides conclusive evidence that PSA testing can save your life.
Great News For Guys: No More Invasive Prostate Exams
Good news for all the over-40 men out there: we don’t need routine screening for prostate cancer. More to the point, we don’t need to subject ourselves to the dreaded “digital rectal exam” that has been a standard procedure for decades. ; ; Most guys don’t need any encouragement to avoid this particular invasive procedure, but now there’s good scientific evidence saying we don’t need it.
One of the most widely used screens for prostate cancer is the PSA test.;I wrote about this;last year, after several studies and a thorough review concluded that
there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
Now, the Choosing Wisely campaign and the American Academy of Family Physicians have included not only PSA testing, but also digital rectal exams as;procedures that are usually unnecessary. Their advice to physicians is very clear:
Dont routinely screen for prostate cancer using a prostate-specific antigen test or digital rectal exam.;
So guys, the next time you go to the doctor, don’t let him give you the PSA test or the dreaded “digital rectal exam.” If your physician hesitates ,;;and hand it to him. If you or your doctor want to know more, the list includes references to long, detailed summaries of the evidence.
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What To Expect During The Exam
You can get a prostate exam easily and quickly at your doctors office. Generally, for cancer screenings, your doctor will take a simple blood test.
Your doctor might also choose to perform a DRE. Before performing this exam, your doctor will ask you to change into a gown, removing your clothing from the waist down.
During a DRE, your doctor will ask you to bend over at the waist or lie on the exam table in a fetal position, with your knees to your chest. They will then insert a gloved, lubricated finger into your rectum.
Your doctor will feel for anything abnormal, such as bumps or hard or soft areas that might indicate a problem. Your doctor may also be able to feel if your prostate is enlarged.
A digital rectal exam can be uncomfortable, especially if you have hemorrhoids, but isnt overly painful. It will last only a couple of minutes.
A DRE is one of your doctors tools that can help them detect several prostate and rectal problems, including:
- prostate cancer
- abnormal masses in your rectum and anus
Your doctor will be able to tell immediately if there are any areas of concern that may warrant further testing.
The results of a DRE exam are either normal or abnormal, but doctors typically rely on several different tests to help them make a prostate cancer diagnosis.
If your doctor feels something abnormal during the DRE, they will probably recommend getting a PSA blood test, if you havent done so already.
- transrectal ultrasound
What Do The Results Mean
PSA levels may be above the baseline for various reasons other than prostate cancer.
Other factors that can raise PSA levels include:
- older age
- an enlarged prostate â because of benign prostatic hyperplasia , for example
- prostatitis, which is inflammation and swelling of the prostate
Also, people with obesity may have lower PSA readings.
In addition, some medications may reduce PSA levels, including:
- 5-alpha reductase inhibitors, which can help treat BPH
- aspirin, which some people take regularly as a blood thinner
- statins, which help manage cholesterol levels
- thiazide diuretics, a kind of water pill that can help reduce high blood pressure
Some herbal medicines and supplements can also lower PSA levels. Tell the doctor about any medications and supplements before undergoing the test.
High PSA levels alone do not indicate cancer. However, if a DRE also reveals changes, a doctor may recommend a biopsy for a more accurate result.
The PCA3 is another test for prostate cancer that doctors use in some circumstances. Find out more.
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What Is The Actual Purpose Of Prostate In Female Body
Many experts believe that prostate in female body use to release some kind of fluid. This fluid appears thick, scanty and has whitish color while containing PSA. Note that, female ejaculation is actually not a part of orgasm and frequency of this has be estimated somewhere around 10 to 54 percent.
During few recent years, medical professionals have taken help from MRIs to detect the presence as well as functionality of female prostate. However, the research should be continued ahead to make ideas more clear but the basic understanding have obtained a boost with this initiative. You might be aware of the fact that prostate gland in males use to store infections inside body. Several studies around the world reveal that Skenes glands also serve the similar kind of function.
Now, it is already clear that skenes glands use to release some fluid during sexual activity and it use to be of watery in appearance. As per one detailed study published in 2007, this fluid that is excreted into the tract from Skene;s Duct use to be consistent with the prostate fluid but it is not observed to have consistency with urine.
How Can I Prevent A Prostate Problem
Researchers have not found ways to prevent prostate problems. Men with a greater chance of developing a prostate problem should talk with their doctor about any lower urinary tract symptoms and the need for regular prostate exams. Recognizing lower urinary tract symptoms and knowing whether you have a prostate problem can help you get early treatment and reduce the effects of prostate problems.
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How Do I Get Ready For A Dre
You do not need to do anything special to prepare for a DRE. But there are a few things to keep in mind.
Tell your health care team if you have hemorrhoids or anal fissures. The DRE may make them worse.
If you are concerned about the cost of your DRE, find out from your insurance provider what costs they will cover beforehand. Ask how much of the cost you will have to pay out of pocket.
You will be asked to sign a consent form before your DRE. The form will state that you understand the benefits and risks of the DRE and agree to have the test. Your doctor or nurse will explain the test before you sign the form, and you can ask questions.
What Exactly Is The Prostate
The prostate is a walnut-size gland located between the bladder and the penis. It surrounds the urethra, the tube that carries urine from the bladder to the penis. When it becomes enlarged, a common condition with age, the urethra is squeezed and urinary problems can result. The prostate plays an important role in reproduction, being responsible for much of the seminal fluid produced by a man.
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Do Prostate Problems Cause Other Problems
Yes, a prostate problem may cause other problems, such as
- problems having sex
- feeling stressed due to chronic pain
- inflammation in areas near your prostate
- bladder stones
- kidney failure
Which problem you may get depends on the type of prostate problem you have. Other problems may vary from man to man for each type of prostate problem.
Questions To Ask Your Health Care Team
Before having a DRE, you may want to ask these questions:
Why do you recommend that I have a DRE?
What happens during the DRE?
Who will do the DRE?
How long will the DRE take?
Will it hurt?
Can a DRE find cancer?
When and how will I get my test results?
Who will explain them to me?
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What Is Prostate Cancer Screening
The prostate is a gland at the base of the male bladder which wraps itself around the beginning of the urethra . Though small, it can cause big problems for mens well-being. Prostate cancer is the fourth leading cause of death in Australian men, after heart attacks, lung cancer and stroke.
The hope with cancer screening is that, by picking up cancer early, we may forestall death and avoid suffering. But for prostate cancer, our screening tests have significant limitations.
Do Trans Women Have A Prostate
Yes, trans women have a prostate the prostate is a gland that sits underneath the bladder and surrounds the urethra, which is the tube that carries urine out of the body.
The following people have a prostate:
- cis men
- trans women
- non-binary people who were assigned male at birth
- some intersex people.
The prostate in cis men is usually the size of a walnut but increases in size with age. This increase in size is less if youre taking feminising hormones or drugs that prevent androgens like testosterone from having effects on the body .
Having male bits and pieces is not easy it is a nuisance but I have always accepted I am a trans woman. A personal experience
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What Do You Want Men To Know About Prostate Cancer
The important thing to know is that, if you live long enough, you will probably get prostate cancer. If you live into your 80s, about 80 percent of men have some sort of prostate cancer. That doesnt mean theyre going to die from prostate cancer because, as a percentage, very few men die from prostate cancer. It means its important to be aware of it and consider screening early, so if its a high-grade type, we can identify it and treat it.;
What Types Of Treatment Are Recommended
The stage of the tumor and ones age at diagnosis may significantly guide treatment options. Because many forms of prostate cancer are slow growing, very early-stage tumors may warrant careful observation, known as active surveillance, rather than aggressive treatment.
When treatment is required, the urologist may recommend either radiation therapy or the surgical removal of the prostate, known as a radical prostatectomy. Radiation therapy can take several forms, with the most common being an external beam of radiation to target the prostate and kill cancer cells. The most common form of external radiation is image modulated radiation therapy . IMRT generally involves five treatments per week for eight weeks.
A small number of cancer centers offer another form of external radiation known as proton therapy. Proton therapy is controversial4 because its cost greatly exceeds that of IMRT, and numerous experts have argued that there is insufficient data to prove that it is more effective or less toxic.
For patients who do not want to undergo repeated treatments, referred to as fractions, brachytherapy provides a highly effective option. Brachytherapy involves a single, surgical insertion of radioactive seeds into the cancerous portions of the prostate.
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Can Trans Women Get Prostate Cancer
Yes, trans women and non-binary people assigned male at birth can get prostate cancer.
There arent many studies of prostate cancer in trans women but they suggest that there is a lower risk than in cis men.
Ive always known that people born male have a prostate. Its something that I have to live with. No health professional raised the risk of prostate problems with me, but I was aware that I was at risk. A personal experience
Symptoms Of Female Prostate Cancer
Aside from a spike in PSA levels, there are other symptoms of prostate cancer in women to look out for. As expected, they mimic the signs of male prostate cancer, such as pressure on the bladder, a frequent need to urinate, and painful urination. Soreness in the lower pelvis, itching around the vaginal opening and urethra, painful sex, and disrupted menstrual cycles are all indicators of prostate cancer in women. Because of how rarely it occurs, patients who develop cancer in the female prostate gland are often misdiagnosed.
Technically, you cannot develop prostate cancer without an actual prostate. However, the Skene glands have been known to foster cancerous growths, adversely affecting your reproductive system, urethra, and bladder.
Problems with the Skene glands also go undetected when the symptoms of female prostate cancer fall in line with other reproductive diseases. This includes uterine or ovarian cancer and polycystic ovarian syndrome , which are far more common. They all cause irregular periods, abdominal aches, sluggish metabolism along with weight gain, pressure behind the pubic bone, and painful sex.;;
Furthermore, the Skene glands have a tendency to grow cysts, which may be benign or cancerous. Theyre manually detectable with your fingers and will probably feel like lumps around your vagina or urethra.
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