Saturday, June 15, 2024

End Stages Of Prostate Cancer

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Get An Annual Check Up

Living with advanced prostate cancer

According to Dr. Ramin, In the United States, the average age of prostate cancer diagnosis is 69. After that year, the chances that a man will develop prostate cancer increase significantly. So, around the age of 50, men should be receiving a regular, annual physical and screening for prostate cancer. Putting in the work of getting comfortable with and committed to regular health checkups puts a man in a much better position to identify problems early when hes older.

Causes Of Advanced Prostate Cancer

Prostate cancer is one of the most common cancers in the UK. It is more common over the age of 65. Prostate cancer can happen in younger people, but it is uncommon in people aged under 50.

If you are a trans woman or are non-binary or assigned male at birth, you also need to be aware of prostate cancer. Advanced prostate cancer may affect trans women, but there is not enough evidence to know how common this is.

Prostate cancer UK have detailed information about trans women and prostate cancer.

The LGBT Foundation can also give you confidential advice and support. You can also talk to one of our cancer support specialists.

Doctors do not know the exact causes of prostate cancer. But there are risk factors of prostate cancer that can increase the chance of developing it. Having one or more risk factors does not mean you will get prostate cancer.

You may be diagnosed with advanced prostate cancer:

  • after previous treatment for early or locally advanced prostate cancer possibly many years ago
  • after being diagnosed with cancer in the prostate, if further tests show the cancer is advanced
  • after tests to check symptoms of bone pain, with no previous diagnosis of prostate cancer.

The most common places for prostate cancer to spread to is to the bones and lymph nodes outside the pelvis.

Whats A Long Time When It Comes To Survival Times

I assume that from the vets perspective, the removal of the dogs spleen would indeed extend life for a long time.

But this is relative, right? What does that a long time mean, really? It depends upon your perspective.

Some animals only live a few days. Others live decades and a few live hundreds of years. A long time is different for each of these creatures.

For example, for a creature who is expected to live an average of two years, one year is half the lifespan. One year is not a long time for humans unless you are a five-year-old who wants to be six. But for the two-year-lifespan creature, thats definitely a long time.

Dogs have an average life expectancy of 12 years. So one year is 8.3% of life for dogs.

For perspective, humans on average have a life expectancy of 72.6 years. So for humans, 8.3% of their lifespan is 6 years.

Is that a long time? It depends upon your viewpoint. If Im a father looking at my little girl, and the doctor is telling me that she will probably live another 6 years, Im not thinking hey, great, thats 8.3% of her lifespan! No. Im thinking, shes only going to live to be 12?? Six years is not a long time in this scenario. At least, not to me.

But if Im looking at an elderly relative who is sick, and a doctor tells me he is probably going to live another 6 years, I might feel relief. Living close to the average lifespan of a human is often considered a long time when we near the end of our lives.

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What Does Staging And Grading Mean For Treatment

The prostate cancer stage and grade are important for determining your course of treatment. Some treatments are only effective for Stage I and II prostate cancer and other treatments are only necessary for Stage III and IV prostate cancer.

Grading is especially useful in early-stage disease. If the tumor shows signs of being aggressive, it may make sense to go forward with more aggressive prostate cancer treatment options. If the tumor does not seem aggressive, it may make sense to go forward with active surveillance or watchful waiting and avoid common side effects.

In any case, the stage and grade must be discussed with your doctor and healthcare team.

What Will Happen In The Last Few Days

What Are The Four Stages Of Prostate Cancer

It can help to know what is normal in the last few days of life so that you know what to expect. You might not be aware of these changes when they happen because you may be drowsy or unconscious.

If you’re supporting someone who is dying, read about what you can do to help and how you can get support.

Pain

Many people worry about being in pain when they are dying. Some people do get pain if their prostate cancer presses on their nerves or makes their bones weak. But not everyone dying from prostate cancer has pain. And if you are in pain, there are things that can help to reduce and manage pain.

You should tell your doctor or nurse if youre in pain or if your pain gets worse. They can talk with you about how best to manage your pain and can help keep it under control.

You may find sitting or lying in some positions more comfortable than others, so ask if you need help getting into a different position.

Your doctor can give you medicines to help manage pain. The type of medicines they give you will depend on what is causing the pain and which medicines are suitable.

Your doctor will monitor how the pain medicines are working and may change the type of medicine or the dose. If youre still in pain or get pain in between taking medicines, its important to tell your doctor or nurse.

Sleeping and feeling drowsy

Not recognising people

Feeling restless or agitated

Changes in skin temperature or colour

Changes in breathing

Loss of appetite

Changes in urinating or bowel movements

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Treatment Options Under Clinical Evaluation

Treatment options under clinical evaluation for patients with prostate cancer include the following:

Cryosurgery

Cryosurgery, or cryotherapy, is under evaluation for the treatment of localized prostate cancer. It is a surgical technique that involves destruction of prostate cancer cells by intermittent freezing of the prostate with cryoprobes, followed by thawing. There is limited evidence regarding its efficacy and safety compared with standard prostatectomy and radiation therapy, and the technique is evolving in an attempt to reduce local toxicity and normal tissue damage. The quality of evidence on efficacy is low, currently limited to case series of relatively small size, short follow-up, and surrogate outcomes of efficacy.

Serious toxic effects associated with cryosurgery include bladder outlet injury, urinary incontinence, sexual impotence, and rectal injury. Impotence is common, ranging from about 47% to 100%.

The frequency of other side effects and the probability of cancer control at 5 years follow-up have varied among reporting centers, and series are small compared with surgery and radiation therapy. Other major complications include urethral sloughing, urinary fistula or stricture, and bladder neck obstruction.

Proton-beam therapy

Vascular-targeted photodynamic therapy using a photosensitizing agent has been tested in men with low-risk prostate cancer.

Neoadjuvant hormonal therapy

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What Are Some Of The Problematic Aspects Of Prostate Cancer

Men who undergo prostate cancer may have enlarged prostate symptoms like frequent urination, especially at night, or leakage. Many men experience erectile dysfunction, which can impact their sex life. In addition, the disease and the treatment might cause fatigue and disrupt your life and motivation. Some cancer patients experience issues with mood, such as depression.

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Treatment For Prostate Cancer In Dogs

If caught very early in the disease process, before metastasis has occurred, surgical removal of the diseased portion of the prostate may be considered. Surgery is often followed by radiation therapy or chemotherapy.

If metastasis has already occurred, then palliative care should be considered. The goal of palliative care is to relieve pain and any clinical symptoms that may be present, while also trying to improve your dogs quality of life for as long as possible.

If a urinary obstruction is present, a small tube called a stent may be placed within the urethra to keep it open so the dog can urinate. Surgery of the prostate is not often performed when advanced disease is present because of the high risk of complications. Radiation therapy may be considered in certain cases.

Your veterinarian may also recommend a nonsteroidal anti-inflammatory drug to relieve pain. Any urinary tract infection that may be present will be treated with appropriate antibiotics. Chemotherapy may be considered, but long-term efficacy has not been established.

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Your Veterinarian Is There To Help

CAT 3: PSMA Radioligand Therapy (PRLT) of End-Stage Prostate Cancer Patients Selected by PSMA PET/CT

If you have done the above steps and are still unsure if you should euthanize, understand that this is normal.

Make an appointment with your veterinarian to discuss your concerns and thoughts with them. They can help support you during this difficult decision.

One of the nicest things we can do for our beloved companions is to allow them to pass in peace and with dignity by limiting the suffering they might experience in their final moments or days.

It is never an easy decision, but ultimately it is a humane one.

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How Do I Know How Long I Have Left To Live

You might want to know how long you have left to live. This can help you prepare and plan the time you have left. There might be things you want to do or people you want to see. But some men dont want to know how long they have left. Everyone is different.

You can ask your doctor how long you have left to live. They wont be able to give you an exact answer. This can be frustrating and it may feel like your doctor is trying to avoid your questions. But no-one can know for certain how long you have left because everyone’s body and everyone’s cancer is different. However, your doctor will be able to give you some idea based on where the cancer has spread to, how you are responding to treatment, how quickly the cancer has spread, and what problems it is causing.

It can be helpful to talk with your family about this. You may not want to upset them but they might have similar questions and thoughts to you.

If you have months or maybe years left to live, it can be difficult for your doctor to say exactly how long you have left. This is because they dont know how you will respond to different treatments. If your treatment stops working so well, there may be other treatments available. Some men may not respond well to one treatment, but may respond better to another. Read more about treatments for advanced prostate cancer.

In The Last Days Of Life Patients And Family Members Are Faced With Making Decisions About Treatments To Keep The Patient Alive

Decisions about whether to use life-sustaining treatments that may extend life in the final weeks or days cause a great deal of confusion and anxiety. Some of these treatments are ventilator use, parenteral nutrition, and dialysis.

Patients may be guided by their oncologist, but have the right to make their own choices about life-sustaining treatments. The following are some of the questions to discuss:

  • What are the patients goals of care?
  • How would the possible benefits of life-sustaining treatments help reach the patients goals of care, and how likely would this be?
  • How would the possible harms of life-sustaining treatments affect the patients goals of care? Is the possible benefit worth the possible harm?
  • Besides possible benefits and harms of life-sustaining treatments, what else can affect the decision?
  • Are there other professionals, such as a chaplain or medical ethicist, who could help the patient or family decide about life-sustaining treatments?

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Grade: How Aggressive Is The Cancer

The pathology team will take a biopsy sample and prepare it with chemicals, then make extremely fine slices of the tissue to examine under the microscope. If prostate cancer is found when looking at biopsied tissue under a microscope, the pathologist assigns a grade to the cancer. There are 2 grading systems currently in use, which can be confusing for patients.

The classical grading system for prostate cancer is called the Gleason score, which ranges from 6 to 10 .

In 2014, the World Health Organization reorganized the Gleason score with the simpler Grade Group system, ranging from 1 to 5 .

Many medical centers report both the Gleason score and the Grade Group, but there may be some that still only report the old Gleason system.

Both systems attempt to communicate a variety of factors in a way that allows the medical team to communicate and compare cases and strategize treatments.

Signs Of Impending Death Identified In Cancer Patients

Tumour innervation and neurosignalling in prostate cancer Urology of V

While many would rather not think about when someone might die, knowing how much longer a seriously ill person has left to live can be very useful for managing how they spend their final days. Researchers have now revealed eight signs in patients with advanced cancer associated with death within 3 days.

Diagnosis of an impending death can help clinicians, patients and their friends and family to make important decisions. Doctors can spare time and resources by stopping daily bloodwork and medication that will not make a short-term difference. Families will know if they still have time to visit their relatives.

This study shows that simple bedside observations can potentially help us to recognize if a patient has entered the final days of life, says study author Dr. David Hui.

Upon further confirmation of the usefulness of these tell-tale signs, we will be able to help doctors, nurses, and families to better recognize the dying process, and in turn, to provide better care for the patients in the final days of life.

The study, published in Cancer, follows on from the Investigating the Process of Dying Study a longitudinal observational study that documented the clinical signs of patients admitted to an acute palliative care unit . During the study, the researchers identified five signs that were highly predictive of an impending death within 3 days.

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What Is Advanced Prostate Cancer

When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.

Prostate cancer is often grouped into four stages, with stages III and IV being more advanced prostate cancer.

  • Early Stage | Stages I & II: The tumor has not spread beyond the prostate.
  • Locally Advanced | Stage III: Cancer has spread outside the prostate but only to nearby tissues.
  • Advanced | Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs.

When an early stage prostate cancer is found, it may be treated or placed on surveillance . Advanced prostate cancer is not curable, but there are many ways to treat it. Treatment can help slow advanced prostate cancer progression.

There are several types of advanced prostate cancer, including:

Biochemical Recurrence

With biochemical recurrence, the prostate-specific antigen level has risen after treatment using surgery or radiation, with no other sign of cancer.

Castration-Resistant Prostate Cancer

Non-Metastatic Castration-Resistant Prostate Cancer

Prostate cancer that no longer responds to hormone treatment and is only found in the prostate. This is found by a rise in the PSA level, while the testosterone level stays low. Imaging tests do not show signs the cancer has spread.

Metastatic Prostate Cancer

  • Lymph nodes outside the pelvis
  • Other organs, such as liver or lungs

Metastatic Hormone-Sensitive Prostate Cancer

Prostate Cancer Patients Want Detailed Life Expectancy Information

Men diagnosed with prostate cancer prefer physicians to explain their life expectancy in quantitative termseither as a number of years or as a probability of living at a time pointaccording to a new study by Cedars-Sinai investigators.

Life expectancy is a crucial factor in deciding whether men should get aggressive treatment like surgery or radiation for prostate cancer.

âProstate cancer is a disease that affects older people, and itâs a very slow-growing cancer,â said Timothy J. Daskivich, MD, MSHPM, assistant professor of Surgery in the Cedars-SinaiUrology Academic Practice and first author of the study. âA lot of people will die with the disease rather than from the disease.â

Daskivichâs previous research has shown that 40% of men in the U.S. with early-stage prostate cancer and with a life expectancy of less than 10 years often undergo radiation therapy or surgery, which goes against medical guidelines. This is important since half of men diagnosed with prostate cancer over the age of 65 in the U.S. have a life expectancy of less than 10 years.

Timothy J. Daskivich, MD

âThere is some evidence to suggest this is because patients are not well-informed about life expectancy when making treatment decisions. However, little data exists on how life expectancy should be ideally communicated to patients,â said Daskivich, who is also director of Health Services Research for the Cedars-Sinai Department of Surgery.

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End Stage Prostate Cancer Symptoms

These are some of the common symptoms of end stage prostate cancer:

  • frequent urination and even more at night
  • pain in lower back, hips or upper legs from metastasis
  • occasional blood in your urine
  • painful urination
  • aches and pains and tiredness
  • erectile difficulties

The pain in the pelvis and hips can be the result of prostate bone cancer that has spread outside the prostate due to metastasis.

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