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Do You Take Antiandrogen Medications Alongside Other Treatment Options For Prostate Cancer

Prostate Cancer Treatment | Cancer Research UK

Yes, antiandrogen medications are usually combined with testosterone-lowering treatments for prostate cancer. Antiandrogen medications dont stop your body from making testosterone. So other treatments or surgical procedures are usually recommended along with these medications.

Examples of treatment options that may be combined with antiandrogen medications include:

Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

  • hormone treatment
  • chemotherapy

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

When To Call Your Doctor Or Nurse

Its important to tell your doctor or nurse if:

  • your bladder feels full or your catheter isnt draining urine
  • your catheter leaks or falls out
  • your urine contains blood clots, turns cloudy, dark or red, or has a strong smell
  • your wound area or the tip of your penis becomes red, swollen or painful
  • you have a fever
  • you feel sick or vomit
  • you get cramps in your stomach area that will not go away
  • you get pain or swelling in the muscles in your lower legs.

Your doctor or nurse will let you know if you should go to the hospital.

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How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer

The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.

However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.

Transrectal Biopsy Of The Prostate

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Today this procedure is usually carried out in the office of an experienced physician such as a urologist. However, it can also be carried out in a hospital or a day surgery center. It is commonly carried out with the accompanying use of a local anesthetic, but always ask the urologist if he or she is going to give you an anesthetic: prostate biopsy can quite often be painful without it.

The patient is asked to lie in one of several possible positions. The physician normally uses a special prostate biopsy gun to drive ultra-fine biopsy needles through the wall of the rectum and into the prostate. This gun is used in combination with a transrectal ultrasound probe, which enables the doctor to see where the biopsy needles are being placed into the prostate. Each hollow needle will remove a fine cylindrical core of prostate tissue in about a second.

This entire procedure, properly called transrectal ultrasound-guided prostate biopsy or TRUS-guided biopsy is usually completed in about 20 minutes, from start to finish.

The Number of Cores Removed

Many different theories exist as to the best way to sample the prostate so as to find any cancer that may be present. There are no absolute prostate biopsy guidelines. In general, however, an experienced physician will seek to take prostate biopsy specimens as follows:

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During Surgery For Prostate Cancer

The most common type of surgery to treat prostate cancer is a radical prostatectomy. This surgery involves removing the entire prostate gland along with nearby tissues .

Since the prostate gland normally connects the bladder to the urethrathe tube inside the penisthe surgeon must also reattach the bladder to the urethra once the prostate gland is removed.

A radical prostatectomy can be performed in three different ways:

  • Open radical prostatectomy: The surgeon accesses the prostate gland by making a larger incision over the lower abdomen. Less commonly, the prostate is accessed through an incision made between the anus and scrotum .
  • Laparoscopic radical prostatectomy: This minimally invasive approach involves accessing the prostate gland by inserting long, thin instruments through several keyhole-size incisions made in the lower abdomen.
  • Robotic-assisted laparoscopic prostatectomy: With this approach, the surgeon sits at a computer console and manipulates mini robotic arms/instruments to remove the prostate gland.

What If A Screening Test Shows An Elevated Psa Level

If a man who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the man continue with PSA tests and DREs at regular intervals to watch for any changes over time.

If a mans PSA level continues to rise or if a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. A urine test may be recommended to check for a urinary tract infection. The doctor may also recommend imaging tests, such as a transrectal ultrasound, x-rays, or cystoscopy.

If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. Most often, the needles are inserted through the wall of the rectum . A pathologist then examines the collected tissue under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to diagnose prostate cancer.

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Why Erectile Dysfunction May Result From Prostate Disease

In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. While these factors can cause erectile dysfunction, doctors now think that 70% of the time the problem can be traced to a physical condition that restricts blood flow, hampers nerve functioning, or both. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.

However, some types of prostate disease and treatments may also be responsible.

Why Would You Have Surgery For A Benign Prostate Condition

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The prostate is the walnut-sized gland that surrounds the urethra in a male. The urethra is the tube that carries urine from the bladder to outside the body. One of the non-cancerous conditions that can affect the prostate is called benign prostatic hyperplasia , which is also known as enlarged prostate.

BPH is the most common prostate problem in men over age 50. About half of men in their 50s and as many as 90% of men in their 70s and 80s have enlarged prostates.

Enlarged prostate surgery is recommended if less invasive treatments have failed, or if you have severe symptoms such as:

  • An inability to urinate.
  • Excessive blood in the urine.
  • Bladder stones.
  • Kidney damage.

Prostate cancer and infertility arent symptoms or causes of BPH. Benign prostatic hyperplasia doesnt cause erectile problems.

Prostate procedures for BPH range from minimally invasive treatments to more extensive surgeries. Your healthcare provider will help you decide which type of prostate surgery is best for you.

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Is It Easy To Orgasm This Way

Lets say it may take some practice and patience.

Actual clinical research on prostate-induced orgasms is seriously lacking, so we dont know how common it is or if its possible for everyone with a prostate to have this type of orgasm.

Every body is different, so some experimenting to see what feels good is in order. If you do manage to have one, reproducing it will be easy.

Surgery To Remove Your Prostate Gland

You might have surgery to remove your prostate gland if:

  • your cancer hasn’t spread outside the prostate gland
  • you are younger and have a fast growing tumour
  • as part of treatment for locally advanced or high risk localised prostate cancer

The aim of a radical prostatectomy operation is to cure prostate cancer. It is major surgery with some possible side effects. If you’re an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.

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How Do You Find The Prostate

Now for the how-to: You can first access the prostate via the perineum, a spot right in between the testicles and the anus. Communication is important during every step. Even before you begin, consider talking to your partner about what feels right for both of you. You can decide on things like how many fingers might feel best. You can agree on whether a firm touch or a lighter touch is in order. Maybe as you talk things through, youll discover you both feel comfortable enough to explore and see what feels right in the moment. That way, even if prostate massage isnt something you regularly want to incorporate into your sex life, youll have explored it in a way that feels safe and fun for everyone involved.

How Are Antiandrogen Medications Dosed

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Antiandrogen medications are oral medications. There are three dosage regimens:

  • Three-times-daily dose: flutamide

  • You may swallow one or more pills with each dose, depending on the medication. Make sure to read your prescription label carefully. Check with your cancer specialist if youre unsure what time you should take your medication.

    Darolutamide is the only antiandrogen medication that needs to be taken with food. The others can be taken with or without food. Its important to take your doses on a regular schedule, as instructed by your cancer specialist.

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    Radical Prostatectomy To Remove The Prostate

    Making decisions about surgeryTalk to your surgeon about what types of surgery are available to you. Ask about the advantages and disadvantages of each option. There may be extra costs involved for some procedures and they are not all available at every hospital. You may want to consider getting a second opinion about the most suitable type of surgery.The surgeons experience and skill is more important than the type of surgery offered.Compared to open surgery, both standard laparoscopic surgery and robotic-assisted surgery usually mean a shorter hospital stay, less bleeding, a smaller scar and a faster recovery. Current evidence suggests that the different approaches have a similar risk of side effects and no difference in outcomes.Whichever surgical approach is used, a radical prostatectomy is major surgery and youll need time to recover.

    View the Cancer Council NSW editorial policy.

    What Is The Outlook For Men Who Have Benign Prostatic Hyperplasia Surgery

    Benign prostatic hyperplasia surgery has a very high success rate. However, for the best results from treatment, you should seek medical help at the earliest signs of a problem. Also, talk with a doctor if you are experiencing symptoms of BPH after surgery.

    There is no evidence that BPH increases the risk of developing prostate cancer. However, the symptoms of BPH and prostate cancer are similar. The American Urological Association and the American Cancer Society recommend annual prostate screenings for men ages 55 to 69. Men at high risk such as African-American men and men with a family history of prostate cancer should begin screening at age 40.

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    How Is Prostate Removal Surgery Done

    Surgery to remove your prostate gland

    • The operation. The surgeon removes the prostate gland, surrounding tissues,
    • Nerve sparing prostatectomy. This type of surgery is for early prostate cancer
    • Removing lymph nodes. During your operation the surgeon examines the prostate and surrounding area.
    • How your surgeon does your operation. Doctors rarely do

    How Is Hormone Therapy Used To Treat Hormone

    How Does Prostate Cancer Work?

    Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:

    Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.

    The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.

    Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.

    Hormone therapy is sometimes recommended for men who have a “biochemical” recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.

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    Questions To Ask Before Surgery

    As you think over the options for surgery, ask your doctor these questions:

    • Is there a good chance my condition will get better?
    • How much will it improve?
    • What are the chances of side effects from a treatment?
    • How long will the effects last?
    • Will I need to have this treatment repeated?

    With newer technologies, doctors can do some minimally invasive procedures with tiny cuts or use tube-style instruments that they insert into you. These procedures may not treat the symptoms to the same degree or durability as more invasive surgical options, they do have faster recoveries, less pain afterward and have reduced risks.

    Other times, the traditional and more invasive surgery may be needed. It all depends on your case and what you and your doctor decide is best for you.

    Doctors can choose from these minimally invasive procedures, endoscopic, or open surgeries to treat moderate to severe symptoms. These procedures are also used if tests show that your ability to pee is seriously affected.

    What Is A Normal Psa Test Result

    There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

    However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.

    Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

    In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.

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    How To Locate Your Prostate

    This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 140,179 times.

    The prostate is a walnut-sized organ in males that plays a major role in the production of semen. The easiest way to access the prostate is by way of an index finger carefully inserted into the rectum. The processes for accessing the prostate as part of a medical exam or for sexual pleasure are the same, and the same precautions should be taken. You should also keep an eye out for signs of potential prostate problems and contact your doctor as needed.

    Immediately After A Prostatectomy

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    • You will stay in hospital for two to five days.
    • Nurses will monitor your vital signs.
    • Your pain will be managed with medication.
    • You may be given antibiotics to reduce the risk of infection.
    • You may have a drip inserted into your arm or hand for a few days.
    • You will most likely have a drain tube out of your abdomen that will be removed in the first day or two after the surgery.
    • You will be fitted with a small tube in your penis. The catheter drains urine into an attached bottle or bag. This catheter will be removed about one to three weeks after the operation. Your surgeon will tell you when it can be removed.
    • In most cases, you will have to go home still wearing the catheter. You will be taught how to care for it.

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