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How Do You Find Out If You Have Prostate Cancer

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Prostate Cancer Screening Ages 55 To 69

How to find out if you are at risk of prostate cancer

This is the age range where men will benefit the most from screening.Thats because this is the time when:

  • Men are most likely to get cancer
  • Treatment makes the most sense, meaning when treatment benefits outweigh any potential risk of treatment side effects

Most men will get prostate cancer if they live long enough. Some prostatecancers are more aggressive others can be slow-growing. Doctors will takeyour age and other factors into consideration before weighing the risks andbenefits of treatment.

You should ask your doctor how often he or she recommends you get screened.For most men, every two to three years is enough.

Depending on the results of your first PSA test, your doctor may recommendyou get screened less frequently.

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Does Prostate Cancer Have Any Symptoms

Most men with early prostate cancer dont have any signs or symptoms.

One reason for this is the way the cancer grows. Youll usually only get early symptoms if the cancer grows near the tube you urinate through and presses against it, changing the way you urinate . But because prostate cancer usually starts to grow in a different part of the prostate, early prostate cancer doesnt often press on the urethra and cause symptoms.

If you do notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous problem called an enlarged prostate, or another health problem. But its still a good idea to get it checked out. Possible changes include:

  • difficulty starting to urinate or emptying your bladder
  • a weak flow when you urinate
  • a feeling that your bladder hasnt emptied properly
  • dribbling urine after you finish urinating
  • needing to urinate more often than usual, especially at night
  • a sudden need to urinate you may sometimes leak urine before you get to the toilet.

If prostate cancer breaks out of the prostate or spreads to other parts of the body , it can cause other symptoms, including:

  • back pain, hip pain or pelvis pain
  • problems getting or keeping an erection
  • unexplained weight loss.

These symptoms can all be caused by other health problems. But its still a good idea to tell your GP about any symptoms so they can find out whats causing them and make sure you get the right treatment, if you need it.

How Can I Reduce The Risk Of Getting Prostate Cancer

You may help to reduce your risk and look after your health generally by:

Maintaining a healthy weight by combining a balanced, low fat diet with regular physical activity.

Doing regular exercise Try to do at least 30 minutes of moderate physical activity five times or more a week. The more active you are, the more you can reduce the risk.

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How Can Treatment Affect Your Quality Of Life

Your age and overall health will make a difference in how treatment may affect your quality of life.

Both surgery and radiation can cause side effects. Radiation is more likely to cause bowel problems. Surgery is more likely to cause leaking urine or erection problems.

Medicines and mechanical aids may help men who have erection problems after surgery. And there are ways to target the radiation and protect the rectum during radiation.

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Questions You May Want To Consider Asking Your Doctor Include:

How Often Should You Check For Prostate Cancer
  • What type of prostate problem do I have?
  • Is more testing needed and what will it tell me?
  • If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
  • What type of treatment do you recommend for my prostate problem?
  • For men like me, has this treatment worked?
  • How soon would I need to start treatment and how long would it last?
  • Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
  • What are the side effects of the medicine?
  • Are there other medicines that could interfere with this medication?
  • If I need surgery, what are the benefits and risks?
  • Would I have any side effects from surgery that could affect my quality of life?
  • Are these side effects temporary or permanent?
  • How long is recovery time after surgery?
  • Will I be able to fully return to normal?
  • How will this affect my sex life?
  • How often should I visit the doctor to monitor my condition?
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Us Preventive Services Task Force Issues New Prostate Cancer Screening Guidelines

Prostate cancer is usually though not always a very slow-growing cancer that takes a long time to start affecting the body.

Most often, it only causes symptoms when it grows to pinch the urethra or invade the sphincter or other body parts.

In fact, some men with prostate cancer don’t show any signs or symptoms of their illness, the CDC notes.

Is It Always Prostate Cancer

No! Lots of the symptoms above can be caused by what you happen to be eating or drinking, or other conditions including things like an enlarged prostate, or prostatitis, which is an inflammation of the prostate.

Its still always worth getting anything new or unusual for you properly checked out though especially if youre someone at a higher risk of getting prostate cancer.

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Sentinel Test Success Data

In its September, 2020 issue, the Journal of Urology published a paper by Wang, et al. demonstrating greater than 90% overall accuracy Thats WAY BETTER than standard TRUS biopsies!!

There are three Sentinel tests:

  • The Sentinel PCa test had 94% sensitivity/ 92% specificity
  • The Sentinel CS test had 93% sensitivity/90% specificity
  • The Sentinel HG test had 94% sensitivity/96% specificity

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Is Active Surveillance Right For You

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There are some risks associated with active surveillance. They include a low risk of infection with every biopsy and a very low risk of cancer progressing in any one interval of surveillance. Sometimes men choose active surveillance for a period of time and then decide to undergo treatment.

Thousands of UCSF patients have chosen active surveillance to initially manage their prostate cancer. This is one of the largest groups of patients on active surveillance in the world. About one-third of these men receive treatment by five years and 50% by 10 years. The window of opportunity to cure prostate cancer is usually measurable in years or even decades. In fact, treatment results for these men appear to be similar to what would have been expected had they chosen treatment right after their original diagnosis. Based on our experience and those reported from other centers, the risk of significant cancer progression in the short to intermediate term, while not zero, appears to be very low.

Some men with risk factors such as family history, genetic mutations and being African American may still be candidates for active surveillance but need a more careful or intense surveillance regimen to make sure any early signs of progression are identified.

The most common reason for seeking treatment is a biopsy that shows the cancer is growing or becoming more aggressive in appearance . Changes in PSA or cancer stage based on imaging results may also lead to treatment.

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Symptoms Of Prostate Cancer

When this happens, you may notice things like:

  • an increased need to pee
  • straining while you pee
  • a feeling that your bladder has not fully emptied

These symptoms should not be ignored, but they do not mean you have prostate cancer.

It’s more likely they’re caused by something else, such as prostate enlargement.

Prostate Specific Antigen Test

A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.

PSA levels also can be affected by

  • Certain medical procedures.

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Prostate Cancer: Psa Tests And Diagnosis

Though most cases of prostate cancer have a good prognosis, the disease is the second leading cause of cancer deaths in American men, according to the Centers for Disease Control and Prevention .

As with other cancers, early detection and treatment may be important for surviving prostate cancer, at least for advanced forms of the disease.

What Age Should I Get A Prostate Exam

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Prostate exams are an essential basic health screening test that everyone at risk of prostate cancer should consider. Current American Cancer Society guidelines suggest that men over the age of 50 should speak with their primary care physician about getting screened routinely for prostate cancer. This guideline may change depending on your risk for prostate cancer.

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Are There Prostate Cancer Risk Factors To Consider

Cancer researchers have identified several factors that could increase a mans risk of developing prostate cancer. In considering whether any of these risk factors apply to you, remember that having one or more of them does not mean you will get the disease. However, you should be sure to get all the prostate cancer screenings your physician recommends. It is also important to know that men without these risk factors may also have prostate cancer.

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How Serious Is My Cancer

If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.

The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.

Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.

If your cancer hasn’t spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.

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Genetic And Genomic Tests For Localized Prostate Cancer

Genetic testing

A man’s inherited genes predict his prostate cancer risk. For a long time, we have known that there is a family risk in prostate cancer. If your father or brother has prostate cancer, or your mother or sister has breast or ovarian cancer, you are at higher risk of being diagnosed with prostate cancer. To partially quantify that genetic risk, a germline test can be performed before a biopsy. This test of DNA from healthy cells can determine whether you have inherited genetic mutations, such as BRCA1 and BRCA2, known to increase prostate cancer risk. If the test shows you’re low risk, you may be able to avoid a biopsy even if you have a slightly elevated PSA, while still being actively monitored for prostate cancer.

Genomic testing

If already diagnosed with prostate cancer, you may undergo another type of test for assessing your genetic risk. A genomic test of tissue from your biopsy or prostatectomy can look for somatic mutations, alterations in the DNA of the cancer cells themselves. Genomic tests measure expression of various genes that relate to how aggressive a cancer is likely to be. They indicate how rapidly cancer cells are growing and how genetically abnormal they are relative to normal cells.

How Does The Doctor Know I Have Prostate Cancer

Men Find Out Their Prostate Cancer Risk

Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.

Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.

If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:

PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.

Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.

MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.

Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.

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Harms Of Early Detection And Treatment

The harms of screening for prostate cancer include harms from the PSA screening test and subsequent harms from diagnosis and treatment. Potential harms of screening include frequent false-positive results and psychological harms. One major trial in men screened every 2 to 4 years concluded that, over 10 years, more than 15% of men experienced at least 1 false-positive test result.5 Harms of diagnostic procedures include complications of prostate biopsy, such as pain, hematospermia , and infection. Approximately 1% of prostate biopsies result in complications requiring hospitalization. The false-positive and complication rates from biopsy are higher in older men.3 Adequate evidence suggests that the harms of screening and diagnostic procedures are at least small.

PSA-based screening for prostate cancer leads to the diagnosis of prostate cancer in some men whose cancer would never have become symptomatic during their lifetime. Treatment of these men results in harms and provides them with no benefit. This is known as overdiagnosis, and follow-up of large randomized trials suggests that 20% to 50% of men diagnosed with prostate cancer through screening may be overdiagnosed.3 Overdiagnosis rates would be expected to increase with age and to be highest in men 70 years and older because older men have high risk of death from competing causes.

Can A Blood Test Determine If You Have Prostate Cancer

When it comes to prostate cancer, screenings play a key role in saving lives. Earlier detection when there are no symptoms leads to earlier treatment and better outcomes. And the good news is that many prostate cancer screenings can be done with a simple blood test. But thats just the start.

Learn more about how the PSA is the first step in the prostate cancer journey.

Understanding the PSA

For more than 20 years, there has been a blood test to monitor men for high levels of a protein called a prostate-specific antigen, or PSA, that is often associated with prostate cancer. Unfortunately, this test is not perfect many harmless conditions can cause heightened levels of this protein, leading to unnecessary tests and procedures that carry their own risk.

The uncertainty over the value of the PSA test led the U.S. Preventive Services Task Force in 2012 to recommend it only be given to people at high risk of prostate cancer. Other groups, including the American Urological Association, opposed this decision at the time.

But that recommendation has been softened. Instead of advising against this test for most men, the task force now suggests that men aged 55 to 69 should talk to their doctor about its risks and potential benefits.

Dr. Vipul Patel, a urologist and robotic surgeon at the AdventHealth, calls that a step in the positive direction.

If youre over 50 years old, get PSA screening and get a rectal prostate exam, he says.

What the PSA Can Reveal

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Tissue Ablation And Focal Therapy

Tissue ablation treatments destroy the prostate cancer through freezing or heating. These treatments can be applied to all or just part of the prostate . Whereas whole gland ablation has largely fallen out of favor, focal ablation has gained popularity. The two most commonly used energy sources are as follows:

Cryosurgery kills cancer cells in the prostate by freezing them through special needles that are inserted into the gland. The needles are placed under ultrasound guidance. This method is effective in curing cancer but can’t treat lymph nodes and commonly causes erectile dysfunction if the entire prostate is treated. Urinary incontinence is a rare but possible side effect.

High-intensity focused ultrasound uses the high temperatures created by focused sound wave energy to kill cancer cells. While HIFU results over the years have been mixed, modern systems such the one used at UCSF allow real-time monitoring of tissue temperatures during treatment, improving outcomes.

Less commonly used ablation methods include interstitial laser ablation, electroporation , vascular targeted photodynamic therapy, gold nanoparticle therapy, and others under development. Focal radiation is used occasionally as well. Currently, there is little data comparing these technologies.

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