Thursday, February 2, 2023

How Is Prostate Cancer Found

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Stage 2 Prostate Cancer

How I found out I have Prostate Cancer. This video could save your life.

In stage 2, the tumor is still confined to your prostate and hasnt spread to lymph nodes or other parts of your body. A doctor may or may not be able to feel the tumor during a prostate exam, and it may appear on ultrasound imaging. The survival rate is still .

The PSA score for stage 2 is less than 20 ng/mL.

Stage 2 cancer is further divided into three phases depending on the grade group and Gleason scores:

  • Gleason score: 6 or less

Joining A Clinical Trial

Clinical trials are medically supervised, carefully controlled patient studies that attempt to determine whether a proposed new treatment is both safe and effective. Clinical trials also look at whether a new treatment can lead to better outcomes than existing treatments. These studies may involve researchers from a variety of disciplines, such as general medicine, medical specialties, genetics, biology, chemistry, engineering and psychology. Clinical trials are conducted at medical centers around the country, and participants are often actively recruited.

New treatments are continually being developed for prostate cancer. Many prostate cancer trials are designated for patients with a rising PSA after local treatment or for those with advanced, metastatic cancers. However, there are also many trials for men with less aggressive cancer, such as the active surveillance trials at UCSF. We also conduct trials of neoadjuvant treatment, which are medications given before surgery for higher-risk prostate cancer. Several new treatments and approaches show promise some as simple as lifestyle changes in diet and exercise.

Funding sources for clinical trials include the National Cancer Institute, Department of Defense, universities and medical centers, private research foundations, pharmaceutical and biotechnology companies, and various combinations of these groups.

Clinical trials usually occur in phases:

When Should You Start Screening

First, talk to your doctor at your next checkup to go over your particular risk factors. You may have more than one risk factor at play and thus have a greater chance of developing prostate cancer than other men.

In general, discussions with your doctor about screening for prostate cancer should begin in your 40s. Here are some rough guidelines:

Do you have family history of prostate,ovarian, breast, colon, or pancreatic cancers,or do you know that gene mutations are present in your family? Discuss screening with your doctor startingaround age 40.

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What Is The Source Of The Information

Researchers funded by the Agency for Healthcare Research and Quality, a Federal Government research agency, reviewed studies on treatments for localized prostate cancer published between January 1, 2007, and March 7, 2014. The report included 52 studies and was reviewed by health care professionals, researchers, experts, and the public.

Testing For Prostate Cancer Metastasis

New Target to Fight Prostate Cancer Progression Found

After your biopsy, additional tests or imaging may be performed to check for cancer spread, though these are not required in all men with newly diagnosed prostate cancer.

You may need additional tests if you have:

  • High PSA levels
  • Extensive prostate involvement on biopsy
  • High Gleason scores
  • Computed tomography scans of your abdomen and pelvis
  • Magnetic resonance imaging of your pelvis

Many centers, including SCCA, are testing other means of finding cancer spread using new types of positron emission tomography scans. We offer prostate-specific membrane antigen PET, which is considered the most sensitive measure of prostate cancer detection. We also have an imaging test called Axumin® PET. Sometimes lymph nodes around the prostate may be checked for metastasis in order to design treatment appropriately.

At SCCA and University of Washington Medical Center, a long-term effort has identified cells in the bone marrow that originated from prostate cancer, even in the absence of other evidence of spread. With these and other studies being offered to men with advanced prostate cancer, we hope to find ways to identify men at the highest risk of relapse so this knowledge can inform our treatment recommendations.

A protein made by the prostate gland and found in the blood. Prostate-specific antigen blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia , or infection or inflammation of the prostate gland.

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New Prostate Cancer Blood Test

If you have an abnormal PSA score, your doctor may recommend another newertest that gives a better sense of yourprostate cancer risk. The prostate health index is one such test that is a more accurateblood test and measures your risk for having prostate cancer. Its approvedby the FDA for men who have PSA scores between 4 and 10.

What are the benefits of the PHI test?

  • Fewer unnecessary biopsies: Some men who have elevated PSA scores are unsure about getting an invasive biopsy. This tool can be used to better determine whether your risk is high enough to warrant a biopsy.
  • More accurate: This test is better at detecting prostate cancer. It can also detect whether you have a more aggressive type of cancer. This information can guide doctors to a more targeted treatment plan for you.

If you score low on the PHI test, your doctor may recommend monitoring youover time to see if your levels rise enough to cause concern.

Concerns About Prostate Cancer Screening

If prostate cancer is found as a result of screening, it will probably be at an earlier, more treatable stage than if no screening were done. While this might make it seem like prostate cancer screening would always be a good thing, there are still issues surrounding screening that make it unclear if the benefits outweigh the risks for most men.

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What Will This Summary Tell Me

This summary will tell you about:

  • What localized prostate cancer is
  • Common treatment options for localized prostate cancer
  • What researchers found about how the treatments compare
  • Possible side effects of the treatments
  • Things to talk about with your doctor

This summary does not cover:

  • How to prevent prostate cancer
  • Less common treatments for localized prostate cancer, such as high-intensity focused ultrasound , cryotherapy , proton-beam radiation therapy , and stereotactic body radiation therapy
  • Herbal products or vitamins and minerals
  • Treatments for cancer that has spread outside the prostate gland

*In this summary, the term doctor refers to your health care professional, including your primary care physician, urologist, oncologist, nurse practitioner, or physician assistant.

Prostate Cancer Risk Assessment

Warning Signs of Prostate Cancer

Prostate cancer represents a wide spectrum of disease. Some prostate cancers progress and need treatment, while others grow slowly, if at all, and can be managed conservatively with a system of careful monitoring called active surveillance. It is important to learn the characteristics of your cancer before making treatment decisions. There are many ways to determine prostate cancer risk, most of which incorporate information from several parameters, including the PSA, Gleason score and tumor extent .

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Prevalence Of Prostate Cancer

Prostate cancer is the second most common cancer in U.S. men and is the second leading cause of cancer death in men. One in nine men born in the U.S. today will be diagnosed with prostate cancer during his lifetime. The risk of dying from prostate cancer, however, is much lower, at one in 41. Your individual risk depends on your risk factors. Continue reading this document to better understand your particular risk.

The American Cancer Society has estimated that more than 248,000 new cases of prostate cancer will be diagnosed each year in the United States and more than 33,000 men will die from the disease. The death rate for prostate cancer is twice as high for African American men as for the general population.

Most cases are diagnosed when men are in their 60s and 70s , although prostate cancer is sometimes detected in men in their 50s or younger. The good news is that the five-year survival rate for all stages of prostate cancer has increased from 69% to almost 99% over the past 20 years. These rates vary depending on the extent of disease. Reasons for this improvement include increased public awareness, earlier detection though screening with prostate specific antigen blood tests, and advances in the treatments for this cancer.

Drugs To Treat Cancer Spread To Bone

If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab. Sometimes, radiation, radiopharmaceuticals, or pain medicines are given for pain control.

Side effects of bone medicines

A serious side effect of bisphosphonates and denosumab is damage to the jaw, also called osteonecrosis of the jaw . Most people will need to get approval from their dentist before starting one of these drugs.

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Promising Prostate Cancer Drug Hints At Improved Immunotherapy

Immunotherapy is a promising cancer treatment, but getting it to work against solid tumors is proving difficult. A new study has not only identified a drug thats effective against solid tumors, but may have uncovered a reason that immunotherapy often fails.

The human immune system is a powerful weapon, but cancer does a good job of hiding from it and creating an environment around itself that keeps immune cells out. Immunotherapy is an emerging treatment that allows scientists to supercharge the immune system against cancer, and while its had some success against things like melanoma and leukemia, the technique hasnt translated well to solid tumors.

But new research into a drug that helps treat prostate cancer might have uncovered a mechanism for immunotherapys patchy record, and point to a way to fix it. Scientists at Washington University in St. Louis started out by testing a drug compound called -9b, which in previous studies had proven promising against cancer. Since the drug is known to block a gene called ACK1, the team engineered mice to completely lack this gene and investigated how well they responded to cancer.

The research was published in the journal Nature Communications.

Unique Germline Variants Found Among Black Prostate Cancer Patients

MR Imaging of Prostate Cancer in Radiation Oncology: What Radiologists ...

In a study appearing in JCO Precision Oncology, researchers uncovered more than two dozen unique pathogenic or likely pathogenic variants within a cohort of Black prostate cancer patients. The Duke University School of Medicine-led team performed whole-exome sequencing of a population-based cohort of 743 Black prostate cancer patients, all of whom had been diagnosed with the disease at 62 years of age or younger. Within 30 men, they found 26 unique pathogenic or likely pathogenic variants in more than a dozen genes, including HOXB13, BRCA1, BRCA2, BRIP1, ATM, CHEK2, and PALB2. Additionally, they identified within 39 men 33 unique variants of unknown significance within 16 genes. The researchers note that most individuals with these germline variants were more likely to have a relative who had been diagnosed with DNA damage repair, or DDR, gene-related cancer. “Variants in DDR genes and HOXB13 may be important cancer risk factors for Black men diagnosed with early-onset prostate cancer, and are more frequently observed in men with a family history of cancer,” the researchers write.

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Who Is At Risk For Prostate Cancer

Certain men are at higher risk than others for prostate cancer, which may affect when they should start being screened. The risk increases with age, particularly after age 50. Some risk factors include:

  • African American men are twice as likely as white men to develop the disease.
  • Having a family history a father or a brother diagnosed with prostate cancer, particularly if it is at a relatively early age increases the risk.
  • Having a family history of breast and ovarian cancer may also be associated with an inherited risk of developing prostate cancer
  • High-fat diet and/or obesity

Who Is More Likely To Develop Prostate Cancer

Anyone who has a prostate can develop prostate cancer. But certain factors can make you more likely to develop it:

  • Age. Your chance of developing prostate cancer increases as you get older. Prostate cancer is rare in people under age 50.
  • Family health history. Your risk of prostate cancer is higher if you have a parent, sibling, or child who has or has had prostate cancer.
  • Race. African Americans are more likely to get prostate cancer. They’re also more likely to:
  • Get prostate cancer at a younger age.
  • Have more serious prostate cancer.
  • Die from prostate cancer.

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Does It Matter Where Treatment Is Performed

A large body of evidence shows that in the case of surgery for prostate cancer, surgical experience matters greatly. Medical centers and surgeons performing a high number of prostatectomies per year demonstrate better outcomes in terms of both cancer control and quality of life than those performing relatively low numbers. We don’t have similar data regarding radiation outcomes, but performing brachytherapy well certainly requires expertise and experience, particularly in prostate ultrasound. Planning and administering EBRT effectively has many subtleties, which likely translate to better outcomes with more experienced doctors. No matter what the practice volume of specific surgeons or radiation oncologists, they should be able to discuss their own demonstrated outcomes both in terms of cancer control and quality of life.

Finding Out If The Cancer Has Spread

Prostate cancer: warning signs, diagnosis and treatment

To find out if cancer has spread outside of the prostate, doctors may perform the imaging tests listed below. Doctors are able to estimate the risk of spread, called metastasis, based on PSA levels, tumor grade, and other factors, but an imaging test can confirm and provide information about the cancers location.

Imaging tests may not always be needed. A CT scan or bone scan may not be necessary for those with no symptoms and low-risk, early-stage prostate cancer, as determined with information from the PSA test and biopsy. Learn more about when these tests are recommended to find out if the cancer has spread.

For people with advanced prostate cancer, ASCO recommends that 1 or more of the imaging tests below be done to provide more information about the disease and help plan the best treatment. This includes when there is a newly diagnosed, high-risk cancer if metastasis is suspected or confirmed if the cancer has returned following treatment or when the cancer grows during the treatment period. Learn more about this guideline on the ASCO website.

Magnetic resonance imaging . An MRI scan uses magnetic fields, not x-rays, to produce detailed images of the body. An MRI can be used to measure the tumors size, and a scan can focus specifically on the area of the prostate or on the whole body. A special dye called contrast medium is given before the scan to create a clearer picture, which is injected into a patients vein.

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What Is Prostate Cancer

Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.

Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.

Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.

Ask your doctor to use this picture to show you where your cancer is.

The prostate

The prostate is a gland found only in men, so only men can get prostate cancer.

The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.

There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.

Genetic Variants Linked To Prostate Cancer In Black Men Identified

Research carried out at Wayne State and Duke University Schools of Medicine has identified 26 unique genetic variants in Black men that appear to be associated with more severe prostate cancer in this population group.

Prostate cancer is the most common cancer diagnosed in adult men in the U.S. Although it has a high survival rate, with an average 15-year survival rate of around 95%, there are still 248,530 cases per year and it ranks second in overall cancer mortality for adult men causing almost 35,000 deaths per year.

Black men have a higher incidence and are more than twice as likely to die from prostate cancer compared with non-Hispanic White men. This is thought to be partly due to societal causes, but could also at least partly be explained by genetic variants that are more common in Black than non-Hispanic White men.

We need to take a closer look at genetic associations to learn more about the susceptibility Black men have to developing prostate cancer, said co-lead investigator Kathleen Cooney, a professor at Duke University, in a press statement. This could potentially reduce health disparities.

Until recently, many genetic studies were unfortunately dominated by non-Hispanic White participants and so knowledge about pathogenic or likely pathogenic variants linked to prostate cancer in Black populations was limited.

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Imaging Tests For Prostate Cancer

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:

  • To look for cancer in the prostate
  • To help the doctor see the prostate during certain procedures
  • To look for spread of prostate cancer to other parts of the body

Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.

The imaging tests used most often to look for prostate cancer spread include:

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