Chemotherapy & Hormone Therapy
- Chemotherapy does not often cause erectile dysfunction, though it may affect the desire for sexual activity. Your desire may fluctuate over the course of treatment.
- Hormone therapy for prostate cancer is designed to decrease testosterone levels or prevent your body from using testosterone. This can result in loss of desire for sex, erectile dysfunction, and difficulty achieving orgasm, which tends to develop slowly over the first few months of hormone therapy.
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Medical History And Physical Exam
If your doctor suspects you might have prostate cancer, he or she will ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors, including your family history.
Your doctor will also examine you. This might include a digital rectal exam , during which the doctor inserts a gloved, lubricated finger into your rectum to feel for any bumps or hard areas on the prostate that might be cancer. If you do have cancer, the DRE can sometimes help tell if its only on one side of the prostate, if its on both sides, or if its likely to have spread beyond the prostate to nearby tissues. Your doctor may also examine other areas of your body.
After the exam, your doctor might then order some tests.
What Does A Digital Rectal Exam Do
In a digital rectal exam , the doctor inserts a gloved finger into your rectum to feel for irregularities of the prostate. Its a common part of a mans routine physical examination.
Your doctor might perform a DRE alone or with a PSA test for routine screening. Its a quick and simple test. Although a DRE can signal a problem, such as an enlarged prostate, it cannot determine if its due to prostate cancer.
Prostate cancer is diagnosed 15 to 25 percent of the time when abnormal findings on a DRE lead to biopsy.
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How Long After A Prostate Biopsy Should One Be Able To Urinate
QUESTION: How long after a prostate biopsy should one be able to urinate? Is it possible not to urinate for 1 month?
Pain During Erection Or Ejaculation
Some men find that erections and ejaculating is painful after surgery, or during and after their course of radiotherapy.
Painful erections following surgery could be due to internal bruising caused by the operation. The tube which carries urine from the bladder to the outside of the body gets inflamed by the radiotherapy treatment.
This side effect should disappear a few weeks after you finish radiotherapy or as you recover from surgery. Talk to your specialist nurse for specific advice. If masturbation and sex is important to you, its important to keep stimulating the penis to keep it healthy. On the other hand, if erections are very painful, you might need to avoid ejaculation for a while and try again later.
The penile injections to stimulate an erection can cause painful erections in some men. This pain might lessen with continued treatment.
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Reasons For Delays In Getting Your Biopsy And Cytology Test Results
The uncertainty you feel while waiting for biopsy and cytology test results can cause a lot of stress and anxiety. Not knowing when the results will be ready and not understanding why testing sometimes takes longer than expected can cause extra concern.
Routine biopsy and cytology results may be ready as soon as 1or 2 days after the sample gets to the lab. But there are many reasons some take much longer to complete.
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The Results Of My Prostate Biopsy Showed Only Inflammation In My Prostate Is There Anything I Should Be Doing To Treat The Chronic Inflammation
Prostatic inflammation is the most common cause of an elevated PSA. In the past, we treated patients with long-term antibiotic therapy however, our infectious disease experts are concerned that this would lead to the intestines becoming colonized with bacteria that are resistant to multiple antibiotics. Accordingly, we now must rely on the patients immune system to deal with the prostate inflammation unless the patient is acutely ill with a high fever and/or a urinary tract infection.
What Does My Prostate Do
The prostate is beneath the bladder and in front of the rectum. Itâs a walnut-shaped gland that surrounds part of the urethra. . Hereâs what it does:
- It produces fluid for semen, which includes sperm produced in the testicles.
- It prevents urine from being included during ejaculation.
If it gets too big, your prostate can block pee from passing through the urethra and out the penis.
How Important Is The Gleason Score
The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Still, other factors are also important, such as:
- The blood PSA level
- How much of each core is made up of cancer
- The number of cores that contain cancer
- Whether cancer was found in both sides of the prostate
- Whether the cancer has spread outside the prostate
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Genetic Testing For Some Men With Prostate Cancer
Some doctors now recommend that some men with prostate cancer be tested to look for certain inherited gene changes. This includes men in whom a family cancer syndrome is suspected, as well as men with prostate cancer that has certain high-risk features or that has spread to other parts of the body. Talk to your doctor about the possible pros, cons, and limitations of such testing.
Husbands Prostate Biopsy Results
My husband went to a local centre who were asking men to come and have a blood test for Prostate Cancer.He then received his results and was informed that it was showing a high result and to check with the GP.He referred my husband to a hospital consultant who sent him for a MRI.He wedas phoned up after 11 days to say that there was an abnormality shown up and he needed to come in for a biopsy,which was 2 days later.That was 4 weeks ago and we havent heard anything about the results.He was sent a follow up appointment for the 18th July,which will be nearly 6 weeks after the biopsy.Is this normal?Dont know if to feel worried about the length of time this appointment will have taken?
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I Have Had Biopsies Three Times With Each One Turning Out Negative My Psa Went From 5 To 7 To 135 And Now It Is At 115 My Doctor Wants To Do Exploratory Surgery I Am Wondering If This Is Really Necessary Would You Recommend That I Get More Testing Done At Well
Im not certain what he meant by exploratory surgery. Sometimes, performing multiple biopsies under anesthesia can help find cancers that were missed by out-patient office biopsies. Please see other Q& A about high PSA and multiple negative biopsies. The key is to have the prostate gland sampled thoughtout especially the anterior region, which is often missed on office biopsies.
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Isnt A Psa Test Enough
The prostate specific antigen test is a common screening test for prostate cancer. PSA is a protein that comes from the prostate gland. The test measures the amount of PSA in your blood. Its a simple blood test, and for some men, it turns out to be a lifesaver.
On the other hand, its value as a diagnostic tool is fairly limited. High PSA levels may be a sign of prostate cancer, but its not enough to diagnose the disease with certainty. Thats because there are other reasons your PSA levels could be high, including urinary tract infection and inflammation of the prostate.
Also, a single abnormally high PSA test result cant tell you if the high level is temporary or rising over time.
Low PSA levels cannot definitively rule out prostate cancer, either. The fact is that PSA tests can result in both false positives and false negatives.
PSA tests can be useful during and after treatment for prostate cancer. Rising PSA levels may signal that treatment is not effective or there is a recurrence of the cancer. If your PSA levels are decreasing, your current treatment is probably doing its job.
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Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
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Temporary Effects On Your Bowel Movements Urine And Semen
- You might see blood in your bowel movements. You might also have a small amount of bleeding from your rectum. These can happen right after your procedure or for the next few days when you have a bowel movement.
- You might see blood in your urine for 7 to 14 days after your procedure. This bleeding might come and go.
- Your semen might look rust-colored for up to 12 weeks after the biopsy. This is because small amounts of blood might be in it.
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When Do I Need A Biopsy
Your doctor may order a biopsy if your prostate-specific antigen level in your blood work is elevated or there is an abnormal lump found during a digital rectal exam. During a digital rectal exam, your doctor inserts a finger up your bottom to feel if your prostate is enlarged or has bumps. Another option before a biopsy is an ultrasound. Instead of a finger, a small probe is inserted to take pictures of the prostate.
An MRI-guided prostate biopsy may be used in patients who have a rising PSA level, yet a negative ultrasound-guided biopsy. It also may be used in situations where a diagnostic prostate MRI performed because of rising PSA demonstrates a very small abnormality that may not be easily targeted by ultrasound. An MRI image to guide a biopsy can improve the ability to detect prostate tumors which may require treatment.
Contact A Caregiver If:
- You cannot get an erection .
- You feel pain or burning when you urinate.
- You feel weak, and your face is hot and red.
- You have a fever and chills.
- You see blood in your urine, bowel movements , or semen.
- Your urine is cloudy and smells bad.
- You have questions or concerns about your procedure or condition.
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What Are The Side Effects Of A Biopsy
Having a biopsy can cause side effects. These will affect each man differently, and you may not get all of the possible side effects.
Pain or discomfort
Some men feel pain or discomfort in their back passage for a few days after a TRUS biopsy. Others feel a dull ache along the underside of their penis or lower abdomen . If you have a transperineal biopsy, you may get some bruising and discomfort in the area where the needle went in for a few days afterwards.
If you receive anal sex, wait about two weeks, or until any pain or discomfort from your biopsy has settled, before having sex again. Ask your doctor or nurse at the hospital for further advice.
Some men find the biopsy painful, but others have only slight discomfort. Your nurse or doctor may suggest taking mild pain-relieving drugs, such as paracetamol, to help with any pain.
If you have any pain or discomfort that doesnt go away, talk to your nurse or doctor.
Its normal to see a small amount of blood in your urine or bowel movements for about two weeks. You may also notice blood in your semen for a couple of months it might look red or dark brown. This is normal and should get better by itself. If it takes longer to clear up, or gets worse, you should see a doctor straight away.
Symptoms of a urine infection may include:
- pain or a burning feeling when you urinate
- dark or cloudy urine with a strong smell
- needing to urinate more often than usual
- pain in your lower abdomen .
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Surgical Approach And Study Design
All patients underwent open retropubic or robotic-assisted laparoscopic RP. Each specimen was evaluated by two specialized uropathologists. Beginning in November 2017, radical prostatectomy was routinely performed with an intraoperative frozen section technique and with full functional length preservation of the prostatic urethra as described earlier .
Patients were stratified by time from biopsy to surgery 3 months vs. > 3 and < 6 months. Relevant outcome variables were pathologic Gleason grade, pT-stage, surgical margin status, lymph node involvement , lymphovascular invasion , perineural invasion , and nerve sparing procedure. Stratified subanalyses were performed for patients with intermediate- and high-risk prostate cancer according to the D’Amico classification .
Prostate Biopsy: How It Works
The instrument used to perform most prostate biopsies today is a spring-loaded device that pokes a hollow needle through the rectal wall to collect small samples of prostate tissue, guided by an ultrasound or MRI.
The samples are quite smalljust several times the diameter of the lead in a mechanical pencil. Later, a pathologist checks the samples under a microscope for signs of cancer.
Prostate biopsy comes with certain risks. For example, when the biopsy needle passes through the rectal wall to reach the prostate, it can spread a bacterial infection to the prostate gland or bloodstream.
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Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
- You are bleeding from your rectum.
- You are urinating very little or not at all.
- You have pain from your procedure that does not get better, even after taking pain medicines.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
Tests To Diagnose And Stage Prostate Cancer
Most prostate cancers are first found as a result of screening. Early prostate cancers usually dont cause symptoms, but more advanced cancers are sometimes first found because of symptoms they cause.
If prostate cancer is suspected based on results of screening tests or symptoms, tests will be needed to be sure. If youre seeing your primary care doctor, you might be referred to a urologist, a doctor who treats cancers of the genital and urinary tract, including the prostate.
The actual diagnosis of prostate cancer can only be made with a prostate biopsy .
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