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How Serious Is Prostate Cancer

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Survival For All Stages Of Prostate Cancer

Hormone deprivation for prostate cancer is dangerous. Avoid it!

Generally for men with prostate cancer in England:

  • more than 95 out of 100 will survive their cancer for 1 year or more
  • more than 85 out of 100 will survive their cancer for 5 years or more
  • almost 80;out of 100 will survive their cancer for 10 years or more

Survival for prostate cancer is also reported in Scotland and Northern Ireland. But it is difficult to compare survival between these countries because of differences in the way the information is collected.;

Cancer survival by stage at diagnosis for England, 2019Office for National Statistics

These statistics are for net survival. Net survival estimates the number of people who survive;their;cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account the background mortality that they would have experienced if they had not had cancer.

Myth: Prostate Cancer Treatment Always Causes Incontinence

Fact:;Next to sexual function, men worry most about;urinary incontinence;as a result of prostate cancer treatment. Sartor says sexual side effects are more common than the urinary side effects the year after surgery. The majority of people do not have significant urinary problems.

If you do have bladder problems, youre more likely to face minor leakage than major accidents and in most men, the situation is temporary or treatable.

To help ensure the best outcome after surgery, Sartor recommends looking for a surgeon who has performed the procedure many times surgeons who are on their 900th procedure, for example, not their 41st. Experience does matter, he says. Its important to consider.

Myth: If The Cancer Comes Back It Cant Be Treated Again

Fact:;Recurrence of prostate cancer can be wrenching. But just because a cancer comes back doesnt mean you cant reach remission again. What it does mean is that youll likely have to try another approach to treatment.

Your first cancer cure is always the best, says Sartor. But you do have a possibility for cure if it comes back particularly if youve had an initial radical prostatectomy, in which case if you catch early, you can radiate and get a pretty good cure rate.

Sartor adds that one of the reasons he often recommends surgery before radiation is for this reason so that people get a second chance at cure if the cancer comes back and they monitor their condition appropriately.

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Outlook For Men With Advanced Prostate Cancer

While it isnt possible to cure;advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain.

Some men may not respond well to one treatment, but may respond better to another. And when your first treatment stops working, there are other treatments available to help keep the cancer under control for longer.

How Do I Know If I Have Prostate Cancer

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Doctors use two tests to look for prostate cancer: a digital rectal exam and a PSA blood test.

The PSA blood test looks for prostate-specific antigen in the blood. Experts are divided on who should have a PSA test and when to have it:

  • The U.S. Preventive Services Task Force recommends that for men aged 55 to 69, the decision to have PSA testing should be an individual one based on a conversation about risks and benefits with their doctor.
  • The American Cancer Society recommends a discussion between the doctor and patient about the pros and cons of PSA tests. Men shouldn’t get the test unless their doctor has given them this information, the group says. It also recommends that the discussion start at age 50 for most men at average risk for prostate cancer, or ages 40 to 45 for those at high risk of prostate cancer.
  • The American Urological Association also recommends that men talk with their doctor about the pros and cons of the PSA test. That discussion should typically take place between the ages of 55 and 69. For those at higher risk for prostate cancer, the discussion can take place as early as ages 40 to 54.

PSA levels in blood are higher if there is prostate cancer, making it a valuable tool in finding early prostate cancer. But PSA levels can also be high from infection or inflammation in the prostate or from an enlarged prostate.

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What You Need To Know About Prostate Cancer

Unless it causes problems, most men dont give a lot of thought to their prostate. The small gland is responsible for producing seminal fluid , and its located beneath the bladder and around the urethra, the tube that transports fluid to the penis.

Most types of prostate cancer are known as adenocarcinomas, which are cancers that develop from gland cells, the Mayo Clinic says.

While some forms of prostate cancer grow and spread quickly, others grow quite slowly. The American Cancer Society notes that some people can have undetectable prostate cancer for decades without it causing any problems. But the risks of prostate cancer are quite serious, particularly as it begins to spread to other areas of the body.

Questions To Ask Your Doctor Or Nurse

  • What type of hormone therapy are you offering me and why?
  • Are there other treatments I can have?
  • What are the advantages and disadvantages of my treatment?
  • What treatments and support are available to help manage side effects?
  • Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
  • How often will I have check-ups and what will this involve?
  • How will we know if my cancer starts to grow again?
  • What other treatments are available if that happens?
  • Can I join any clinical trials?
  • If I have any questions or get any new symptoms, who should I contact?

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Hormonal Therapy For Aggressive Prostate Cancer: How Long Is Enough

  • By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Men weighing treatment options for intermediate- or high-risk cancer that is still localized to the prostate can face a tricky question. A standard approach in these cases is to give radiation to the prostate along with drugs that block testosterone, a hormone that makes the cancer cells grow faster. For how long should this hormone therapy last? Thats not entirely clear. The drugs have side effects, such as fatigue, impotence, and a loss of muscle mass. But radiation doesnt control prostate cancer effectively without them. Doctors therefore aim to give hormone therapy only for as long as it takes to help their patients, without causing any undue harm.

Now, newly published results from a phase 3 clinical trial are providing some needed guidance.

Average Psa Test Doubling Time

Prostate Cancer – How Dangerous Can it Be?

Another red flag. This calculation denotes the;time it takes your PSA values to double.

Therefore it may signify the aggressiveness of any prostate abnormalities, whether it’s an enlarged prostate, prostatitis, or prostate cancer.

If your average PSA readings double in less than three years your doctor will most likely order a biopsy, to look in to the problem further and discuss possible prostate cancer treatment options.

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What Questions Should I Ask My Healthcare Provider

If you have prostate cancer, you may want to ask your healthcare provider:

  • Why did I get prostate cancer?
  • What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
  • Has the cancer spread outside of the prostate gland?
  • What is the best treatment for the stage of prostate cancer I have?
  • If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
  • What are the treatment risks and side effects?
  • Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
  • Am I at risk for other types of cancer?
  • What type of follow-up care do I need after treatment?
  • Should I look out for signs of complications?

A note from Cleveland Clinic

Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.

To Treat Or Not To Treat

Up until now, with a few notable exceptions, doctors have myopically focused on treating prostate cancer, says Adami. They are willing to spend tens of thousands of dollars on chemotherapy that has minimal effects on cancer mortality, often with substantial side effects. But we ignore entirely the fact that large groups of prostate cancer patients die from other causes that actually are preventable.

Among older patients especially, that activity can take the form of vigorous walking. Recently, Mucci has spearheaded an intervention with Adami and other colleagues in Sweden, Iceland, and Ireland in which men walk in groups with a nurse three times a week. In a pilot study, researchers found improvements in just 12 weeks in body weight, blood pressure, sleep, urinary function, and mental health.

Scientists at HSPH are also searching for genetic and lifestyle markers that help predict how aggressive a patients prostate cancer will be. For example, an ongoing project led by Mucci and Adami draws on detailed cancer registries in Nordic countries, including an analysis of 300,000 twins, to tease out the relative contribution of different genes to prostate cancer incidence and survival.

is a Boston-based journalist and author of The Coke Machine: The Dirty Truth Behind the Worlds Favorite Soft Drink.

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Possible Side Effects Of Chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow , the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can also be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and how long they are taken. Some common side effects can include:

These side effects usually go away once treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.

Along with the risks above, some side effects are seen more often with certain chemo drugs. For example:

  • Docetaxel and cabazitaxel sometimes cause severe allergic reactions. Medicines are given before each treatment to help prevent this. These drugs can also damage nerves , which can cause numbness, tingling, or burning sensations in the hands or feet.
  • Mitoxantrone can, very rarely, cause leukemia several years later.
  • Estramustine carries an increased risk of blood clots.

If you notice any side effects while getting chemo report them to your cancer care team so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

Risk Factors For Prostate Cancer

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Because prostate cancer tends to not show symptoms in its early stages, risk factors are another useful tool to identify candidates for screening. The Mayo Clinic notes that risk certainly increases as you grow older, and obese men may be more likely to have prostate cancer that is aggressive or difficult to treat.

For unknown reasons, black men are also at a greater risk of prostate cancer than men of other races. Not only are they more likely to get prostate cancer, but the risk of prostate cancer being aggressive or advanced is also higher.

Finally, your family history or genetics can also help determine your prostate cancer risk. For example, men with close relatives who had prostate cancer are more likely to get it. Also, a family history of breast cancer or the presence of the genes BRCA1 or BRCA2 within the family also raises the likelihood of a man developing prostate cancer.

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Prostatitis: A Common Problem In Men Under 50

“The;PSA;test is a good screening tool for prostate cancer, but it is not very specific,” says Erik P. Castle, MD,;a urologist and researcher at the Mayo Clinic in Phoenix, Arizona. “Common causes of inflammation in the gland, called;prostatitis, can cause high;PSA;levels.”

Prostatitis;is the most common prostate problem for men younger than 50.

Prostatitis;caused by bacteria can be treated with antibiotics. Another, more common type of;prostatitis, called;nonbacterial;prostatitis, can be harder to treat and may last a long time.

Learn The Facts About Prostate Cancer

Most people dont think;prostate cancer;is going to happen to them, unless their father or brother had it, says;Oliver Sartor, MD, a professor of medicine and urology at the Tulane University School of Medicine in New Orleans.

However, given that about 164,000 men in the United States will be diagnosed with the disease in 2018, according to the;American Cancer Society , its likely that you or someone you know will be affected. Prostate cancer is the second leading cause of death from cancer in American men, right behind lung cancer.

But while its a serious disease, and it does take lives, most men dont die from it. In fact, the ACS;says that more than 2.9 million Americans whove been diagnosed with prostate cancer are still alive today.

Despite this prevalence, myths and confusion abound when it comes to understanding your own personal level of risk, and what to do when your doctor says you have prostate cancer.

The diagnosis almost always hits people out of the blue, Dr. Sartor says. It’s not what you plan on, and of course it’s very disruptive. For many men, prostate cancer creates a general cognitive dissonance: Why me? What did I do wrong? What am I going to do about it now that my life is being threatened?

Additional reporting by Andrea Peirce

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Stage Iv Prostate Cancer Prognosis

Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.

How We Treat Prostate Cancer

The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.

Symptoms Of Prostate Cancer

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Prostate cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour grows and causes changes in the body such as changes in bladder habits. Other health conditions can cause the same symptoms as prostate cancer.

The signs or symptoms of prostate cancer include:

  • more frequent urination , especially at night
  • a strong or sudden urge to urinate
  • difficulty starting the flow of urine
  • weak or slow urine stream
  • interrupted urine stream
  • being unable to empty the bladder completely
  • having difficulty controlling the bladder , which can cause urine to leak and dribble
  • blood in the urine or semen
  • burning or pain during urination
  • discomfort or pain when sitting, caused by an enlarged prostate
  • painful ejaculation
  • trouble getting an erection
  • pain or stiffness in back, hips or pelvis that doesn’t go away
  • fatigue

In rare cases, prostate cancer can cause paraneoplasticsyndrome. This is a group of symptoms including high blood pressure, fatigueand weight loss that may happen when substances released by cancer cellsdisrupt the normal function of nearby or distant organs or tissues.

In some cases, prostate cancer can cause serious problems.These cancer-related emergencies are uncommon but need to be treated right awayand are usually a sign of advanced cancer:

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Myth: You’ll Insult Your Doctor If You Get A Second Opinion

Fact:;Seeking a second opinion isnt bad manners its good sense. Even doctors themselves ask for help and input from their colleagues. There’s nothing wrong with talking to several doctors to get to that comfort zone that you deserve before undertaking a significant procedure, Sartor says.

You should feel free to ask for second opinions about everything from your diagnosis to your treatment options. Dont sacrifice your own well-being for fear of hurting your doctors feelings.

What About Other Treatments I Hear About

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

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Testing For Prostate Cancer Metastasis

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
  • Bone scans;
  • 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. 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.

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