What Are The Stages Of Prostate Cancer
Cancer staging is first described using what is called a TNM system. The “T” refers to a description of the size or extent of the primary, or original, tumor. “N” describes the presence or absence of, and extent of spread of the cancer to lymph nodes that may be nearby or further from the original tumor. “M” describes the presence or absence of metastases — usually distant areas elsewhere in the body other than regional lymph nodes to which the cancer has spread. Cancers with specific TNM characteristics are then grouped into stages, and the stages are then assigned Roman numerals with the numerals used in increasing order as the extent of the cancer being staged increases or the cancer prognosis worsens. Prognosis is finally reflected by considering the patient’s PSA score at presentation as well as their Gleason score in assigning a final stage designation.
The American Joint Commission on Cancer system for prostate cancer staging is as follows:
Traditionally, advanced prostate cancer was defined as disease that had widely metastasized beyond the prostate, the surrounding tissue, and the pelvic lymph nodes and was incurable. However, a more contemporary definition includes patients with lower grade disease with an increased risk of progression and/or death from prostate cancer in addition to those with widely metastatic disease.
The National Cancer Institute and the National Comprehensive Cancer Network guidelines on prostate cancer version 2.2017 indicate the following:
Is Prostate Cancer Curable
Prostate cancer is the most common type of cancer among men, second only to skin cancer. Learning that one has any type of cancer isnt easy, but the first question on most patients minds after diagnosis is, is prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either. Non-invasive radiation therapy can effectively treat prostate cancer; in the case of Pasadena CyberKnife, radiosurgery treatment generally takes less than a week, and you can typically resume your normal activities the same day you receive treatment.
Doctors Speak Out About Alternative Prostate Cancer Treatment
Traveling to eight countries on three continents, he interviewed doctors about various aspects of their specialty. In all, 56 doctors are included in the filmMDs, DOs, NDs, and some PhDs that dont practice but do a lot of research.
All of the people in the documentary are highly-credentialed. We had a shorter version of the film that ran on PBC recently, and I had doctors complaining that these were voodoo doctors; I had to go to the head of the programming for this particular station and say, Look at the credentials of these people!
Its almost like you cannot attack conventional thinking because thats how they make their money, and thats all theyve learned. They dont have the frame of mind to go outside of that. I swear, if some of these guys got prostate cancer, they would change their entire thinking about it if they looked into what Ive learned,;Peter says.
Fox News host Tucker Carlson makes the case that the Pentagons vaccine mandate is being used to rid the military of anyone who doesnt meet the governments new standards, including Christians and Republicans, which he he said amounts to a takeover of the US military.
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What Is The Most Effective Treatment For Prostate Cancer
The choice of treatment for prostate cancer depends on many factors such as the patients prostate cancer risk as calculated from prostate-specific antigen levels, Gleason score, and tumor staging. Patients can discuss the significance of these factors in the choice of treatment with their doctor.
The standard effective treatment choices for men with early-stage prostate cancer are as follows
- Active surveillance: Monitoring the progression/status of the low-risk or early-stage cancer with regular testing and not treating it right away.
- Prostatectomy: Surgical removal of the prostate.;
- Radiation therapy: Use of high-energy waves to destroy cancer cells.
Radiation therapy is one of the most effective treatments for many men with early-stage prostate cancer. It is also the best prostate cancer therapy for older men or those with other co-existing diseases. It can be delivered to the patient in any of the two ways
- External beam radiation: Sending/focusing high-energy waves from an external machine into the tumor.
- Brachytherapy: Placing a radioactive dye in the tumor through an implant or hollow tubes.
For metastatic prostate cancer, androgen deprivation therapy is usually the choice of treatment. ADT is also the only option in patients with prostate cancer who are unfit or unwilling to undergo surgery or/and radiation therapy.
Adjusting To Your New Normal
While most people do well with prostate cancer treatment, and the survival rate is very high, treatments can change people physically and emotionally. Side effects of treatment are fairly common, and some of these can persist long after treatment has been completed.
The concept of “survivorship” with cancer is finally being addressed, and medical professionals are becoming much more aware of the need to help people live their best “new normal” possible after a diagnosis.
If you are coping with any of the late effects of cancer treatment, talk to your healthcare provider. It’s only recently that the idea of cancer rehabilitation has taken off, and is improving the lives of people who have survived treatment. Counseling can also be an integral part of cancer rehabilitation, helping people adjust to the many emotions and changes that can occur. Because this is so new, you may need to initiate the conversation with your practitioner.;
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What The Research Shows About Radiation Vs Surgery
The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.
The results, published in 2016, showed that the rate of disease progression among men assigned to radiotherapy or radical prostatectomy was less than half the rate among men assigned to active monitoring. However, there was no significant difference in survival at the median 10-year mark for radiation therapy, surgery or active surveillance.
If youre interested in directly comparing treatment outcomes by treatment method and risk group , the Prostate Cancer Free Foundation provides an interactive graph on its website with information from data obtained from over 100,000 prostate cancer patients over a 15-year period.
As discussed earlier in the sections on the side effects of radiation therapy and surgery, the researchers conducting the ProtecT trial also looked at side effects and quality-of-life issues and found that the three major side effects of these two treatment options that affect quality of life after prostate cancer treatment are urinary incontinence, sexual dysfunction and bowel health.
The trial found that urinary leakage and erectile dysfunction were more common after surgery than after radiation therapy. Gastrointestinal bowel problems were more common after radiation therapy.;
How Long Can You Live With Prostate Cancer With No Treatment
Studies have shown that between 86% and 98% of men with LPC do not die from their cancer in all age groups, the researchers wrote. In fact, more than 95% of patients with LPC live at least 10 years after their diagnosis, whereas only 25% of patients in this study expected to live more than 10 years.
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External Beam Radiation For Prostate Cancer
When most patients think of radiation therapy, they think of external beam radiation therapy;, in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.
EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated ;radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.
Changes To Your Sex Life
Sex will be a little different if you have surgery to remove your prostate gland. It means you wonât ejaculate, though you can still have an orgasm. Trouble getting erections or having orgasms is also a risk after an operation or if you have radiation therapy.
You can work with your doctor to cut those risks. Start by asking about “nerve-sparing” surgery and more precise radiation therapy. You can ask about the success they’ve had in protecting other men from these side effects.
If you do end up having problems after treatment, youâre not out of luck. Keep in mind that for many men, the problems go away on their own once the body has time to heal. Medications, devices, penile implants, and couples counseling also can make your sex life satisfying again. But most of all, be patient with yourself.
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Low Risk Localised Prostate Cancer
The treatments your doctor will offer you are:
- active surveillance or watchful waiting
- surgery to remove your prostate
- radiotherapy either internal or external beam
Your doctor will discuss the possible risks and benefits of each treatment with you.;
Radiotherapy and surgery work equally well at curing prostate cancer but have different side effects. Your doctor can explain these to you.
The table;below shows that there is very little difference in survival between the treatments. Understanding these and the possible side effects of each treatment;can help you and your doctor to make a decision.;
| Treatment for low risk localised cancer | Percentage of men who survive after 10 years |
|---|---|
| Active surveillance | 98 out of 100 |
| Surgery to remove your prostate | 99 out of 100 |
| Radiotherapy aiming to cure cancer | 99 out of 100 |
| Active surveillance | Surgery to remove the prostate | External beam radiotherapy | |
|---|---|---|---|
| 39 out of 100 | 71 out of 100 | 38 out of 100 | |
| Difficulty getting an erection | 29 out of 100 | 66 out of 100 | 48 out of 100 |
| Problems controlling your bowels | 2 out of 100 | 1 out of 100 | 5 out of 100 |
The risk of the same side effects after 6 years of treatment is similar between the different treatment groups.;
What Are The Potential Complications
Prostate cancer and treatment can lead to problems with urination as well as erectile dysfunction.
If stage 2 prostate cancer spreads outside the prostate, it can reach nearby tissues, the lymph system, or bloodstream. From there, it can metastasize to distant sites. Later-stage prostate cancer is difficult to treat and can be life-threatening.
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What Does The Prostate Do
The prostate is a male gland that releases;prostate fluid, one of the components of semen.
The muscles of the prostate gland help propel this fluid into the urethra;during ejaculation.
It is a;muscular gland that is often described as walnut or small apricot-sized.
An enlarged prostate can be a sign of prostate cancer, the third biggest cancer killer.
Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
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Transurethral Resection Of Bladder Tumors
TURBT is a procedure to diagnose and treat early-stage bladder cancer. With TURBT, a tissue sample from a suspicious area can be obtained. If cancer is present, we can remove the cancerous tissue by inserting a scope in the urethra, in a process called resection. This process is minimally invasive and does not require incisions.
What Are Prostate Cancer Survival Rates By Stage
Staging evaluation is essential for the planning of treatment for prostate cancer.
- A basic staging evaluation includes the patient examination, blood tests, and the prostate biopsy including ultrasound images of the prostate.
- Further testing and calculations may be performed to best estimate a patient’s prognosis and help the doctor and patient decide upon treatment options.
Prognosis refers to the likelihood that the cancer can be cured by treatment, and what the patient’s life expectancy is likely to be as a consequence of having had a prostate cancer diagnosis.
If a cancer is cured, your life expectancy is what it would have been had you never been diagnosed with prostate cancer. If the cancer cannot be cured due to it recurring in distant locations as metastases, or recurs either locally or in an area no longer able to be treated in a curative manner, then estimates can be made of what is likely to be your survival based again on group statistics for people who have been in the same situation.
Nomograms are charts or computer-based tools that use complex math from analysis of many patients’ treatment results.
The prognosis for prostate cancer varies widely, and depends on many factors, including the age and health of the patient, the stage of the tumor when it was diagnosed, the aggressiveness of the tumor, and the cancer’s responsiveness to treatment, among other factors.
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Tools To Help You Decide
The Predict Prostate tool can help you decide between monitoring and more radical treatment.;It is for men whose prostate cancer hasn’t spread.
It can’t tell you exactly what is going to happen in the future, but it gives you an idea about the differences in survival between the different treatment options. The tool works less well for men with a very high PSA or those with a fast growing or;large tumour.;;
To be able to use the tool;you need to know the following about your cancer:
- PSA level
- stage of cancer
- grade of cancer
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.
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How Is Stage 2 Prostate Cancer Treated
Your doctor will recommend treatment based on several factors, including your age, overall health, and whether or not youre having symptoms.
Your doctor might consider active surveillance if you have a slow-growing cancer and no symptoms. That means you wont actually be treating the cancer, but you will be monitoring it carefully with your doctor. This might involve visiting your doctor every six months, which would include a digital rectal exam and PSA testing. You might also need an annual prostate biopsy.
Active surveillance is only an option if you can commit to following up as advised by your doctor. Treatment will be considered if there are any changes.
Treatment may involve a combination of therapies, some of which are:
Diagnostic Advances In Prostate Cancer
Prostate cancer diagnosis is followed by staging of the cancer. If theres no evidence of metastasis of the original prostate tumor, meaning the cancer hasnt spread to other parts of the body, your cancer will also be assigned to a risk stratification group, also known as a risk group. The risk group attempts to predict the likelihood that the disease has spread microscopically outside the prostate. We informally refer to three risk groups: low risk, intermediate risk and high risk, although as many as six different groups exist.;;
The specific stage and/or risk stratification of your cancer may determine your treatment options. In general:
Depending on your specific diagnosis, you may have two or more good treatment choices that have similar outcomes, and you probably have time to investigate those options.;
Recent areas of advancement in oncology may provide a more accurate picture of your specific diagnosis, directing you and your doctor to more appropriate treatment options. Two specific developments include prostate-specific PET scan agents that may allow us to get more accurate imaging than we could before and the results of advanced genomic testing, which may help identify more aggressive cancers that are less suitable for active surveillance.;
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