What Causes Prostate Cancer
Experts arent sure why some cells in the prostate gland become cancerous . Genetics appear to play a role. For example:
- Youre two to three times more likely to get prostate cancer if your father, brother or son has the disease.
- Inherited mutated breast cancer genes and other gene mutations contribute to a small number of prostate cancers.
Screening For Prostate Cancer
There are no tests available with sufficient accuracy to screen populations of men for early signs of prostate cancer. However, early detection and treatment can significantly improve prostate cancer survival.
The test most commonly used to aid early detection of prostate cancer is the prostate specific antigen blood test. This is not a diagnostic test as it can only indicate changes in the prostate. If you are concerned about prostate cancer you should talk to your doctor and make an informed choice about whether to have one of the tests designed to find early signs of prostate cancer, in view of the potential risks and benefits.
There are no proven measures to prevent prostate cancer.
What Is Early Prostate Cancer
Cancer is divided into four different stages, based on far it has spread. If you have early-stage prostate cancer, then your cancer is either Stage I or II.
This means cancer has not spread outside the prostate gland. Since it is contained, it is easier to treat and does not require common types of cancer treatment, like chemotherapy.
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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.
Filed in Treatment
In order of most important first, the answer to this question depends on a number of factors:
How Common Is Prostate Cancer
About one in nine men will receive a prostate cancer diagnosis during his lifetime. Prostate cancer is second only to skin cancer as the most common cancer affecting males. Close to 200,000 American men receive a diagnosis of prostate cancer every year. There are many successful treatments and some men dont need treatment at all. Still, approximately 33,000 men die from the disease every year.
Choosing A Treatment Option
Treatment Options for Localized or Locally Advanced Prostate Cancer A man diagnosed with localized or locally advanced prostate cancer has 3 major treatment options: Active Surveillance, surgery, and radiation therapy. For patients whose cancer appears more aggressive, combination treatment may be recommended. For example, radiation therapy…
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
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Considering Less Common Medical Treatment Options
Is Early Onset Prostate Cancer Common
The average age for a first prostate cancer diagnosis is 68. In the U.S., about 10% of men newly diagnosed with prostate cancer are under 55. You may also develop prostate cancer when youâre much younger, in your teens or as a young adult, though this is extremely rare.
Around the world, thereâs been an increase in early onset prostate cancer in men between 15 and 40 years old.
Experts arenât sure why thereâs an increase. It may be related to certain risk factors. It may also be because of changes in how itâs diagnosed. Screenings are more frequent, and thereâs more awareness that prostate cancer can happen in younger men.
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How Early Onset Prostate Cancer Is Different
Doctors think the type of prostate cancer you get when youâre younger may be different from prostate cancer with a later onset and are doing research to learn more.
If you get a prostate cancer diagnosis when youâre younger, itâs more likely to be in a more advanced stage. Youâre also more likely to have a lower rate of survival than middle-aged men and older men would.
In the U.S., the average 5-year survival rate for prostate cancer is between 95% and 100% for men ages 40-80.
For younger men, the 5-year survival rate is lower. For men ages 25-34, itâs 80%. For men ages 20-29, itâs 50%. For men ages 15-25, itâs 30%.
What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
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What Are Possible Side Effects Of Treatments For Localized Prostate Cancer
All treatments can cause side effects. The most common side effects are urinary, bowel, and sexual problems. Some problems happen soon after treatment, but others develop over time. Some side effects may get better, but some may last a long time or may never go away. Talk with your doctor if you have any side effects. There may be ways to help manage them.
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How Is Early Prostate Cancer Treated
Early cancers are usually dealt with in one of three ways:
- Monitoring through active surveillance or watchful waiting
- radical radiotherapy or brachytherapy.
Although any one of them may be most appropriate for you, these treatments can have very different effects on your quality of life. So you have an important part to play in making an informed choice.
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Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.
What Are The First Steps In Prostate Cancer Treatment
When a man receives a prostate cancer diagnosis, especially if testing shows the disease is in early stages, the doctor and patient often start with a watch and wait approach.
Prostate cancer is one of the most common cancers among men. As a result, theres a large body of data that show what treatments are most effective at any given stage of the disease. If prostate cancer is detected early and appears to be slow-growing, invasive procedures, chemotherapy, radiation and other approaches can sometimes do more harm than good.
As long as your doctor is monitoring your early-stage prostate cancer and has signed off, you can also try diets and doctor-approved, non-invasive alternative therapy to improve prostate cancer symptoms or general health. Beware, however herbal remedies, homeopathy, and acupuncture, etc., have shown limited or no effect on prostate cancer and could interfere with your doctors prescribed treatment. The most effective complementary/alternative therapy is focused on symptom relief rather than curing the cancer itself.
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Figure 1 Location Of The Prostate Gland
The prostate gland, about the size of a walnut, produces fluid that forms part of the semen that is ejaculated during sexual activity. The prostate is located adjacent to the rectum and just below the bladder, and wraps around the upper part of the urethra, which carries urine from the bladder out of the body.
This location creates challenges in both diagnosis and treatment. During a digital rectal exam, for example, a doctor is able to feel only the back portion of the prostate. If cancer has developed in the apex, base, or deep inside the prostate, it may not be palpable.
Surgeons and radiation oncologists also face challenges in eradicating a tumor without causing lasting damage to surrounding organs and structures. When removing a tumor from the breast or colon, a surgeon is able to remove enough surrounding tissue to ensure clean margins, meaning that all the cancer has been removed. But when treating prostate cancer, a comparable amount of tissue cannot be removed surgically or targeted. It takes a skilled surgeon and radiation oncologist to eradicate diseased tissue without harming portions of the rectum, bladder, and penis, thereby minimizing the likelihood of complications.
Its also important to understand the limits of current medical knowledge about prostate cancer.
What About Trans People
People born with a prostate can develop prostate cancer. Individuals born without a prostate cannot develop prostate cancer.
Anyone born with a prostate should speak to their doctor about screening for prostate cancer.
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Treatment Options For Early Stage Prostate Cancer
Early stage, or localized, prostate cancer refers to cancer that is still confined to the prostate either Stage I or Stage II. If you have been diagnosed with early stage prostate cancer you will be able to chose which kind of treatment is best for you. You do have time to do the research you need to make the right decision for you. Consider including those you love and respect as part of your journey, as they can provide, support, insight, and help. Some prostate cancer treatment options may impact your sexual function so it is important to be open and honest with your partner. Ask your doctor questions and try to talk to other men who have been diagnosed with prostate cancer.
In ZEROs annual survey more than half of the patient/survivors had support when making a treatment decision from someone not on their medical team . Of those, nearly all were a wife/spouse/partner.
Most men with early stage prostate cancer have several treatment options. To learn more about the treatment options here, visit our treatment section. The most common treatment options for early stage, or localized, prostate cancer include:
While all prostate cancer treatment can have side effects, the most common side effects of surgery and radiation are erectile dysfunction and urinary incontinence . It is important to talk with your doctor to understand potential side effects of each treatment option available to you.
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How Prostate Cancer Spreads
- The cells escape into the bloodstream, initially by invading small blood vessels around the tumor, then traveling to larger blood vessels that enable the cells to circulate around the body .
- The cells are filtered through the bodys lymph system although some are captured in lymph nodes, others may travel elsewhere in the body.
- The cells migrate along the length of a nerve, escaping from the prostate into adjacent soft tissue .
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Cancer Staging May Miss Errant Cells
Once a pathologist confirms that cancer is present, the doctor will next determine how far the cancer extends a process known as cancer staging and discuss the implications with you. This is perhaps the most important information of all for you to obtain, as it determines whether the cancer is likely to be curable, or whether it has already spread to additional tissues, making prognosis much worse.
If you were my patient, I would ask you to consider two important points. First, cancer staging actually occurs in two phases: clinical and pathological . Of the two, pathological staging is more accurate.
A second point to understand, however, is that even pathological staging can be inaccurate . A cancer spreads, or metastasizes, once a primary tumor sheds cancer cells that travel elsewhere in the body and establish other tumor sites. Metastasis is a complex process that researchers do not fully understand. What is clear is that this process involves multiple genetic mutations and steps, and that each type of cancer spreads in a unique way.
Advantages And Disadvantages Of External Beam Radiotherapy For Early Prostate Cancer
You may want to think about the advantages and disadvantages of external beam radiotherapy when deciding about treatment.
Radiotherapy and radical prostatectomy are both treatments that may cure early prostate cancer. They are equally effective in treating the cancer.
To choose the treatment that is best for you, it can help to look at the different advantages and disadvantages of each one. You can then make your decision in partnership with your doctor.
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