How Is Prostate Cancer Diagnosed
Screenings are the most effective way to catch prostate cancer early. If you are at average cancer risk, youll probably have your first prostate screening at age 55. Your healthcare provider may start testing earlier if you have a family history of the disease or are Black. Screening is generally stopped after age 70, but may be continued in certain circumstances.
Screening tests for prostate cancer include:
- Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum and feels the prostate gland, which sits in front of the rectum. Bumps or hard areas could indicate cancer.
- Prostate-specific antigen blood test: The prostate gland makes a protein called protein-specific antigen . Elevated PSA levels may indicate cancer. Levels also rise if you have BPH or prostatitis.
- Biopsy: A needle biopsy to sample tissue for cancer cells is the only sure way to diagnose prostate cancer. During an MRI-guided prostate biopsy, magnetic resonance imaging technology provides detailed images of the prostate.
Prostate Cancer Treatment Options: What Are They
Prostate cancer is, most often, a slow-growing cancer.
For some men, prostate cancer causes no symptoms or long-term issues, so treatment isnt necessary.
In these cases, doctors may recommend active surveillance. That is, theyll keep an eye on the development of the tumor using various tools and tests, including:
- Digital rectal exams
- Transrectal ultrasounds
- Prostate biopsies
Men who require treatment for their condition are most often treated with surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of these modalities.
Hormone Treatment Side Effects
While hormone therapy is among the most effective forms of systemic therapy for prostate cancer, any man considering hormone therapy should weigh the risks and benefits of the treatment, including possible side effects.
Most hormone therapies cause similar side effects due to changes in the levels of hormones . The side effects of medicine-based hormone therapy and the time it takes to get over some of them depend on the type of medicine, the dose, the length of time itâs given and your overall health.
Similar side effects can occur with surgical removal of the testicles . Though orchiectomy is a simple outpatient procedure, it also has the typical side effects and risks associated with surgery, including risks for bleeding and infection.
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During Treatment For Advanced Prostate Cancer
When treatments such as hormone therapy, chemotherapy, or immunotherapy are used for more advanced prostate cancer, the PSA level can help show how well the treatment is working or when it might be time to try a different treatment.
Treatments should lower the PSA level , although in some cases they may just help keep it from rising further, or even just slow the rise. Of course, other factors, such as whether youre having symptoms from your cancer and whether imaging tests show it is growing, are also important when deciding if it might be time to change treatments.
If the cancer has spread outside the prostate, the actual PSA level is often not as important as whether it changes, and how quickly it changes. The PSA level itself does not predict whether or not a man will have symptoms or how long he will live. Many men have very high PSA levels and feel just fine. Other men with low PSA levels can have symptoms.
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.
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Symptoms Of Prostate Cancer
Though early warning signs of prostate cancer are rare, sometimes men experience symptoms before they are diagnosed. The severity of symptoms may depend on where the cancer is located in the prostate and how advanced it has become. However, having any of these symptoms does not necessarily mean that you have prostate cancer or that the disease has progressed beyond its early stages.
Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it is no longer possible to cure it. However, it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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Treatment For Prostate Cancer
How prostate cancer is treated? In cancer care different types of treatment options are available. Urologists, medical oncologists, and radiation oncologists often work together to develop overall treatment plans that may combine different types of treatments.
Treatment options and recommendations depend on several factors, including the type of cancer, stage of cancer, possible side effects, and the patients overall health.
Active surveillance is always preferred for those with a very low risk of prostate cancer that can be treated with surgery or radiation therapy. The following testing should be done for active surveillance:
A PSA test every three to six months A DRE at least once a year and a prostate biopsy within 6 to 12 months.
Surgeries involve the removal of the prostate and some surrounding tissues and lymph nodes during the operation. The type of surgery depends on the stage of cancer and the patients overall health condition.
Prostate Cancer: Where Can You Find A Helping Hand
This is your one-stop source for information on prostate cancer. You can easily search for support groups, doctors, and clinical trials. And, your donation to the PCF funds prostate cancer research, with 84 cents of every dollar going toward their research mission.
PCRI focuses on improving the lives of prostate cancer patients and caregivers. We love that you can take a prostate cancer staging quiz to find out more about your prognosis. To take it, youll need to know the results of your PSA, biopsy, digital rectal exam, bone scan, and CT scan.
The American Cancer Society is considered the go-to source for reliable cancer information. Their site offers news releases, clinical trial opportunities, online support groups, and more. We especially like their Understanding Health Insurance page, which navigates you through the often complex process of utilizing health insurance for cancer treatments.
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The Factor That Can Develop The Risk Of Prostate Cancer Are
Age: A persons age is essential the older you get, your prostate cancer will increase. It usually happens after 50 years of age.
Race: though not always nut, black people have a higher chance of developing prostate cancer. In black people, prostate cancer is more aggressive and advanced.
Family history: if the blood relatives are parents, children, or siblings, then the family history can cause an increased risk of prostate cancer. Especially in a family with a history of the BRCA1 or BRCA2 gene, wherein the family has a significant risk of developing breast cancer and risk of developing prostate cancer.
Obesity: People with a higher risk of prostate cancer are usually heavyweight, and there are mixed results regarding cancer development in obese people. In obese people, there can be relatively more aggressive cancer, and they are likely to return to the initial treatment.
Guide To Managing Side Effects Of Chemotherapy
Follow these simple rules to manage your side effects:
Pay attention. Be aware of all expected and unexpected reactions to the drugs.
Be proactive. Make a list of your medications. Talk with your health care providers about what signs to look for and when to call them.
Relax and get well. Chemotherapy drugs are powerful and can take a toll on the body. Focus on getting well by finding ways to alleviate stress. These may include listening to music, doing yoga or stretching exercises, taking walks or watching TV.
Keep a journal. Write down any physical and emotional changes you experience while taking the medications. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your health care team to manage your side effects.
Consult your doctor. Talk with your health care providers about any side effects you experience. There are several drugs designed to help ward off or treat different side effects.
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Changes You Shouldnt Ignore
Early-stage prostate cancer rarely causes symptoms but as the disease progresses, you may experience certain warning signs. Knowing the signs of prostate cancer will help you keep an eye out for any concerning changes to your health.
Keep in mind, though, these symptoms dont indicate trouble with your prostate, Dr. Weight says. In fact, almost all of them come standard with aging. But if you experience several symptoms or have other concerns, it may be a good idea to visit a urologist.
Stage 2 Prostate Cancer
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
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Tests For Prostate Cancer
There is no single test for prostate cancer. All the tests used to help diagnose the condition have benefits and risks, which your doctor should discuss with you.
The blood test, known as a prostate-specific antigen test, measures the level of PSA and may help detect early prostate cancer. Men and anyone with a prostate are not routinely offered PSA tests to screen for prostate cancer, as results can be unreliable.
This is because the PSA blood test is not specific to prostate cancer. PSA can be raised due to a large non-cancerous growth of the prostate , a urinary tract infection or inflammation of the prostate, as well as prostate cancer. Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not. This means a raised PSA can lead to unnecessary tests and treatment.
However, you can ask to be tested for prostate cancer once the benefits and risks have been explained to you.
Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesnt mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a mans relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
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Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
Genetic Testing For Prostate Cancer
You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.
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Expert Review And References
- American Cancer Society. Prostate Cancer Early Detection, Diagnosis, and Staging. 2019: .
- Garnick MB . Harvard Medical School 2015 Annual Report on Prostate Diseases. 2015.
- Hermanns T, Kuk C, Zlotta AR. Clinical presentation, diagnosis and staging. Nargund VH, Raghavan D, Sandler HM . Urological Oncology. Springer 2015: 40: 697-718.
- Logothetis CJ, Kim J, Davis J, Kuban D, Mathew P, Aparicio A. Neoplasms of the prostate. Hong WK, Bast RC Jr, Hait WN, et al . Holland Frei Cancer Medicine. 8th ed. People’s Medical Publishing House 2010: 94: 1228-1254.
- PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Patient Version. Bethesda, MD: National Cancer Institute 2020: .
- PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Health Professional Version. Bethesda, MD: National Cancer Institute 2020: .
What Are The Treatments For Prostate Cancer
Your treatment options usually depend on your age, your general health, and how serious the cancer is. Your treatment may include one or more of options:
- Observation,which is mostly used if you are older, your prostate cancer isn’t likely to grow quickly, and you don’t have symptoms or you have other medical conditions. Your doctor will keep checking on your cancer over time so to see whether you will need to start treatment for the cancer. There are two types of observation:
- Watchful waiting means having little or no testing. If symptoms begin or change, you will get treatment to relieve them, but not to treat the cancer.
- Active surveillance means having regular tests to see if your prostate cancer has changed. If the tests show the cancer is starting to grow or if you develop symptoms, then you will have treatment to try to cure the cancer.
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Favorite Online Support Networks And Advocacy
PHEN is an organization geared toward African-American men a group that has the nations highest prostate cancer incidence and mortality rates. It offers support groups, survivor networks, and a monthly newsletter that features new treatments and clinical trials. Their annual Fathers Day Rally event takes place at churches nationwide.
Living With Prostate Cancer
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.
Nevertheless, it can have an effect on your life. As well as causing physical problems such as erectile dysfunction and urinary incontinence, a diagnosis of prostate cancer can understandably make you feel anxious or depressed.
You may find it beneficial to talk about the condition with your family, friends, a family doctor and other people with prostate cancer.
Financial support is also available if prostate cancer reduces your ability to work.
Read more about living with prostate cancer
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Symptoms Of Prostate Cancer That May Indicate Spread
Many prostate cancers can be found early through screening and cause zero symptoms. Much advanced cancer can cause symptoms-
- The urination-related problem includes a slow or weak urinary system or the need to urinate at night.
- Trouble getting an erection or having erectile dysfunction.
- Pain in the hips and back, and chest or other areas. That can form cancer in the bones closer to prostate cancer.
- Weakness in the legs or feet.
- Loss of bladder control from cancer pressing on the spinal cord.
Many problems are associated with prostate cancer, including non cancerous prostate gland growth, which can result in a lot of pain in that area.