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.
What Active Surveillance Means
For many men, prostate cancer never affects their lives, said Christopher L. Runz, DO, attending urologist at University of Maryland Shore Regional Health. Active surveillance means we actively watch the cancer and make sure it stays low-grade, which means the cancer may potentially never spread.;
Active surveillance requires regular prostate specific antigen screenings and MRIs, with occasional biopsies. Men who are older and have a shorter life expectancy become candidates for active surveillance when they have a Gleason score of 7 .
What Is The Outlook
It is difficult to give an outlook . Your symptoms may last a long time, although they may come and go or vary in severity. Painkillers can keep discomfort to a minimum.
Most men diagnosed with chronic prostatitis/CPPS tend to have an improvement in their symptoms over the following six months. In one study, about a third of men had no further symptoms one year later. In another large study, one third of men showed moderate to marked improvement over two years.
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What Are Prostate Cancer Symptoms
Prostate cancer is difficult to diagnose in the early stages as it does not highlight any symptoms. The signs of this condition develop when cancer has progressed. Nonetheless, you should stay wary of common prostate cancer symptoms.
Some of the prostate cancer symptoms include:
Problems in urination
Advanced prostate cancer can lead to urinary issues. It is because the tumour may press on the bladder which is located nearby.;
You may experience repeated urgency to urinate, painful urination, blood in the urine and more.;
Sexual problems
Among the top prostate cancer symptoms is the issue of sexual problems faced by men.;
Men living with this cancer may have difficulty in maintaining or getting an erection. You may also experience the presence of blood in the semen and painful ejaculation.;
Pain and discomfort
If you are suffering from prostate cancer, you may have pain in your lower back, abdomen, and pelvic area. You should consult your healthcare provider if you feel persistent discomfort in these body parts.;
It is possible that some of the above-given symptoms are signs of other urological or sexual conditions. Therefore, screening tests are indicated to draw an accurate diagnosis.;
Read:;What are the early signs of prostate cancer?
Initial Treatment Of Prostate Cancer By Stage
The stage of your cancer is one of the most important factors in choosing the best way to treat it. Prostate cancer is staged based on the extent of the cancer and the PSA level and Gleason score when it is first diagnosed.
For prostate cancers that haven’t spread , doctors also use risk groups to help determine treatment options. Risk groups range from very low risk to very high risk, with lower risk group cancers having a smaller chance of growing and spreading compared to those in higher risk groups.
Other factors, such as your age, overall health, life expectancy, and personal preferences are also taken into account when looking at treatment options. In fact, many doctors determine a mans possible treatment options based not just on the stage, but on the risk of cancer coming back after the initial treatment and on the mans life expectancy.
You might want to ask your doctor what factors he or she is considering when discussing your treatment options. Some doctors might recommend options that are different from those listed here.
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A Biopsy Is Done To Diagnose Prostate Cancer And Find Out The Grade Of The Cancer
A transrectal biopsy is used to diagnose prostate cancer. A transrectal biopsy is the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure may be done using transrectal ultrasound or transrectal MRI to help guide where samples of tissue are taken from. A pathologist views the tissue under a microscope to look for cancer cells.
Sometimes a biopsy is done using a sample of tissue that was removed during a transurethral resection of the prostate to treat benign prostatic hyperplasia.
If cancer is found, the pathologist will give the cancer a grade. The grade of the cancer describes how abnormal the cancer cells look under a microscope and how quickly the cancer is likely to grow and spread. The grade of the cancer is called the Gleason score.
To give the cancer a grade, the pathologist checks the prostate tissue samples to see how much the tumor tissue is like the normal prostate tissue and to find the two main cell patterns. The primary pattern describes the most common tissue pattern, and the secondary pattern describes the next most common pattern. Each pattern is given a grade from 3 to 5, with grade 3 looking the most like normal prostate tissue and grade 5 looking the most abnormal. The two grades are then added to get a Gleason score.
What Affects My Treatment Options
Your treatment options will depend on whether your cancer is contained within the prostate gland , has spread just outside of the prostate or had spread to other parts of the body .
You may have a choice of treatments. Your doctor or specialist nurse will explain all your treatment options, and help you to choose the right treatment for you.
Your treatment options and which treatment you choose may depend on several things, including:
- how far your cancer has spread
- how quickly your cancer may be growing
- the advantages and disadvantages of each treatment
- what each treatment involves
- the possible side effects of each treatment
- practical things, such as how often you would need to go to hospital, or how far away your nearest hospital is
- your own thoughts about different treatments
- how the treatment you choose now could affect your treatment options later if your cancer comes back or spreads
- your general health
- how long youre expected to live for.
The first treatment you have may affect which treatments you can have in the future, if you need further treatment. Speak to your doctor or nurse about this.
It can help to write down any questions you want to ask at your next appointment. And to take someone to appointments, such as your partner, friend or family member.
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What The Results Showed
After five years, there were no significant differences in survival associated with any of the selected treatments. Just one man in the favorable risk category died from prostate cancer during the study, and there were eight deaths from the disease in the unfavorable risk group.
Many men in the study had initial problems with sexual, bowel, urinary, and hormonal functioning. Brachytherapy caused more irritative urinary problems during the initial six months than the other treatments, but then those symptoms steadily improved. Brachytherapy and EBRT were associated with minor bowel symptoms such as urgency, bleeding, frequency, and pain that resolved within a year in men from both risk groups.
Dr. Marc Garnick, Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, agreed the study provides a valuable resource that adds to existing information. Yet he cautioned against brachytherapy, warning that this particular treatment in some cases has long-term urinary side effects that can significantly alter a patients quality of life. I do not routinely recommend brachytherapy, Garnick said. This is especially true in patients with a pre-existing history of urinary tract infections or prostatitis.
How Is Prostatitis Treated
Treatment depends on the type of prostatitis.
Chronic prostatitis/chronic pelvic pain syndrome. Treatment for chronic prostatitis/chronic pelvic pain syndrome aims to decrease pain, discomfort, and inflammation. A wide range of symptoms exists and no single treatment works for every man. Although antibiotics will not help treat nonbacterial prostatitis, a urologist may prescribe them, at least initially, until the urologist can rule out a bacterial infection. A urologist may prescribe other medications:
- silodo
- 5-alpha reductase inhibitors such as finasteride and dutasteride
- nonsteroidal anti-inflammatory drugsalso called NSAIDssuch as aspirin, ibuprofen, and naproxen sodium
- glycosaminogly
- cans such as chondroitin sulfate
- muscle relaxants such as cyclobenzaprine and clonazepam
- neuromodulators such as amitriptyline, nortriptyline , and pregabalin
Alternative treatments may include
- warm baths, called sitz baths
- local heat therapy with hot water bottles or heating pads
- physical therapy, such as
- Kegel exercisestightening and relaxing the muscles that hold urine in the bladder and hold the bladder in its proper position. Also called pelvic muscle exercises.
- myofascial releasepressing and stretching, sometimes with cooling and warming, of the muscles and soft tissues in the lower back, pelvic region, and upper legs. Also known as myofascial trigger point release.
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How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
About The Prostate And Prostate Cancer
The prostate gland is part of the male reproductive system and produces fluid that mixes with semen during ejaculation to help sperm travel. The prostate is a walnut-sized, rubbery organ that surrounds the urethrathe urinary duct that carries urine from the bladder out of the bodyand sits directly below the bladder.
The prostate gland, which grows during puberty, is considered an organ and is made up of several dozen lobules or saclike glands, held together with connective prostate tissue and muscle between them. The glands are called exocrine glands, because they secrete liquid to outside the body.
An enlarged prostate, called benign prostatic hyperplasia , is common in men over the age of 40 and may obstruct the urinary tract. The abnormal prostate cell growth in BPH is not cancerous and doesnt increase your risk of getting prostate cancer. However, symptoms for BPH and prostate cancer can be similar.
A condition called prostatic intraepithelial neoplasia , where prostate gland cells look abnormal when examined under a microscope, may be connected to an increased risk of prostate cancer. Prostate cancer is often caught by a doctor performing a digital rectal exam , through a prostate-specific antigen blood test, through a prostate biopsy;or with a CT scan.
Another condition, prostatitis, is the inflammation of the prostate. While not cancerous, it may cause higher PSA levels in the blood.
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What Were The Results
Compared with patients who chose active surveillance, patients who chose
- Surgery had greater increases in sexual problems and leaking urine at 3, 12, 24, 36, and 48 months.
- EBRT or brachytherapy had greater increases in sexual problems, trouble urinating, and bowel problems at three months but not at other times.
- SBRT had less anxiety about prostate cancer at 24 months but not at other times.
Across treatment groups, patients didnt differ in regret about their treatment decision.
Compared with patients who had surgery, patients who chose SBRT or EBRT had a 51 percent lower chance of prostate cancer coming back.
Compared with patients who chose other treatments, patients who chose active surveillance had, on average per year, more
- Doctor visits to check on their prostate cancer
- Total doctor visits
- Specialist visits
There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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What Is The Diagnosis For Prostate Cancer Treatment
Prostate cancer treatment can be successfully given if the right diagnosis happens early. Men who are at a higher risk of developing this cancer should start their screening process soon. Doctors perform a variety of tests to diagnose prostate cancer:
Digital rectal exam : A DRE is a simple exam in which a doctor examines the prostate through the rectum.;
Laboratory tests and imaging: You may be indicated to take a couple of blood tests and urine tests. You may also have to undergo imaging tests such as MRI, CT Scan and X-rays depending upon your condition.;
Prostate-specific antigen test: PSA is a very specific test that helps in the detection of prostate cancer. Your healthcare provider will assess a blood sample to test the levels of PSA . High levels of PSA indicate more likelihood of prostate cancer.;
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
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Seven Types Of Standard Treatment Are Used:
Watchful waiting or active surveillance
Watchful waiting and active surveillance are treatments used for older men who do not have signs or symptoms or have other medical conditions and for men whose prostate cancer is found during a screening test.
Watchful waiting is closely monitoring a patients condition without giving any treatment until signs or symptoms appear or change. Treatment is given to relieve symptoms and improve quality of life.
Active surveillance is closely following a patient’s condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including digital rectal exam, PSA test, transrectal ultrasound, and transrectal needle biopsy, to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer.
Other terms that are used to describe not giving treatment to cure prostate cancer right after diagnosis are observation, watch and wait, and expectant management.
Surgery
Patients in good health whose tumor is in the prostategland only may be treated with surgery to remove the tumor. The following types of surgery are used:
Expert Review And References
- American Cancer Society. Prostate Cancer. Atlanta, GA: American Cancer Society; 2015: .
- American Society of Clinical Oncology. Prostate Cancer. 2014: .
- Garnick MB . Harvard Medical School 2015 Annual Report on Prostate Diseases. 2015.
- National Cancer Institute. Prostate Cancer Treatment . 2015: .
- National Cancer Institute. Prostate Cancer Treatment for Health Professionals . 2015: .
- National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer . .
- Princess Margaret Cancer Centre. Princess Margaret Cancer Centre Clinical Practice Guidelines: Prostate Cancer. 2015: .
- Saad F, Chi KN, Finelli A, Hotte SJ, Izawa J, Kapoor A, et al. The 2015 CUA-CUOG Guidelines for the management of castration-resistant prostate cancer . Canadian Urological Association Journal. 2015: .
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Questions To Ask Your Doctor Or Nurse
You may find it helpful to keep a note of any questions you have to take to your next appointment. If youre choosing a treatment, you might find it helpful to ask your doctor or nurse some of these questions.
- What treatments are suitable for me?
- How quickly do I need to make a decision?
- What are the advantages and disadvantages of each treatment? What are their side effects?
- How effective is my treatment likely to be?
- Can I see the results of treatments youve carried out?
- Is the aim to keep my prostate cancer under control, or to get rid of it completely?
- If the aim of my treatment is to get rid of the cancer, what is the risk of my cancer coming back after treatment?
- If the aim of my treatment is to keep the cancer under control, how long might it keep it under control for?
- What treatments and support are available to help manage side effects?
- Are all of the treatments available at my local hospital? If not, how could I have them?
- After treatment, how often will I have check-ups and what will this involve? How will we know if my cancer starts to grow again?
- If my treatment doesnt work, what other treatments are available?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?