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What Does It Mean To Have Aggressive Prostate Cancer

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Cancer That Clearly Has Spread

How do I know whether I have aggressive prostate cancer?

If the cancer has spread outside the prostate, it will most likely go to nearby lymph nodes first, and then to bones. Much less often the cancer will spread to the liver or other organs.

When prostate cancer has spread to other parts of the body , hormone therapy is probably the most effective treatment. But it isnt likely to cure the cancer, and at some point it might stop working. Usually the first treatment is a luteinizing hormone-releasing hormone agonist, LHRH antagonist, or orchiectomy, sometimes along with an anti-androgen drug or abiraterone. Another option might be to get chemotherapy along with the hormone therapy. Other treatments aimed at bone metastases might be used as well.

How Prostate Cancer Develops

However, sometimes something goes wrong within prostate cells, and cancer develops.

In general, cancer is a condition in which a normal cell becomes abnormal and starts to grow and/or reproduce uncontrollably without having the signals or brakes that stop typical cell growth. Prostate cancer occurs when a normal prostate cell begins to grow out of control. In many cases, prostate cancer is a slow-growing cancer that does not spread beyond the prostate gland before the time of diagnosis.

Once prostate cancer forms, it feeds on androgens and uses them as fuel for growth. This is why one of the backbones of treatment for men, especially with advanced prostate cancer, is to lower a mans androgen levels with drugs collectively termed hormone therapy.

Not all prostate cancer cells are alike. Prostate cancers that are composed of very abnormal cells are much more likely to both divide quickly and spread, or metastasize, from the prostate to other regions of the body. Often, prostate cancer spreads first to tissues that are near the prostate, including the seminal vesicles and nearby lymph nodes.

Researchers have identified various biological and genetic subtypes of prostate cancer. Although these subtypes are typically not yet used to guide treatment recommendations, they are the subject of active research funded by the Prostate Cancer Foundation.

Help support PCFs research into causes and treatments of prostate cancer: Donate Today!

How Important Is The Gleason Score

The Gleason score is very important in predicting the behavior of a prostate cancer and determining the best treatment options. Still, other factors are also important, such as:

  • The blood PSA level
  • How much of each core is made up of cancer
  • The number of cores that contain cancer
  • Whether cancer was found in both sides of the prostate
  • Whether the cancer has spread outside the prostate

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Prostate Cancer Survival Rates

Answering the question of how curable is prostate cancer? first requires understanding what doctors mean when they refer to curability. Regardless of the type of cancer, doctors consider cancer cured when a patient remains cancer-free for a specified period after treatment. The higher the number of patients who stay cancer-free for five years or longer, the higher the curability of that particular disease.

Prostate cancer, therefore, has one of the highest curability rates of all types of cancer, thanks in large part to early detection standards and advances in treatment, such as the stereotactic body radiation therapy offered by Pasadena CyberKnife. When the cancer is detected in the early local or regional stages that is, before the cancer has spread or when it has only spread to limited areas in the pelvic regions the five-year survival rate is nearly 100 percent.

Survival rates decline significantly when cancer is detected at later stages however, the good news is that only about five percent of men are diagnosed after the cancer has become widespread throughout the body. In short, more than 90 percent of men who are diagnosed with prostate cancer live for five years or longer after treatment, making it one of the most curable forms of cancer.

Watchful Waiting And Active Surveillance

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Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities., Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery. For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.

Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression., This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.

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Does An Elevated Psa Level Mean I Have Prostate Cancer

Prostate cancer is a disease that forms in the tissues of the prostate, a male gland just below the bladder which is partly responsible for making the fluid that is part of semen. Prostate cancer forms within cells in the prostate.

The disease takes a variable course from patient to patient. Some prostate cancers spread quickly, while many others develop and grow slowly. Prostate cancer risk increases as men age, making age the number one risk factor for this disease. If diagnosed early, prostate cancer is highly treatable.

Prostate-specific antigen is a protein produced by the prostate that is used to track progression of known prostate cancer. As a marker for known disease, PSA level is very reliable for most patients. However, the value of PSA as a tool for prostate cancer screening has long been a controversial subject. Heres what you should know.

How Is Prostate Cancer Treated

The best treatment for your prostate cancer depends on your age, general health and the grade and stage of your cancer. Although nearly all treatments have side effects, most can be effectively managed. Ask your doctor what side-effects to expect and how best to manage these.

Active surveillance is sometimes a valid option and is a way of monitoring prostate cancer when it isnt causing symptoms or problems. This form of treatment may be suggested by your doctor if the cancer is small and slow growing and its unlikely to spread. The possible side effects of treatment such as surgery may have more impact on your life than the cancer. You will still need regular prostate tests, which may include repeated biopsies, to make sure things haven’t changed.

Watchful waiting is another way of monitoring prostate cancer in case symptoms develop or change. It involves regular prostate specific antigen tests and check ups. Watchful waiting is not as strict as active surveillance and additional biopsies are not usually needed.

Surgery involves the removal of the prostate , and sometimes the surrounding tissue. Surgery requires on average three to six days in hospital, followed by a four to six week recovery period.

Surgery is an option if you have localised prostate cancer and you are fit for surgery. Once the cancer has spread outside the prostate gland, surgery is not normally an option, however other treatments are available.

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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.

What Are The Symptoms Of Prostate Cancer

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In most cases, prostate cancer causes no symptoms.

In rare cases, men may experience certain symptoms when they have advanced prostate cancer. However, these symptoms are also present in many men who do not have cancer, so it is best to discuss them with a doctor before jumping to any conclusions. Some of these symptoms can include difficulty emptying the bladder, blood in the urine, and bone pains.

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Cases Of Aggressive Prostate Cancer On The Rise Research Finds

Cases of aggressive prostate cancer appear to be on the rise, researchers reported Tuesday.

The good news is its still rare for prostate cancer to spread. Just 3 percent of cases have already started spreading when men are diagnosed and prostate cancer overall has not become more common, the team found.

And the American Cancer Society strongly questioned the findings and the methods used to get them.

The researchers — who were looking for evidence to support a return to widespread prostate cancer screening — found that cases of metastatic prostate cancer the type that has started to spread in the body nearly doubled in men aged 55 to 69 since 2004. The reason is not yet clear.

One hypothesis is the disease has become more aggressive, regardless of the change in screening, said Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine, who led the study.

The other idea is since screening guidelines have become more lax, when men do get diagnosed, its at a more advanced stage of disease. Probably both are true. We dont know for sure, but this is the focus of our current work, Schaeffer continued.

One hypothesis is the disease has become more aggressive, regardless of the change in screening.”

In 2012, the U.S. Preventive Services Task Force recommended against using a blood test called a prostate-specific antigen test to check most healthy men for prostate cancer.

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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.

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Quality Of Life With Advanced Stage Prostate Cancer

Since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of advanced prostate cancer. It is associated, however, with significant cost in terms of morbidity as well as economics. Side effects of androgen deprivation therapy include hot flashes, osteoporosis, loss of libido or impotence, and psychological effects such as depression, memory difficulties, or emotional lability. Recently Harle and colleagues reported insulin resistance, hyperglycemia, metabolic syndrome, and metabolic complications being associated with castration and thus being responsible for increased cardiovascular mortality in this population.

Because of the palliative nature of androgen ablation, quality of life is an important component of evaluating competing therapies. Intermittent androgen deprivation is one approach to hormonal therapy that has been developed with the aim of minimizing the negative effects of therapy while maximizing clinical benefits and the patients quality of life. It can be used in any clinical situation where continuous androgen deprivation treatment could be applied.

General Prostate Cancer Survival Rate

Prostate Cancer: After Biopsy  what does it mean?

According to the American Cancer Society:

  • The relative 5-year survival rate is nearly 100%
  • The relative 10-year survival rate is 98%
  • The 15-year relative survival rate is 91%

Note: Relative survival rate means the percentage of patients who live amount of years after their initial diagnosis.

Keep in mind, however, that because the compiled list figures are of cancers diagnosed up to 15 years ago, you may have an even greater chance of survival than these indicate due to advances in prostate cancer treatment technology

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Are There Other Treatment Options

There hasn’t been enough good research on other treatments such as “high intensity focal ultrasound” , cryotherapy or hyperthermia treatment . Because of this, medical societies in Germany don’t recommend using them in the treatment of prostate cancer, or only recommend using them for research purposes.

What Makes Prostate Cancer Become Aggressive Study Investigates

They suggest that the finding could help predict disease aggressiveness, improve personalized treatments, and open the door to precision medicine for advanced prostate cancer.

In a study paper now published in the journal Cell, they describe how they investigated a genomic variant known to be linked to aggressive prostate cancer.

Using state-of-the-art tools, they confirmed the link in a large group of people with prostate cancer.

They also identified how the variant influences a genetic circuit involving three genes that could potentially drive the disease to an incurable stage.

The genomic variant is a difference in a DNA building block located in chromosome 19q13 that is known as the single nucleotide polymorphism rs11672691.

Previous studies had already linked this particular variant to aggressive prostate cancer. But they did not explain how the link worked.

Comparing the order in which millions of DNA building blocks occur in the human genomes of any two individuals would reveal hardly any differences. But where they do occur, these differences or variants can give rise to disease.

How human genomic variants, says senior study author Gong-Hong Wei, a professor in the Faculty of Biochemistry and Molecular Medicine at the University of Oulu in Finland, cause disease and its progression is in general one of the most compelling puzzles and questions in medicine.

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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.

Who Is At Risk For Prostate Cancer

Life Expectancy with Prostate Cancer Diagnosis

Certain men are at higher risk than others for prostate cancer, which may affect when they should start being screened. The risk increases with age, particularly after age 50. Some risk factors include:

  • African American men are twice as likely as white men to develop the disease.
  • Having a family history a father or a brother diagnosed with prostate cancer, particularly if it is at a relatively early age increases the risk.
  • Having a family history of breast and ovarian cancer may also be associated with an inherited risk of developing prostate cancer
  • High-fat diet and/or obesity

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What Is The Gleason Grade Or Gleason Score What Do The Numbers In The Gleason Score Mean For Example 3+4=7 Or 3+3=6

Pathologists grade prostate cancers using numbers from 1 to 5 based on how much the cells in the cancerous tissue look like normal prostate tissue under the microscope. This is called the Gleason system. Grades 1 and 2 are not often used for biopsies most biopsy samples are grade 3 or higher.

  • If the cancerous tissue looks much like normal prostate tissue, a grade of 1 is assigned.
  • If the cancer cells and their growth patterns look very abnormal, a grade of 5 is assigned.
  • Grades 2 through 4 have features in between these extremes.

Since prostate cancers often have areas with different grades, a grade is assigned to the 2 areas that make up most of the cancer. These 2 grades are added to yield the Gleason score . The highest a Gleason score can be is 10.

The first number assigned is the grade that is most common in the tumor. For example, if the Gleason score is written as 3+4=7, it means most of the tumor is grade 3 and less is grade 4, and they are added for a Gleason score of 7. Other ways that this Gleason score may be listed in your report are Gleason 7/10, Gleason 7 , or combined Gleason grade of 7.

If a tumor is all the same grade , then the Gleason score is reported as 3+3=6.

The higher the Gleason score, the more likely it is that your cancer will grow and spread quickly.

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