How Fast Does Prostate Cancer Spread To The Bones
Early detection can catch prostate cancer even before there are any symptoms. Some types of prostate cancer grow very slowly.
There are four main stages of prostate cancer. Within each stage, the cancer is graded based on factors like the size of tumor, prostate-specific antigen level, and other clinical signs.
If the cancer has spread to the bones, its considered to be the most advanced, or stage 4.
Newer lab tests look at the genes inside cancer cells. This can provide more information on how quickly the prostate cancer may progress.
Theres also a grading system known as the Gleason system, which assigns the cancer into a grade group based on how closely it resembles normal tissue.
During the biopsy to diagnose prostate cancer, the cells are closely examined. The more abnormal cells that are in the biopsy sample, the higher the Gleason score and grade group.
When more abnormal cells are present, the cancer is more likely to spread quickly.
Uk Guidelines For Keyhole Surgery
The National Institute for Health and Care Excellence has guidelines for keyhole surgery. These state that surgeons can use it to remove cancer of the prostate but they must:
- tell people having the surgery about the risks and benefits
- monitor people closely
- collect information about any problems people have and report on them
Researchers are looking into whether keyhole surgery is as good as open surgery.
External Beam Radiation Therapy
After completing external beam radiation therapy , urinary and bowel side effects may persist for two to six weeks, but they will improve over time. You may need to continue some medications.
Some patients report continued, though lessening fatigue for several weeks after treatment. Other minor problems may include dry itchy skin, a sensation of heaviness in the perineum, anal and rectal irritation, and flare-up of hemorrhoids. However, patients are usually well enough to continue with normal daily activities.
Symptoms Of Prostate Cancer
Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis .
When this happens, you may notice things like:
- an increased need to pee
- straining while you pee
- a feeling that your bladder has not fully emptied
These symptoms should not be ignored, but they do not mean you have prostate cancer.
It’s more likely they’re caused by something else, such as prostate enlargement.
Surprising Prostate Cancer Research
Klotzs research includes a ground-breaking study that followed 993 men with low-grade prostate cancer over 13 years. Under active surveillance with selected delayed intervention , 95% of patients survived, which is about the same rate as conventional treatment. Two-thirds of the studys patients avoided treatment entirely.
Klotzs process is simple. He gives his patients a PSA test every three months, and conducts a biopsy every couple of years. If he detects a sudden change, he will intervene surgically. Interestingly, my young age is of no advantage to me here. Many doctors dont like active surveillance for guys who have long lives ahead of them, as it gives the cancer more years to grow.
What Happens To The Prostate After Radiation
The entire prostate gland is radiated when we treat the cancer. The prostate normally produces some of the fluid in the ejaculation. Radiation therapy has the side effect of damaging the glands in the prostate, so a lot less fluid is produced. The ejaculation may be dry or nearly dry. In addition, you will probably be sterile after radiation, but this is not 100% guaranteed and should not be relied upon as a form of birth control. You can still usually have erections because the nerves and blood vessels that go to the penis are not as damaged as the prostate gland.
The prostate gland will end up having a lot of scar tissue. It will shrink in size to about half its original weight within a couple years after finishing radiation. The urethra passes through the canter of the prostate gland like the hole of a doughnut. Sometimes this passage can widen, other times it can shrink after radiation. In summary, the prostate gland is heavily damaged from radiation and does not work normally afterwards.
Surgery To Remove Your Prostate Gland
You might have surgery to remove your prostate gland if:
- your cancer hasn’t spread outside the prostate gland
- you are younger and have a fast growing tumour
- as part of treatment for locally advanced or high risk localised prostate cancer
The aim of a radical prostatectomy operation is to cure prostate cancer. It is major surgery with some possible side effects. If you’re an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.
How Is Bph Diagnosed
Diagnosing BPH in its earlier stages can lower the risk of developing complications. Delay can cause permanent bladder damage for which BPH treatment may be ineffective. In addition to a complete medical history and physical examination, diagnostic procedures for BPH may include the following:
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Digital rectal exam. A procedure in which the doctor inserts a gloved finger into the rectum to examine the rectum and the prostate gland for signs of cancer.
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Intravenous pyelogram. A series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
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Cystoscopy . An examination in which a scopeâa flexible tube and viewing deviceâis inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.
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Urine flow study. A test in which the patient urinates into a special device that measures how quickly the urine is flowing. A reduced flow may suggest BPH.
My Prostate Cancer Diagnosis
I was diagnosed two years ago, at the relatively young age of 51, after a routine PSA test. I had no symptoms, no urinary issues and no troubles in the bedroom, as the health magazines carefully refer to it. But I found doctors curiously unwilling to advise me on what to do.
They load you up with documents about the possible side effects of each treatment option. They direct you to online decision-making tools that ask you questions about how afraid of death you are and how important your sex life is. They make a lot of hand gestures that signal that youre weighing equally heavy things.
They tell you: yes, I can make pretty sure your cancer doesnt spread. But your quality of life will be diminished forever. Then they ask: you sure you want me to go ahead?
An Increased Psa Level
A biochemical relapse is when your PSA level rises after having treatment that aims to cure your cancer.
You might not need to start treatment straight away. Your doctor will continue to monitor your PSA levels regularly to see if your PSA rises quickly or stabilises. You might have a scan if your PSA rises quickly.
The choice about whether to have treatment and what treatment to have will depend on:
- the treatment you have already had
- your general health
Sexuality And Feeling Good About Your Body
Prostate cancer treatment can often affect sexual function. Learning to be comfortable with your body during and after prostate cancer treatment is a personal journey, one that is different for everyone. Information and support can help you cope with these changes over time. Learn more in Sex and the Man With Cancer.
Treatment Options After Recurrence
After surgery to remove your prostate
PSA levels are usually extremely low about a month after surgery. You may hear your doctor saying that your PSA level is undetectable . If your PSA level starts to rise, this might mean the cancer has come back.
Your doctor might recommend:
- hormone treatment
After external beam radiotherapy
PSA levels usually get lower slowly over months or years. Defining the limit for cure is complicated and you should ask your cancer specialist. Usually a level of 2 ng/ml above the lowest point after treatment is taken as a sign of recurrence, or 3 increases in a row .
Your treatment options may be:
- surgery to remove your prostate
- hormone treatment
- high frequency ultrasound
After internal beam radiotherapy
PSA can rise temporarily after brachytherapy. This is called PSA bounce. The level then lowers slowly. Usually a level of 2 ng/ml above the lowest point after treatment is taken as a sign of recurrence.
After hormone treatment
If you are given hormone treatment alone, the PSA can rise after you finish hormone treatment. It may then become stable or static. If it rises this may suggest the cancer is becoming resistant to the hormone treatment.
If hormone treatment is no longer controlling your cancer, your doctor may suggest:
- abiraterone
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
What Happens At A Follow
Discussion with your doctor or nurse
At each appointment, your doctor or nurse will ask how youve been since your last appointment.
Tell them about any symptoms or treatment side effects youve had, as well as any other problems or concerns. You can tell them how you are feeling emotionally as well as physically. You can also discuss any practical problems you might have, such as problems at work or with day-to-day activities. You may be given a questionnaire about your physical, social, emotional and practical needs. You might hear this called a holistic needs assessment form.
Your GP or hospital doctor or nurse can help you deal with side effects, or refer you to someone else who can. For example, if you have problems with leaking urine , they might refer you to a continence service. Or if you have problems getting or keeping erections , they can refer you to an erectile dysfunction service. They can also help you get support for emotional problems, such as feeling anxious or depressed, and practical problems, such as managing your finances.
You might feel embarrassed talking about some of the side effects of treatments, such as erection problems. But remember doctors and nurses see people with these problems every day, so be as open as you can. They are there to help.
PSA test
You may be asked to avoid any vigorous exercise or ejaculating in the 48 hours before a PSA test, as this could cause a temporary rise in your PSA level.
Dry Orgasm And Infertility
Both the prostate and the glands responsible for semen production are removed during surgery, which is a common prostate cancer treatment. If you received this treatment, youd still be able to have an orgasm but youd no longer ejaculate.
This means that youll no longer be fertile. If you plan to have children in the future, you may consider banking your sperm before your surgery.
Why A Psa Test Is Done
A PSA test may be done to:
- help find prostate cancer early in men who dont have any signs or symptoms of the disease
- check for cancer in men who have signs or symptoms of prostate cancer
- confirm a diagnosis when other tests suggest prostate cancer
- predict a prognosis for prostate cancer
- predict if cancer has spread outside the prostate
- plan treatment for prostate cancer
- monitor men with prostate cancer who are being treated with active surveillance
- find out if cancer treatments are working
- find out if cancer has come back after treatment
A PSA test is often used together with a digital rectal exam to increase the chance of finding prostate cancer early when it is easier to treat. Using these tests together is better than using either test alone.
When To See A Doctor
Consult with your doctor if you experience any of the symptoms discussed on this page particularly if they have been going on for a while. You will need a thorough work-up to determine the underlying cause, which may or may not be prostate cancer.
Its important to understand that other diseases or disorders can share these same symptoms. Benign prostatic hyperplasia , also called enlargement of the prostate, and are quite common. Men with these benign conditions can experience symptoms more often and more severely than men with prostate cancer.
Erectile dysfunction is relatively common, especially as one ages, and can also have causes unrelated to prostate cancer, such as smoking or cardiovascular disease. Experiencing a lower amount of fluid during ejaculation can be related to something as simple as diet or dehydration.
Its important to keep track of your symptoms, determining whats normal or abnormal for your own body. If you are worried about a particular symptom, or if its interfering with a relationship, you should discuss your concerns with your primary care physician.
Prostate Cancer | Bills Story
Factors That Increase Risk Of Recurrence
There are many different factors that can help you determine what your risk of recurrence is. Your doctor will go over these during the initial course of treatment, therefore stressing the importance of follow up appointments.
One factor is the involvement of your lymph nodes. If your cancer has metastasized to your lymph nodes, recurrence is more likely. Similarly, the larger the tumor, the more likely that you are to experience complications and rates of recurrence. If the tumor is intertwined or growing into other areas of your body, this also increases risk. The Gleason score is a system of grading your prostate cancer based on severity and localization. The higher the grade, the more likely youll experience recurrence. Finally, the stage of prostate cancer affects recurrence rates. When caught early, recurrence is not as likely as cancers that are in stage three or four.
Cancer can be extremely aggressive and will change your life forever. Make sure that youre doing everything you can to avoid potential problems. Eat well, exercise regularly, and get enough sleep. Strengthening your immune system is a great way to reduce your risk of recurrence.
Testing Options For Prostate Cancer
There is no one age for prostate cancer testing, but the American Cancer Society makes recommendations about screenings. According to the ACS, patients in any of these groups should consider asking their doctor about testing:
- Men age 50 or older who have an average risk of prostate cancer and a life expectancy of at least 10 more years
- Men age 45 or older with a high risk, including African-American men and those with a first-degree relative who had prostate cancer before age 65
- Men age 40 or older who have a higher risk, such as more than one first-degree relative diagnosed with prostate cancer at an early age
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.
Living With Prostate Cancer
As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment.
Nevertheless, it can affect your life. As well as the possible side effects of treatment, 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 men with prostate cancer.
Financial support is also available if prostate cancer reduces your ability to work.
If Your Prostate Cancer Has Spread
If cancer has spread to other parts of your body it cant be cured. This is advanced prostate cancer. Treatment can help to control the cancer and your symptoms. This might be:
- hormone treatment to lower your testosterone levels
- bisphosphonates to help with bone pain
- radiotherapy to particular parts of the skeleton
- radioactive liquid treatment radiotherapy , such as radium-223
If hormone therapy is no longer working for you, you might have:
- chemotherapy
For Starters Lets Talk About What The Prostate Is And What It Does
What is the prostate? The prostate is an important organ in the male reproductive system. The prostate is positioned just below the bladder.
What does the prostate do? The prostate plays a role in the production and emission of semen. In young men, the prostate is about the size of a walnut. As men age, the prostate usually grows larger.
The Criteria For Active Surveillance
My own cancer met the three Cancer Care Ontario criteria for active surveillance:
- It is not detectable by a digital exam .
- My PSA score is under 10 and steady.
- My Gleason score is under seven.
For me, active surveillance is by no means an easy decision. I feel fear every time I await the results of my PSA test. I know there is a significant chance that the next one will require life-changing action, and that this delay incurs a risk that the cancer has spread without my team of doctors knowing it. I have a small child, and the thought plagues me that for his sake I should take less risks. But life itself is risk. I will live with risk and an active sex life for now. I will be a guinea pig for this experimental science.
The chances are that something else will kill me anyway. Why does that make me happy now?
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.
Managing Bone Pain And Weakness
Symptoms like nausea, hot flashes, and pain can usually be relieved with medication. Some people find that complimentary treatments like acupuncture or massage help manage side effects.
Your doctor may also recommend orthopedic surgery to stabilize your bones, relieve pain, and help prevent bone fractures.
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have .
What Are The Treatments For Prostate Cancer
If you need treatment, your doctor will decide the type. Decisions about how to treat this cancer are complex, and you may want a second opinion before making a treatment decision. Treatment may include watchful waiting, a single therapy, or some combination of radiation, surgery, hormone therapy, and less commonly chemotherapy. The choice depends on many things. Prostate cancer that hasnât spread usually can be cured with surgery or radiation.
Watchful waiting
Since prostate cancer can grow slowly and may not be fatal in many men, some patients — after discussing the options with their doctors — opt for “watchful waiting.” This means not treating it. Instead, the doctor regularly checks the prostate cancer for signs that it is becoming more aggressive. Watchful waiting is typically recommended for men who are older or have other life-threatening conditions. In these cases, a less aggressive cancer may be growing so slowly that it’s not likely to be fatal.
Surgery
Laparoscopic robotic prostatectomy is a surgery using a laparoscope aided by robotic arms. This operation is now the most popular form of radical prostatectomy in the United States.
After surgery, most men have temporary incontinence, but they usually regain complete urinary control over time. If it is severe or lasts a long time, incontinence can be managed with special disposable underwear, exercises, condom catheters, biofeedback, penile clamps, implants around the urethra, or a urethral sling.
Radiation
How A Psa Test Is Done
A PSA test is a blood test that is done in a lab or hospital. Ejaculation can affect PSA levels in the body, so you may be told not to ejaculate for a few days before the test.
Tell your doctor if you are taking drugs to treat benign prostatic hyperplasia, prostatitis, urinary problems or baldness. These drugs can lower PSA levels.
Symptoms Of Advanced Prostate Cancer
The symptoms of advanced prostate cancer depend on where the cancer has spread to. Find out about the possible symptoms and when to see your doctor.
Advanced prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. If your cancer has spread you might:
- have bone pain
- have weight loss for no known reason
What Have I Learned By Reading This
You learned about:
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.