Thursday, July 18, 2024

What Is The Most Aggressive Form Of Prostate Cancer

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Prostate Cancer Treatment: Radiation Therapy

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Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.

Low Dose Rate Brachytherapy

In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.

High Dose Rate Brachytherapy

High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.

Both methods have side effects that can include erectile dysfunction, urinary tract problems, diarrhea, and other side effects.

How Is Prostate Cancer Diagnosed And Evaluated

Your primary doctor will ask about your medical history, risk factors and symptoms. You will also undergo a physical exam.

Many patients undergo regular prostate cancer screening before symptoms appear. Screening may involve one or more of the following tests:

  • Prostate-specific antigen : This test analyzes a blood sample for levels of PSA, a protein the prostate produces. Higher PSA levels could indicate cancer is present.
  • Digital Rectal Exam :This test examines the lower rectum and the prostate gland to check for abnormalities in size, shape or texture. The term “digital” refers to the doctor’s use of a gloved, lubricated finger to conduct the exam.

If screening test results are abnormal, your doctor may perform the following imaging tests:

  • Bone Scan: Your doctor may perform a bone scan to determine if cancer has spread to your bones. A bone scan injects small amounts of radioactive material called a radiotracer into the bloodstream. The radiotracer travels through the area under examination. It gives off radiation in the form of gamma rays, which are detected by a gamma camera. This information goes to a computer, which creates images of your bones.
  • PET/CT: Doctors use PET/CT scanning to see if prostate cancer has returned . Like Bone Scan, PET/CT injects a radiotracer into the bloodstream. The radiotracer attaches to proteins on the surface of prostate cancer cells or is taken up by cancer cells for metabolism.
  • Certain Factors Affect Prognosis And Treatment Options

    The prognosis and treatment options depend on the following:

    • The stage of the cancer .
    • The patients age.
    • Whether the cancer has just been diagnosed or has recurred .

    Treatment options also may depend on the following:

    • Whether the patient has other health problems.
    • The expected side effects of treatment.
    • Past treatment for prostate cancer.
    • The wishes of the patient.

    Most men diagnosed with prostate cancer do not die of it.

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    Ne Differentiation And Somatostatin Receptors

    An immunohistochemical study investigating the expression of the five subtypes of somatostatin receptors in PCa has shown that the greatest proportion of cells with strong stainings is seen in SSTR2, mainly in the group of CRPCa with NE differentiation . The cloning of the SSTRs has led to the development of subtype-selective analogues. Among those, the SSTR2-specific somatostatin analogues octreotide and lanreotide have attracted significant attention. Typing the somatostatin receptor expression in NE tumors is considered to be of great relevance for somatostatin analogue-based diagnostic and therapeutic approaches. The presence of somatostatin receptors on the cancer cell surface may provide a readily available, noninvasive means to identify PCa with NE differentiation with imaging techniques as well as for peptide receptor radionuclide therapy .

    Prostate Cancer Treatment: Hormone Therapy

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    Hormone therapy is designed to use drugs to shrink or slow the growth of prostate cancer cells, but it does not kill the prostate cancer cells. It is used to reduce the symptoms of prostate cancer and to slow the spread of aggressive prostatic cancers by blocking or reducing the production of male hormones like testosterone.

    Hormone Therapy Side Effects

    • Weight gain

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    Risk And Other Prostate Conditions

    The most common misconception is that the presence of non-cancerous conditions of the prostate will increase the risk of prostate cancer.

    While these conditions can cause symptoms similar to those of prostate cancer and should be evaluated by a physician, there is no evidence to suggest that having either of the following conditions will increase a mans risk for developing prostate cancer.

    Benign Prostatic Hyperplasia is a non-cancerous enlargement of the prostate. Because the Urethra runs directly through the prostate, enlargement of the prostate in BPH squeezes the urethra, making it difficult and often painful for men to urinate. Learn more about BPH.

    Prostatitis, an infection in the prostate, is the most common cause of urinary tract infections in men. Most treatment strategies are designed to relieve the symptoms of prostatitis, which include fever, chills, burning during urination, or difficulty urinating. There have been links between inflammation of the prostate cancer and prostate cancer in several studies. This may be a result of being screened for cancer just by having prostate-related symptoms, and currently, this is an area of controversy. Learn more about prostatitis.

    Transitional Cell Prostate Cancer

    This is also known as urothelial carcinoma. This cancer starts in the cells that line the urethra . Transitional cell cancer can start in the bladder and spread to the prostate or, more rarely, it can start in the prostate itself.

    Studies of men with transitional cell prostate cancer show that PSA levels can be low or high. More research is needed before we can know whether PSA tests can help to diagnose transitional cell prostate cancer.

    Men with this cancer often have difficulty urinating and find blood in their urine. This is because the cancer grows around the urethra, causing it to narrow. This means transitional cell carcinoma is often diagnosed when men have surgery called transurethral resection of the prostate to treat their urinary problems, as the tissue removed during surgery is looked at under the microscope.

    If the cancer started in the prostate and has not spread outside the prostate, then you may be offered surgery and radiotherapy. If the cancer has spread to areas just outside the prostate or to more distant areas of the body such as the bones then chemotherapy and/or radiotherapy may be an option.

    Your doctor or nurse will tell you what treatment options are available to you. Read more about how these cancers are treated below.

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    Enhancing Healthcare Team Outcomes

    Prostate cancer diagnosis and treatment can be complex and is often controversial. an interprofessional team of specialty-trained nurses, nurse practitioners, physician assistants, primary care providers, and urologists must work to manage:

    These and many more issues continue to challenge clinicians who deal with prostate cancer patients and men at risk for this common, potentially lethal male malignancy.

    The interprofessional team can optimize the treatment of these patients through communication and coordination of care. Primary care providers, urologists, oncologists, radiation oncologists, and nurse practitioners provide diagnoses and care plans. Specialty care urologic nurses should work with the team for coordination of care and are involved in patient education and monitor compliance. The interprofessional team can thus improve outcomes for patients with prostate cancer.

    What Is Prostate Cancer

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    Prostate cancer only affects men. Cancer begins to develop in the prostate a gland in a mans reproductive system. The word prostate comes from Medieval Latin prostate and Medieval French prostate. The ancient Greek word prostates means one standing in front, from proistanai meaning set before. The prostate is so called because of where it is at the base of the bladder.

    The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.

    The urethra a tube that goes from the bladder to the end of the penis and carries urine and semen out of the body goes through the prostate.

    There are thousands of very small glands in the prostate they all produce a fluid that forms part of the semen. This fluid also protects and nourishes the sperm. When a male has an orgasm the seminal-vesicles secrete a milky liquid in which the semen travels. The liquid is produced in the prostate gland, while the sperm is kept and produced in the testicles. When a male climaxes contractions force the prostate to secrete this fluid into the urethra and leave the body through the penis.

    It is a myth to think that a high blood-PSA level is harmful to you it is not. High blood PSA levels are however an indication that something may be wrong in the prostate.

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    Prostate Cancer Treatment: Chemotherapy

    Chemotherapy is designed to kill fast-growing cancer cells anywhere in the body so it is often used when aggressive prostate cancer cells metastasize to other body sites. Usually, chemotherapy is given through a special intravenous line in a series of treatments over several months. There have been new advances in both the hormonal and chemotherapy treatment of prostate cancer. Unfortunately, chemotherapy often kills other fast-growing body cells like hair cells, mucosal cells, and cells that line the gastrointestinal tract. This can result in several unwanted side effects.

    Prostate Cancer Chemotherapy Side Effects

    • Hair loss

    Surgery For Aggressive Prostate Cancer Gives 92% 10

    Patients with the most aggressive form of prostate cancer who have surgery radical prostatectomy were found to have a 10-year cancer-specific survival rate of 92%, which is high, and a 77% overall survival rate, according to researchers from the Fox Chase Cancer Center and the Mayo Clinic, USA. This compares to an 88% 10-year cancer specific survival rate and 52% overall survival rate for those who underwent radiotherapy without surgery. The findings were presented at the American Urological Associations 84th Annual Meeting, Chicago.

    Stephen Boorjian, M.D., a urologist at the Mayo Clinic, said:

    Its long been believed that patients with aggressive prostate cancer are not candidates for surgery. We found that surgery does provide excellent long-term cancer control for this type of prostate cancer. In addition, by allowing the targeted use of secondary therapies such as androgen deprivation, surgery offers the opportunity to avoid or at least delay the potentially adverse health consequences of these treatments.

    Their study included 1,847 individuals with aggressive prostate cancer. Between 1988 and 2004 1,238 of them underwent a surgical procedure to have their prostate taken out at the Mayo Clinic, while 609 received radiotherapy at the Fox Chase Cancer Center. 344 of the patients who received radiotherapy were also given androgen deprivation therapy.

    The investigators worked out their overall and cancer-specific survival rates:

    Dr. Boorjian said:

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    Prostate Cancer Treatment: Watch And Wait

    “Watch and wait,” is a phrase that is being used more frequently to describe a program of active surveillance without other cancer treatment for some patients with prostate cancer. It means that if your cancer is not aggressive , treatments may be deferred and your condition periodically checked. This approach is used because the risks of urinary and sexual problems inherent in most prostate cancer treatments are serious and may be put off or avoided if the cancer is not aggressive. However, aggressive prostatic cancer is usually treated even if secondary complications of treatments are serious.

    Questions Related To Aggressive Variant Prostate Cancer

    Most Aggressive Form of Prostate Cancer on the Rise

    A first question is whether it is possible to distinguish AVPCas with NE differentiation from those without on the basis of the pure morphology, that is, the hematoxylin-eosin-stained sections. The answer is no, because the neoplastic population is quite homogenous in morphology and there is no cellular hint to the presence of NE differentiation, even in cases in which the tumor is composed of cells co-expressing NE and prostate markers. This means that immunohistochemistry has to be performed in all cases of AVPCa to detect an NE differentiation. This is in agreement with the results of the investigation by Labrecque et al , showing that molecular profiling identifies five diverse phenotypes based on the expression of well-characterized AR or NE genes: AR-high tumors, AR-low tumors, amphicrine tumors composed of cells co-expressing AR and NE genes, double-negative tumors, and tumors with small cell or NE gene expression without AR activity .

    A further question is whether NE differentiation can be observed in PCas that are still hormone sensitive and therefore not really part of the spectrum of AVPCa. The answer is yes, and they have the morphology of mixed acinar and NE adenocarcinoma .

    Another question is what kind of molecular features can be detected in the AVPCa without NE differentiation. The answer is that such tumors can be characterized by the presence of specific alterations in the DNA that can have a role from the therapeutic point of view .

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    About Rare Prostate Cancers

    Although prostate cancer is a common cancer in men, there are different types of prostate cancer, and some of these are rare. Because they are rare, we dont know as much about them. If you are diagnosed with one of the cancers mentioned here, speak to your doctor or nurse about what that means and what treatments are suitable for you.

    Like most things in our body, the prostate is made up of different types of cells . The type of cancer that develops depends on the cell it starts in.

    The most common type of prostate cancer starts in some of the cells that line the prostate, called glandular epithelial cells. There are two types of gland cells basal cells and luminal cells . Prostate cancer can develop in either of these cells.

    When we talk about common prostate cancer here, we mean this type of prostate cancer. You may hear it called adenocarcinoma or acinar adenocarcinoma or see this written in your biopsy results .

    Rarer types of cancer can also develop from gland cells, or from other types of cells in the prostate.

    Some men have more than one type of prostate cancer. For example, they may have some common prostate cancer as well as a rare cancer.

    Some of the rare cancers may be more aggressive than common prostate cancer. This means they may grow faster and are more likely to spread outside the prostate.

    How Are These Cancers Treated

    Different prostate cancers behave in different ways, and they might respond differently to treatments. Treatment can depend on whether there is a mix of cancer types.

    Some rare cancers may be treated in a different way to common prostate cancer. For example, hormone therapy does not work for men with small cell cancer and so isnt usually given as a main treatment for this.

    Because these cancers are so rare, there isnt enough evidence to say which treatments will work best for all of them. Your treatment will depend on your situation for example, the type of cancer you have and whether it has spread to other parts of the body. Your symptoms, and any treatments youve already had, may also affect the treatment youre offered.

    If you have any questions about your cancer speak to your doctor or nurse. Theyll be able to explain your test results and talk you through your possible treatment options.

    Treatments for localised cancer

    If your cancer is contained within the prostate , you may be offered treatment that aims to get rid of the cancer such as surgery or radiotherapy.

    Some rare prostate cancers may be more likely to come back after treatment than common prostate cancer. If theres a risk your cancer could spread outside the prostate after treatment, you might be given other treatments before, at the same time as, or after your main treatment.

    If you have small cell prostate cancer you might have chemotherapy before another treatment.


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    Why Is Rare And Aggressive Cancer Difficult To Treat

    Rare and aggressive cancers often present tough challenges that make them more difficult to treat than common tumor types. For a rare cancer case, doctors may not have a standard FDA-approved therapy to help guide them in clinical decision-making. In aggressive cancer cases, cancer cells can often become resistant to standard treatment options, and patients may therefore exhaust these options very quickly. Patients with rare and/or aggressive cancers may thus be good candidates for molecular profiling, a service that can provide direction for a treatment plan when the treatment path may not be so clear.

    Clues In Diet And Lifestyle

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    To clarify the prognosis for a tumor, HSPH researchers are homing in on other factors that might affect susceptibility to prostate cancer, especially the aggressive form of the disease. Edward Giovannucci, professor of nutrition and epidemiology, recently looked at nine diet and lifestyle factors. He found that smoking, obesity, and lack of physical activity raise the risk of developing a more virulent cancer. According to Giovannucci, The question is whether there are two types of prostate canceran aggressive and nonaggressive formor whether certain factors cause a nonaggressive form to become more aggressive. Evidence provided by HSPH researchers suggests that an increase in insulin in the bloodstream, caused by obesity and physical inactivity, may encourage tumor growth.

    Other investigations have linked dietary factors to the disease. A 2011 study by HSPH research associate Kathryn Wilson, together with Mucci and Giovannucci, professor of nutrition and epidemiology Meir Stampfer, and other colleagues, found that men who drank coffee had a notably lower risk of aggressive prostate cancer. Those who consumed six cups or more a day were 20 percent less likely to develop any form of the disease, and 60 percent less likely to develop a lethal disease those who consumed one to three cups a day showed no difference in developing any form of the disease, but had a 30 percent lower risk of developing a lethal form.

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