Established Risk Factors: Age Race And Family History
The only risk factors for prostate cancer that can be considered established are age, race/ethnicity, and family history. Study of age-specific incidence curves reveals that prostate cancer risk begins to rise sharply after age 55 years and peaks at age 7074, declining slightly thereafter. Autopsy studies confirm that prostate cancer has a long induction period, and that many men have incipient lesions in their 20s and 30s.2 As Figure 1 shows, the risk of prostate cancer is approximately 60% higher in African Americans than in whites. Mortality among African Americans is approximately double that of whites. Conflicting data exist as to whether this mortality difference is explained entirely by differences in socioeconomic status variables and stage at diagnosis, or whether an inherent difference exists between these racial/ethnic groups in the underlying biology of prostate cancer. It should be emphasized that biological explanations for these risk differences could involve genetic factors, environmental factors, or, more likely, an interaction between the two.
What Questions Should I Ask My Healthcare Provider
If you have prostate cancer, you may want to ask your healthcare provider:
- Why did I get prostate cancer?
- What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
- Has the cancer spread outside of the prostate gland?
- What is the best treatment for the stage of prostate cancer I have?
- If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
- What are the treatment risks and side effects?
- Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
- Am I at risk for other types of cancer?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.
Active Surveillance May Help Your Quality Of Life
With this approach, you have regular checkups, including a PSA test and rectal exam. Youll get a prostate biopsy if needed. You can start treatment at any time if the cancer starts to grow.
Active surveillance is a good choice for many men with low-risk prostate cancer, because they can avoid the side effects of treatment. This is an especially important choice if you are older or in poor health.
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Side Effects Of Prostate Cancer Radiotherapy
Radiotherapy to the prostate can cause some side effects, such as loose or watery poo and passing urine more often.
Side effects tend to start a week or 2 after the radiotherapy begins. They gradually get worse during the treatment and for a couple of weeks after the treatment ends. But they usually begin to improve after around 2 weeks or so after treatment finishes
Everyone is different and the side effects vary from person to person. You may not have all of the effects mentioned.
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Aggressive Prostate Cancer Definition And 3 Indisputable Facts To Know
Do you know that prostate cancer can be aggressive and non-aggressive? Yes, it can and this depends on the stage in which the disease is. Prostate cancer is an abnormal growth of the cells of the prostate. These growths often lead to tumor that can metastasize to other organs of the body. Understanding the stages of the prostate cancer will enable your doctor to determine if the cancer is aggressive or not. This article defines aggressive prostate cancer and provides you with 3 indisputable facts that are linked with the condition.
3 Facts about aggressive prostate cancer
1.Aggressive prostate cancer is diagnosed on individuals whose cancers have metastasized beyond the localized region of the prostate. Biopsy, Bone scans and X-rays are applied to detect the aggressiveness of the cancer. Diagnosis for this classification of cancer is not that difficult because the symptoms are evidently seen in the patients.
2.If a patients prostate cancer is classified as aggressive, you will notice the following symptoms in the person ? bloody urine, difficulty in passing urine, incontinence, weight loss, body weakness, painful ejaculation, persistent pain in the back, etc. The symptoms mentioned are just a few of the many other symptoms of advanced aggressive Stage IV prostate cancer that individuals experience.
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Image Guided Radiation Therapy
In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.
In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.
Calypso is another form of IGRT where the prostate can be tracked during the treatment.
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Possible Side Effects Of Radiation Treatment For Prostate Cancer
The radiation used to destroy cancer cells can also hurt normal cells in the nearby area. Side effects from radiation treatment are related to the area of the body being treated. Patients start to have side effects a few weeks into their treatment. While side effects may be unpleasant, there are treatments to help deal with them. Most side effects are temporary and slowly start to go away once treatment is done.
You will be seen by your radiation oncology providers often during treatment. These visits are a chance to ask questions and to talk about any side effects and how to best manage them. You can also call your providers to speak about any side effects.
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Brca1 Or Brca2 Gene Changes
You might hear your doctor call these mutations. Youâre born with them, so they fall in the category of risk factors you canât control. They run in families, but they only affect a small number of people. They raise the odds of breast and ovarian cancers in women and prostate cancer in some men.
Key Points To Remember
- With active surveillance, you can choose to wait to start treatment, such as surgery or radiation. Some men will never need surgery or radiation. And others will be able to delay having surgery or radiation until tests show that their cancer is growing.
- Surgery or radiation may be used to remove or destroy the cancer right away. But in many cases, the cancer would never have caused you problems. And having these treatments may not cure the cancer.
- Surgery and radiation can cause serious side effects, such as erection, bladder, and bowel problems. And these can have a big impact on your quality of life.
- There is a chance that your prostate cancer may grow during active surveillance. But you will have frequent checkups and tests to watch for any changes. And if the cancer grows, it can still be successfully treated.
- Men with low-risk localized prostate cancer and some men with medium-risk localized prostate cancer have a very low risk of dying from prostate cancer. This is true no matter what approach they choose.
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Anthropometric Factors And Physical Activity
Measures of obesity and height have been extensively studied in relation to prostate cancer risk. These studies do not indicate any substantial association between either obesity or height and prostate cancer.13 Adult height was hypothesized to be important, in part because it is influenced by nutrition during childhood. However, attained height is not correlated with adult levels of the somatotrophin insulin-like growth factor -1, which has been linked to prostate cancer risk. The lack of association between obesity and prostate cancer is vexing because obesity reduces sex hormone-binding globulin levels, which could lead to an increase in bioavailable testosterone, and increases both insulin and bioavailable IGF-1, which are both potentially important prostate mitogens. Relatively little research has been conducted so far on body fat distribution, as opposed to total body fat. Of particular interest is abdominal fat, which has metabolic effects different from those of subcutaneous fat. In addition, investigators have hypothesized that physical activity, apart from its beneficial effect on body fat, could reduce prostate cancer risk. The data thus far, however, are not conclusive, perhaps due to difficulty in measuring physical activity in study populations or assessment of activity during the wrong period of life.
What About My Physical And Emotional Wellness
Eating a healthy diet including a variety of foods, will ensure you have what your body needs to cope with treatment and recovery. Regular physical activity can improve your cancer recovery and reduce side effects such as fatigue.
- Dont be afraid to ask for professional and emotional support.
- Consider joining a cancer support group.
- Learn to ignore unwanted advice and horror stories.
- Live day-to-day and remember that every day is likely to be different.
Complementary therapies can work alongside medical treatments and some have been shown to improve quality of life or reduce pain. There is no evidence that these therapies can cure or prevent cancer. Some have not been tested for side-effects, may work against other medical treatments and may be expensive. Talk to your doctor about using complementary therapies.
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Consult A Doctor To Learn More About Your Risk Factors
We offer you access to New Jerseys largest network of cancer specialists. If you are concerned about your prostate health or are experiencing any of the prostate cancer symptoms mentioned above, make an appointment with one of our expert urologists or oncologists today.
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What Are Prostate Tests And How Is Prostate Cancer Diagnosed
Tests which check for prostate cancer include:
- A digital rectal exam . In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
- A prostate-specific antigen blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
- Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.
If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.
During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.
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Other Ways To Measure Risk Of Prostate Cancer Growing And Spreading
In addition to the risk groups above, doctors are still learning about the best use of other types of tests and prognostic models to help decide the most effective treatment options for someone. If your doctor suggests using one of these ways to help determine your treatment options, have them explain what it can tell you, as well as how accurate its likely to be.
Low Risk Prostate Cancer And An Opportunity Lost: More Activity Required In Active Surveillance
Men who are being monitored may be more open to interventions for improving their general health and quality of life
Prostate cancer is the most frequently registered cancer in Australian men, with an estimated 17 729 new diagnoses in 2018.1 For the 25% who are diagnosed with low risk disease, active surveillance is now the recommended management strategy, as their cancer may never progress.2 Avoiding or at least postponing radical treatment reduces the quality of life risks associated with surgery or radiation therapy. However, there is no evidence-based consensus about the optimal approach to surveillance, and practices differ between countries with regard to the type, frequency, and sequence of follow-up.3 AS differs from watchful waiting in that it has a curative intent watchful waiting involves less intense routine monitoring, intervening only when symptoms appear. One standard approach to AS recommends prostate-specific antigen assessment every 36 months, a digital rectal examination at least once a year, and at least one biopsy within 12 months of diagnosis, followed by serial biopsy every 25 years.
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- 1 Cancer Council NSW, Sydney, NSW
- 2 University of Adelaide, Adelaide, SA
- 3 Royal Adelaide Hospital, Adelaide, SA
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Veterans & Chemical Exposure
Exposure to chemicals and defoliants can add to prostate cancer risk and severity. Studies have shown Vietnam and Korean War Veterans with exposure to defoliants like Agent Orange have a higher occurrence of prostate cancer. In fact, Veterans are about twice as likely to be diagnosed with prostate cancer than men who have never served in the military. Read more about Veterans and prostate cancer here.
Farmers and other men who work with large amounts of pesticides can be at increased risk and those who are frequently exposed to metal cadmium like welders, battery manufacturers, and rubber workers are abnormally vulnerable to prostate cancer. There is some evidence that firefighters are also at higher risk.
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The ProtecT trial has one important weakness: The participants have only been observed for ten years so far. But it would only be possible to draw any reliable conclusions about the pros and cons of the three treatment approaches after 15 or 20 years.
Surgery is the only treatment for which there is currently conclusive long-term data gathered over a period of 23 years. This data comes from a Scandinavian study that compared the surgical removal of the prostate with the watchful waiting approach. But only about one third of the men in this study had low-risk prostate cancer. So its not possible to draw any reliable conclusions about the long-term pros and cons of the current standard treatment options for low-risk prostate cancer.
The ProtecT trial also has another limitation: The check-ups that men had in the active surveillance group were different from the current standard approach in Germany. In the ProtecT trial, the men had a PSA test every 3 months in the first year, and then every 6 to 12 months after that. If the PSA levels were too high or if the men developed symptoms such as problems urinating, they had further tests. In Germany, men who have abnormal PSA test results are also advised to have regular biopsies . This is meant to increase the likelihood of finding out soon enough if the cancer progresses, but it can also be more distressing.
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What Increases Your Risk Of Prostate Cancer
Factors that can elevate risk prostate cancer include:
- A family history of prostate cancer
- Inherited genetic mutations, such as BRCA1/BRCA2 genes and Lynch syndrome
- Conditions such as prostatitis, inflammation of the prostate, and benign prostatic hyperplasia or BPH, a noncancerous enlargement of the prostate gland
- A diet high in red meats and high-fat dairy and low in fruits and vegetables
- Age: approximately 60 percent of cases are diagnosed in men older than 65
- Race and ethnicity: African-American men and Caribbean men of African ancestry are more likely to be diagnosed with prostate cancer
Research has also shown that a healthy lifestyle, including a well-balanced diet and maintaining a healthy weight, may reduce prostate cancer risk.
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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Who Is More Likely To Develop Prostate Cancer
Anyone who has a prostate can develop prostate cancer. But certain factors can make you more likely to develop it:
- Age. Your chance of developing prostate cancer increases as you get older. Prostate cancer is rare in people under age 50.
- Family health history. Your risk of prostate cancer is higher if you have a parent, sibling, or child who has or has had prostate cancer.
- Race. African Americans are more likely to get prostate cancer. They’re also more likely to:
- Get prostate cancer at a younger age.
- Have more serious prostate cancer.
- Die from prostate cancer.
Gene And Protein Tests For Prostate Cancer
For men with prostate cancer that is localized , a major issue is that its often hard to tell how quickly the cancer is likely to grow and spread. This can make it hard to decide if the cancer needs to be treated right away, as well as which types of treatment might be good options.
Some types of lab tests, known as genomic, molecular, or proteomic tests, can be used along with other information to help better predict how quickly a prostate cancer might grow or spread, and as a result, help decide what treatment options might be best and when they should be given. These tests look at which genes or proteins are active inside the prostate cancer cells. Examples of such tests include:
These tests continue to be studied to find more areas where they can be useful in prostate cancer risk and treatment decisions.
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