Tuesday, November 29, 2022

Where Does Prostate Cancer Come From

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Can Prostate Cancer Be Prevented

What Is a Normal PSA for a Man Without Prostate Cancer? | Ask a Prostate Expert, Mark Scholz, MD

There are no clear prevention strategies for prostate cancer. There is some conflicting evidence that a healthy diet composed of low fat, high vegetables and fruits may help reduce your risk of prostate cancer. Routine screening, with PSA blood test and physical exam, is important to detect prostate cancer at an early stage. A healthy diet and regular exercise are also critical in maintaining good health and preventing disease in general.

What Is Advanced Prostate Cancer

When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.

Prostate cancer is often grouped into four stages.

  • Stages I & II: The tumor has not spread beyond the prostate. This is often called early stage or localized prostate cancer.
  • Stage III: Cancer has spread outside the prostate, but only to nearby tissues. This is often called locally advanced prostate cancer.
  • Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs. This stage is often called advanced prostate cancer.

When an early stage prostate cancer is found, it may be treated or placed on surveillance . If prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Stage IV prostate cancer is not curable, but there are many ways to control it. Treatment can stop advanced prostate cancer from growing and causing symptoms.

There are several types of advanced prostate cancer, including:

Biochemical Recurrence

If your Prostate Specific Antigen level has risen after the first treatment but you have no other signs of cancer, you have biochemical recurrence.

Castration-Resistant Prostate Cancer

Metastatic Hormone-Sensitive Prostate Cancer

Treatment For Bladder Cancer Depends On Your Overall Health Progression Of The C

Information is a powerful weapon against uncertainty and fear, and you can use this to your advantage. Prostate cancer is one of the most common types of cancer diagnosed in men. Prostate cancer is a common type of cancer in men, according to the mayo clinic. A diagnosis of lung cancer naturally causes some overwhelming emotions, but you dont have to let those emotions get the best of you. One in seven men in the united states will receive a prostate cancer diagnosis during his lifetime. Although it is the most commonly diagnosed cancer in american women, breast cancer can impact people of all genders. However, as with other types of cancer,. Treatment for bladder cancer depends on your overall health, progression of the c. Not only does the stage tell you how serious the disease is, but it can help you and. Staging tells you how advanced the cancer is, how big it is in the prostate, and whether it has spread to other parts of the body, such as the nearby lymph nodes, liver, and bone. Breast cancer is the second most common cancer found in women after skin cancer but that doesnt mean men arent at risk as well. A cancer diagnosis can leave you unable to comprehend anything else your doctor says, but its important to pay attention to what stage of cancer you have. When malignant cancer cells form and grow within a persons breast tissue, breast cancer occurs.

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Understanding The Recurrent Prostate Cancer

Recurrent prostate cancer is when prostate cancer returns after the initial treatment or partial to complete remission has occurred. This is due to the reemergence of surviving prostate cancer cells that have grown large enough to be detected.

Following a prostatectomy, your prostate-specific antigen levels being to decrease. Eventually, they are no longer detectible, which is an indication that prostate cancer is no longer present. However, there is no clear reference for a normal PSA. It differs between men and can be affected by a number of factors. Following your initial prostate cancer treatment, PSA levels should stabilize and be low enough to where theyre not detected on blood tests. In some cases, PSA levels begin to rise again, indicating a need for further tests.

Even if youve had a prostatectomy, prostate cancer can recur in the immediately surrounding tissue, lymph nodes, seminal vesicles, muscles that control urination, the rectum, the wall of the pelvic, or metastasize into lymph nodes and bones further away.

Remission And The Chance Of Recurrence

Metastatic prostate cancer

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someones risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.

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Digital Rectal Exam And Psa Test

Two tests are particularly helpful in screening for prostate cancer.

Digital rectal exam

A DRE is done to determine if the prostate is enlarged and is either soft, has bumps or is very firm . During a digital rectal exam, a doctor checks for prostate abnormalities using a gloved, lubricated finger .

PSA Test

Another test is done on a blood sample to determine the level of a protein produced by prostate cells. The PSA test may indicate a person has a higher chance of having prostate cancer but controversies about the test exist . The patient and his doctor need to carefully consider the meaning and the use of these test results.

Prostate Cancer Risk Groups

In addition to stage, doctors may use other prognostic factors to help plan the best treatment and predict how successful treatment will be. Examples of these include the National Comprehensive Cancer Network risk group categories and the Cancer of the Prostate Risk Assessment risk score from University of California, San Francisco.

Information about the cancers stage and other prognostic factors will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

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Who Is At Risk For Prostate Cancer

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

Staging: The Tnm System

How Does Prostate Cancer Work?

Staging is done as part of the diagnosis process to determine how extensive your cancer is within your prostate and whether it has spread to lymph nodes or other organs.

Prostate cancer is typically staged using the TNM system, which is based on:

  • The extent of the primary tumor
  • Whether the cancer has spread to nearby lymph nodes
  • The presence or absence of distant metastasis
  • Your PSA level at the time of diagnosis
  • Your Gleason score and the amount of cancer

Using this information, prostate cancer is then grouped into stages I through IV, with stage I being the least advanced and stage IV being the most advanced.

  • Stage I: Cancer is confined to your prostate. Gleason score is 6 or below. PSA level is less than 10.
  • Stage II: The tumor is more advanced but does not extend beyond your prostate.
  • Stage III: The tumor extends beyond your prostate and may be in a seminal vesicle. Cancer has not spread to lymph nodes.
  • Stage IV: The tumor has spread to another part of your body, such as your bladder, rectum, lymph nodes or bones.

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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.

What Is A Normal Psa Test Result

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.

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Cancer That Clearly Has Spread

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.

Prostate Cancer Treatment Options: What Are They

Welcome: Prostate Cancer ~ 6 things to know

Prostate cancer is, most often, a slow-growing cancer.

For some men, prostate cancer causes no symptoms or long-term issues, so treatment isn’t necessary.

In these cases, doctors may recommend active surveillance. That is, they’ll keep an eye on the development of the tumor using various tools and tests, including:

  • Digital rectal exams
  • Transrectal ultrasounds
  • Prostate biopsies

Men who require treatment for their condition are most often treated with surgery, radiation therapy, hormone therapy, or a combination of these modalities.

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When A Gleason Score Increases

If your Gleason score changes while youre on active surveillance, its time for a discussion with your urologist to better understand the situation.

You may find it helpful to ask these questions:

  • In what way did my Gleason score increase? Remember that the numbers that comprise your Gleason score represent the two most common grades of tissue in your biopsy. Finding out which number increased is important to understanding how your tumor has changed. A change in your first number means that most of your tissue samples are now grade 4 . A new Gleason score of 3+4 means that grade 3 is still the most prominent type of tissue in your biopsy.
  • How does this impact my risk level? Your risk level is based on the distribution of grade 3 and grade 4 samples. A Gleason 7 has a more favorable risk level than a Gleason 7 .
  • Is it time to consider active treatment? It can be unsettling to find out that your prostate cancer has changed or may be getting worse. However, even if your urologist recommends staying on active surveillance, it may bring you peace of mind to better understand at what point youll need to consider other options.

What Are The Signs Of Prostate Cancer

Most early prostate cancers are detected with PSA tests or digital rectal exams before they cause any symptoms. However, more advanced prostate cancers can cause a variety of symptoms including:

  • Trouble starting to urinate .
  • Urinating much more often than usual.
  • The feeling that you can’t release all of your urine.
  • Pain with urination or ejaculation.
  • Blood in your urine or semen.
  • Impotence/erectile dysfunction.
  • Numbness in the lower extremities.
  • Loss of bladder or bowel control.

All of these symptoms can be caused by things other than prostate cancer, so experiencing them doesn’t necessarily mean you have prostate cancer. When older men have problems urinating, it is usually caused by a problem called benign prostatic hyperplasia , which is not prostate cancer. If you have any of these symptoms, you need to see your provider for testing.

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What Screening Tests Are Used For Prostate Cancer

There are two tests used for prostate cancer screening:

The American Cancer Society recommends that men make an informed decision on whether or not they should be screened after talking about the risks and benefits of screening with their healthcare provider. Screening is not recommended in men without symptoms of prostate cancer if they have a life expectancy of less than ten years. Men at average risk of developing prostate cancer should begin this conversation at age 50. African American men and men with one relative with prostate cancer should talk with their healthcare provider about screening beginning at age 45. Men at the highest risk, those with more than one first degree relative with prostate cancer at an early age should begin talking about screening at age 40. Repeat screening is based on baseline PSA results, but typically occurs every 1-2 years.

Management Of Blood In Urine By Prostate Cancer Patients

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There is no standard treatment for blood in urine and prostate cancer. Thats because blood in the urine is a symptom and not a disease in itself. So, to manage the problem, physicians start by evaluating it. In addition to asking about a patients medical history and appearance of the blood in urine, physicians request a urine sample to be analyzed in a test called urinalysis, and/or a urine cytology, which consists of microscopically seeking abnormal cells in the urine.

Blood tests may be ordered to look for high levels of wastes that kidneys are supposed to remove. Additional exams that may be requested include a computed tomography scan, a kidney ultrasound, an intravenous pyelogram , a cystoscopy, or a biopsy. If prostate cancer is confirmed, treatment options include watchful waiting or active surveillance, surgery, radiation therapy, cryosurgery, hormone therapy, chemotherapy, vaccine treatment and bone-directed treatment.

The treatment plan is defined by a physician or a multi-disciplinary team of physicians, including urologists and oncologists. Treatment depends on factors like the cancers stage and grade, patients age and expected lifespan, and additional health conditions. Other considerations include the patients and physicians opinions about the urgency of treating the cancer, potential side effects from each treatment, and the probability of each treatment in curing the cancer.

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What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening

Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening

that requires treatment.

Detecting Prostate Cancer Recurrence

If you have recurrent prostate cancer, its usually detected during follow up appointments. Once you undergo initial prostate cancer treatment, youll need to see your urologist once every few months to monitor your PSA levels and discuss any new symptoms. If your PSA levels begin to rise, it can be an indication that the cancer has returned. Your doctor will use imaging tests to try and locate the cancer and determine the best course of action for a second round of treatment. Tools for detection are continually improving, so be open to suggestions from your doctor.

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