Treatment Of Prostate Cancer
Early detection is the best way to start treatment. Treatment will come in various forms and will be dependent on the stage at which cancer has gotten to. The treatments can also have side effects. These treatments are:
When in doubt, you notice symptoms, have a family history of prostate cancer or are in the age risk zone, you can consult with our doctor when you call 080 8111 1121. Early screening is the best chance against prostate cancer. You can also book a PSA blood test by contacting the same number above.
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How Will My Cancer Be Monitored
Your doctor will talk to you about how often you should have check-ups. At some hospitals, you may not have many appointments at the hospital itself. Instead, you may talk to your doctor or nurse over the telephone. You might hear this called self-management.
You will have regular PSA tests. This is often a useful way to check how well your treatment is working. Youll also have regular blood tests to see whether your cancer is affecting other parts of your body, such as your liver, kidneys or bones.
You might have more scans to see how your cancer is responding to treatment and whether your cancer is spreading.
Your doctor or nurse will also ask you how youre feeling and if you have any symptoms, such as pain or tiredness. This will help them understand how youre responding to treatment and how to manage any symptoms. Let them know if you have any side effects from your treatment. There are usually ways to manage these.
Bone Metastasis: The Vicious Cycle
The canonical Wnt signaling pathway seems to play a role in the onset of castration resistance in PCa . Moreover, alterations of canonical Wnt signaling, such as modulation of the dickkopf genes or mutations of sclerostin , which inhibits LRP5, contribute to disrupt bone formation, a process whereby Wnt signaling exerts a crucial role . Wnt signaling also induces the expression of osteoprotegerin , which prevents the binding of RANKL to RANK, thereby inhibiting osteoclast function and leading to a bone active effect .
The TGF- superfamily also exerts a major role in the context of the bone microenvironment and its remodeling in PCa. TGF- supports the development of bone metastasis from PCa in animal models . In particular, bone morphogenetic proteins and Noggin, which antagonizes BMP signaling, are functionally involved in skeletal and joints morphogenesis, bone remodeling, and in different cellular processes, including osteogenesis . One of the main BMPs involved in the recruitment of osteoblasts is represented by BMP6 . On the other hand, the recruitment of osteoclasts and stimulation of their activity in PCa is mediated by MMP-7, which cleaves RANKL , and Noggin, which antagonizes BMPs and impairs bone formation .
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Talking With Your Health Care Team About Side Effects
Before starting treatment, talk with your doctor about possible side effects. Ask:
Which side effects are most likely?
When are they likely to happen?
What can we do to prevent or relieve them?
Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.
Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan. Create a caregiving plan with this 1-page fact sheet that includes an action plan to help make caregiving a team effort. This free fact sheet is available as a PDF, so it is easy to print.
Can Prostate Cancer Spread
Medically Reviewed by: Dr. BautistaUpdated on: November 18, 2019
Like other cancers, prostate cancer can spread if the cancer cells grow out of control. At ITC, we treat all different types of cancer and know that patients often have a lot of questions surrounding their diagnosis.
We often are asked what is prostate cancer? Can prostate cancer spread? How is it diagnosed? And more. At Immunity Therapy Center, we know that each diagnosis is unique and every patient is different which is why we focus on a holistic approach to prostate cancer. And we believe that when patients have the knowledge, theyre more likely to take control of their health.
To give you the knowledge to prepare, lets take a closer look at prostate cancer, what symptoms to look for, and how it can spread.
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Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- a radiologist
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
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Where Prostate Cancer Spreads
Many patients ask, can prostate cancer spread? The answer is, yes. Roughly 80 percent of the time 4 , when prostate cancer cells spread, they spread to bones 5 . Often, the cells spread to the hips, spine, and pelvic bones. This either happens as the cells travel through the blood or lymph nodes or direct invasion. When the cells relocate, they grow and form new tumors .
The good news is that for most men who are diagnosed with prostate cancer, its not terminal. Over 3.1 million men in America who have been diagnosed with prostate cancer are alive today.
Aside from skin cancer, prostate cancer is the most common cancer 6 in American men, with 1 of 9 men diagnosed in their lifetime. If caught early, there are a variety of treatments, including taking the holistic approach to prostate cancer.
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The Spread Of Prostate Cancer
Prostate cancer is at its most dangerous when it leaves the prostate and spreads around the body
Plexin-B1 helps cells to move, and helps cancer cells to spread
Dr Williamson is developing drugs to stop Plexin-B1 from helping cancer cells to spread
She has also discovered that cancers with more Plexin-B1 are more likely to be aggressive
A new diagnostic? The project will now find out if Plexin-B1 can be used to predict which cancers will spread and which will not
Plexin-B1 is also relevantto hormone therapy, one of the main ways prostate cancer is treated
Dr Williamson discovered that Plexin-B1 might stop hormone therapy from working
Blocking Plexin-B1 could both stop cancer spreading and make hormone therapy work better
About the Researchers
Cancer Division, Kings College London
Dr Magali Williamson
Magali has been at Kings College London since 2014 and leads the Prostate Cancer Metastasis Group. Her main research interest lies in understanding how prostate tumours spread to other parts of the body and ways in which to block this process.
Dr Ritu Garg
Looking For More Survivorship Resources
For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:
ASCO Answers Cancer Survivorship Guide:Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.
Cancer.Net Patient Education Video:View a short video led by an ASCO expert that provides information about what comes after finishing treatment.
Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.
The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.
This is the end of Cancer.Nets Guide to Prostate Cancer. Use the menu to choose a different section to read in this guide.
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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.
Staging: The Tnm System
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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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Watchful Waiting And Active Surveillance
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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What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
How Prostate Cancer Spreads
Cancer cells sometimes break away from the original tumor and go to a blood or lymph vessel. Once there, they move through your body. The cells stop in capillaries — tiny blood vessels — at some distant location.
The cells then break through the wall of the blood vessel and attach to whatever tissue they find. They multiply and grow new blood vessels to bring nutrients to the new tumor. Prostate cancer prefers to grow in specific areas, such as lymph nodes or in the ribs, pelvic bones, and spine.
Most break-away cancer cells form new tumors. Many others don’t survive in the bloodstream. Some die at the site of the new tissue. Others may lie inactive for years or never become active.
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Second Cancers After Prostate Cancer
Prostate cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors may develop a new, unrelated cancer later. This is called a second cancer.
Unfortunately, being treated for prostate cancer doesnt mean you cant get another cancer. Men who have had prostate cancer can still get the same types of cancers that other men get. In fact, they might be at higher risk for certain types of cancer.
Men who have had prostate cancer can get any type of second cancer, but they have an increased risk of certain cancers, including:
This risk is probably related to the dose of radiation. Newer methods of giving radiation therapy may have different effects on the risks of a second cancer. Because these methods are newer, the long-term effects have not been studied as well.
Resources For More Information
Prostate Cancer Foundation
Leading philanthropic organization funding and accelerating prostate cancer research globally. Also provides information about prostate cancer, treatment and resources to help patients and families.
Offers peer-to-peer support and educational materials to help men and their families/caregivers make informed decisions about prostate cancer detection, treatment options and related side effects.
Provides cancer support for men with anal, prostate and breast cancer, with emphasis on African-American and gay males. Provides multiple language support.
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How Doctors Find Metastatic Prostate Cancer
When you are diagnosed with prostate cancer, your doctor will order tests such as:
- MRI scans
- PET scans
These tests may focus on your skeleton and in your belly and pelvic areas. That way doctors can check for signs that the cancer has spread.
If you have symptoms such as bone pain and broken bones for no reason, your doctor may order a bone scan. It can show if you have signs of cancer spread in your bones.
Your doctor will also ask for blood tests, including a check of PSA levels, to look for other signs that the cancer is spreading.
PSA is a protein made by the prostate gland. A rise in PSA is one of the first signs your cancer may be growing. But PSA levels can also be high without there being cancer, such as if you have an enlarged prostate a prostate infection, trauma to the perineum, or sexual activity can also cause PSA level to be high.
If you’ve been treated, especially if a surgeon removed your prostate, your PSA levels should start to go down. Doctors usually wait seve,ral weeks after surgery before checking PSA levels. A rise in PSA after treatment may suggest the possibility cancer is back or spreading. In that case, your doctor may order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan. The radiotracer Axumin could be used along with a PET scan to help detect and localize any recurrent cancer.
Though very rare, it’s possible to have metastatic prostate cancer without a higher-than-normal PSA level.