What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life,;making healthy choices and feeling as good as you can.
What Are Risk Factors And Symptoms Of Prostate Cancer
There is no specific cause of prostate cancer that we know of, however, researchers have identified some major risk factors:
- Age a mans chance of getting prostate cancer increases after age 50. About two-thirds of prostate cancer is diagnosed in men age 65 and older, with the average age of diagnosis at 66. It is rare in men under 40.
- Race prostate cancer is more common among Black men. It also occurs less often in Asian-Americans and Latino men than non-Hispanic whites.
- Family history men with immediate family members who have had prostate cancer are more likely to get it themselves, especially if the relatives were young at the time of diagnosis.
There is no clear evidence indicating diet, obesity, smoking, sexually transmitted disease or inflammation of the prostate are risk factors for prostate cancer.
Prostate cancer has no symptoms until it is in the advanced stages. At that point, men may find it difficult to urinate, have blood in their urine or have pain in their bones, secondary to the spread of prostate cancer.
Inherited Risk Of Prostate Cancer
Over past decades, scientists have learned that some prostate cancer that runs in families is hereditary. In these cases, mutations in genes that raise the risk of prostate cancer occur in every cell of the body and are passed on from either a mother or father to a child, said Elias Obeid, MD, MPH, medical oncologist and director of the Prostate Risk Assessment Program at Fox Chase Cancer Center.
These inherited alterations in genes may be responsible for up to 10 percent of all prostate cancers, according to the American Cancer Society, and often occur in genes that repair damage to DNA, including BRCA1 and BRCA2 genes. ;
Mutations in these two genes are best known for causing breast and ovarian cancer in women. But they also raise prostate cancer risk in men who inherit them, especially faulty BRCA2 genes, which are tied to aggressive prostate cancer, Obeid said.
Other genes that can cause prostate cancer through mutations include those related to DNA repair, such as CHEK2 and ATM; HOXB13, which is related to the development of the prostate gland; and the genes tied to a disease called Lynch syndrome.
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Dr Michael Mosley: Lessons Every Man Should Learn From My Dads Prostate Cancer Diagnosis
Over the course of a week I read a lot of scientific articles and one of the things I always keep a keen eye out for is anything on prostate cancer.
It is the most common cancer in British men and over the last decade, while deaths from other common cancers such as bowel and breast have fallen, deaths from prostate cancer have risen.
I have a particular interest in prostate cancer because my dad was diagnosed with it when he was in his 60s .
I am acutely aware of the fact that because dad had prostate cancer, my chances of getting it are around two-and-a-half times higher than if he hadnt.
So you might think that I am very pro screening for prostate cancer but if my dads experience taught me anything, its that this particular issue is far more complex than you might think.
It is the most common cancer in British men and over the last decade, while deaths from other common cancers such as bowel and breast have fallen, deaths from prostate cancer have risen;
The prostate is a gland, about the size of a walnut, which surrounds the urethra the tube which you pee through. Unfortunately it grows from our 50s onwards and men often experience symptoms caused by the prostate compressing the urethra such as waking up frequently during the night and finding it hard to start urinating.
Although these can also be symptoms of prostate cancer, they are normally the result of an enlarged prostate.
Which brings us back to screening.
What Recent Research Tells Us About Prostate Cancer Screening
Depending on how often screening is done, it may help reduce the chances of dying of prostate cancer, but the research indicates that the vast majority of men with prostate cancer die of a different cause, even if they are not treated.
Two major research studies have tried to shed light on the value of regular screening: the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and the European Randomized Trial of Screening for Prostate Cancer .8 The PLCO studied 76,000 men, aged 55-74, for 7-10 years and found that the death rate from prostate cancer was low, and that it did not differ between the men who were screened every year for the first six years of the study and those who received their usual care .9 For most of the patients, usual care included at least one screening during the first seven years of the study. There were also no significant differences in overall death rates between the groups. Although the randomized portion of the study was completed in 2006, researchers are still studying the patients to see how long they live.10
Recent updates to a 2010 meta-analysis of six randomized, controlled prostate cancer screening trials further support the U.S. Preventive Services Task Force recommendations. Analysis of data on almost 330,000 men showed no significant difference in the risk of death from prostate cancer between the men who received PSA screenings and those who did not.13
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In 9 Men Will Be Diagnosed With Prostate Cancer In Their Lifetime
Benign prostatic hyperplasia
Each year, approximately 175,000 men are diagnosed with prostate cancer in the United States. 1 in 9 men will get diagnosed with prostate cancer during their lifetime. However, only 1 in 41 of these men will die as a result of it, due to the advances in early diagnosis and treatment . In the early stages, when it is most treatable, prostate cancer causes no symptoms. This is why the American Urological Association recommends screening of all men between 55 and 69 years old with a PSA every 1 to 2 years. For men at higher risk , screening can start even sooner . Prostate cancer that is more advanced can cause the following symptoms: trouble urinating, decreased force of urinary stream, painful urination, blood in the urine or semen, erectile dysfunction, pain in the pelvic area, or bone pain. Talk to your primary care provider or your Urologist and get screened for prostate cancer.;
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What Puts You At Increased Risk
Other factors that may increase your risk of developing prostate cancer include:
Age. Your risk of prostate cancer increases as you age. Its most common after age 50, with about six in 10 cases found in men older than age 65.
Race. African-American men are ata greater risk of prostate cancer than men of other races. As well, it affects African-American men at a younger age and is often more aggressive.
Family history. If you have a blood relative with prostate cancer, your risk increases. There are also other cancers that may be genetically related, and you may have an increased risk if you have a family history of breast or pancreatic cancer.
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Are Older Men Undertreated
Schwartz and colleagues reviewed the treatment decisions and factors influencing them in a cohort of men with localized prostate cancer. Age, comorbidity, and Gleason score were found to be independent predictors of suboptimal treatment. It was concluded that most men older than 70 years with moderately or poorly differentiated tumors and no to mild comorbidity were given suboptimal treatment. Most of these men were undertreated, receiving watchful waiting therapy when potentially curative therapy could have been applied. With optimal treatment, clinical outcomes could have been improved.
Thompson and colleagues investigated otherwise healthy octogenarians diagnosed with prostate cancer who underwent radical prostatectomy. At the last follow-up visit, 10 patients had survived more than a decade after surgery, and 3 patients had died within 10 years of surgery. The remaining 6 patients were alive at less than 10 years of follow-up. Seventy-four percent of patients were continent. No patient had died of prostate cancer, and the 10-year, all-cause survival rate was similar to that observed in healthy patients 60 to 79 years old undergoing radical prostatectomy. These findings indicate that careful selection of patients even older than 80 years can achieve satisfactory oncologic and functional outcomes after surgery. It is important to note, however, that the rate of urinary incontinence after surgery exceeds that of younger counterparts.
Should I Get Screened
Diagnostic tests for prostate cancer are recommended for any man who has symptoms of prostate cancer, such as pain or changes in urination. Men over the age of 50 who have no symptoms sometimes undergo screening tests. In May 2012, the U.S. Preventive Services Task Force recommended against prostate-specific antigen screening tests for men of any age.3 However, in May 2018, the Task Force revised their recommendation, stating that men ages 55-69 years old should talk to their doctor about the potential benefits and harms of PSA screening. The USPSTF continues to recommend against PSA screening in men ages 70 and older.4
What about other methods of screening, like digital rectal exams, which are usually done together with PSA testing? The Task Force continues to conclude that they tend to do more harm than good.
The U.S. Preventive Services Task Force is an independent group of medical professionals that reviews all evidence on preventive health care services. It adopted its current position after expressing doubts about the value of prostate cancer screening for several years. In 2008, the Task Force said screening was not recommended for men over 75, but wasnt sure about its value for men younger than 75.5 In 2009, the American Urological Association issued new guidelines saying that annual screening was no longer recommended.6
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What Are The Treatment Options For Prostate Cancer
Prostate cancer is a slow-growing tumor, and not all prostate cancers need to be treated. Non-treatment options may include observation and active surveillance. Observation is a way of monitoring prostate cancer without treating it, and usually doesnt involve regular biopsies or frequent testing. Active surveillance is tracking the prostate cancers status through routine PSA tests, DREs, biopsies and imaging, where action is taken only if the cancer changes or grows.
However, depending on the stage and grade of the disease, there are multiple treatment options for cancer that is clinically localized to the prostate and has not spread outside the prostate. Some treatment options are:
- Radical prostatectomy removal of the prostate. This procedure may be performed in a minimally invasive way, such as laparoscopically, using a robot or through a traditional, larger incision.
- Radiation therapies external beam, which is radiation focused on the prostate from outside the body, or brachytherapy, where radioactive seeds are placed in the prostate through the skin.
- Cryotherapy the prostate is frozen and rapidly thawed, using needles placed through the skin.
How Can You Tell If You Have Prostate Cancer
Unfortunately, you often cannot tell if you have prostate cancer. In most men, prostate cancer does not cause any symptoms until it is advanced and incurable. Furthermore, these symptoms are often caused by benign enlargement of the prostate rather than prostate cancer. The best way to detect prostate cancer early is through regular screening with the PSA blood test and a prostate examination by a physician.
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Impact Of Age On Treatment
The rising number of men diagnosed with prostate cancer is a result of increasing life expectancy as well as the current practice of screening by prostate-specific antigen blood tests. Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making. Although organ-confined disease can be cured by radical prostatectomy and full-dose local radiation therapy, treatment options for advanced- stage disease remain palliative. They include active surveillance, or watchful waiting, early versus delayed hormonal therapy to control disease progression, and continuous or intermittent androgen deprivation. Observational studies of older men with early stage disease have suggested conservative management as a viable option.,
Chodak and associates evaluated 828 men who were managed expectantly in a series of nonrandomized trials. Median follow-up was approximately 6.5 years. Patients with poorly differentiated cancers had a 10-fold increased risk of death from prostate cancer as compared with men showing highly differentiated prostate cancer. A 5-year disease-specific survival of only 34% was found in men with poorly differentiated prostate cancer. In contrast a 5-year disease-specific survival of 87% was described in men with well-or moderately differentiated cancers.
What Causes Prostate Cancer
Experts arent sure why some cells in the prostate gland become cancerous . Genetics appear to play a role. For example:
- Youre two to three times more likely to get prostate cancer if your father, brother or son has the disease.
- Inherited mutated breast cancer genes and other gene mutations contribute to a small number of prostate cancers.
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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.
Tests Used To Check The Prostate
This first step lets your doctor hear and understand the story of your prostate concerns. Youll be asked whether you have symptoms, how long youve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
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Four Key Mistakes To Avoid If You Are Diagnosed With Low
Here are key mistakes Dr. Hu has identified
- Mistake: Automatically opting for treatment when you have low-risk prostate cancer.;Even though treatment for low-risk prostate cancer is generally;not;recommended, in the recent study, more than 85% of the men with low-risk prostate cancer chose to have some sort of treatment. The most common treatment was radiation therapy , and the second most common was surgery . Just 15% opted to skip treatment. The good news is that, as the study went on, there was a trend toward a greater percentage of men opting for active surveillancea trend that has accelerated according to recent surveys. However, Dr. Hu thinks too many men are;still;missing out on this proven approach.
- Mistake: Choosing active surveillancebut not doing follow-up tests.;According to the results of this study,;fewer than 5%;of the men who skipped treatment complied with recommended monitoring. They had fewer office visits, and fewer repeat PSA tests, compared with men who had some form of active treatmentand only 13% underwent a second biopsy within two years, as recommended.
If abnormalities are detected on the digital rectal examination or PSA test, patients should undergo urologic evaluation with transrectal ultrasound-guided prostate biopsy. No further urologic evaluation is necessary in patients who have an unremarkable digital rectal examination and a normal serum PSA level, because the incidence of prostate cancer is only 0.4 percent in this group.15
Family History And Genetics
Your family history is information about any health problems that have affected your family. Families have many common factors, such as their genes, environment and lifestyle. Together, these factors can help suggest if you are more likely to get some health conditions.
Inside every cell in our body is a set of instructions called genes. These are passed down from our parents. Genes control how the body grows, works and what it looks like. If something goes wrong with one or more genes , it can sometimes cause cancer.
Is prostate cancer hereditary?
If people in your family have prostate cancer or breast cancer, it might increase your own risk of getting prostate cancer. This is because you may have inherited the same faulty genes.
My father had prostate cancer. What are my risks?
- You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer.
- Your chance of getting prostate cancer may be even greater if your father or brother was under 60 when he was diagnosed, or if you have more than one close relative with prostate cancer.
- Your risk of getting prostate cancer may also be higher if your mother or sister has had breast cancer.
Do you have a family history of prostate cancer?
If you’re over 45 and your father or brother has had prostate cancer, you may want to talk to your GP. Our;Specialist Nurses;can also help you understand your hereditary risk of prostate cancer.
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