Prostate Talk » Prostate Cancer

Prostate Cancer – Staging Prostate Cancer

admin — Fri, 17 Jul 2009 15:57:01 +0000

If cancer is found in the prostate, the doctor needs to know the stage of the disease and the grade of the tumor. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The grade tells how closely the tumor resembles normal tissue in appearance under the microscope.

Doctors use various blood and imaging tests to learn the stage of the disease. Imaging tests, such as ultrasound and magnetic resonance imaging, or MRI, produce pictures of images inside the body.

There are four stages used to describe prostate cancer. Doctors may refer to the stages using the Roman numerals I-IV or the capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.

Stage I or Stage A — The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA.

Stage II or Stage B — The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.

Stage III or Stage C — The cancer has spread outside the prostate to nearby tissues. A man may be experiencing symptoms, such as problems with urination.

Stage IV or Stage D — The cancer has spread to lymph nodes or to other parts of the body. The bones are a common site of spread of prostate cancer. There may be problems with urination, fatigue, and weight loss.

Source: http://nihseniorhealth.gov/prostatecancer/stagingprostatecancer/08.html

Prostate Cancer – Planning Treatment

admin — Fri, 17 Jul 2009 15:42:54 +0000

A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient’s progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others.

Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it.

Some prostate cancer patients take part in studies of new treatments. These studies — called clinical trials — are designed to find out whether a new treatment is safe and effective.

Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor.

Source: http://nihseniorhealth.gov/prostatecancer/planningtreatment/02.html

Prostate Cancer Symptoms and Diagnosis

admin — Tue, 07 Jul 2009 16:57:04 +0000

Most cancers in their early, most treatable stages don’t cause any symptoms. Early prostate cancer usually does not cause symptoms.

However, if prostate cancer develops and is not treated, it can cause these symptoms:

a need to urinate frequently, especially at night
difficulty starting urination or holding back urine

Possible symptoms of prostate cancer:

inability to urinate
weak or interrupted flow of urine
painful or burning urination

difficulty in having an erection
painful ejaculation
blood in urine or semen
pain or stiffness in the lower back, hips, or upper thighs.

Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If you have any of these symptoms, see your doctor or a urologist right away to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system.

The doctor will ask questions about your medical history and perform a digital rectal exam to try to find the cause of the prostate problems. In this exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean cancer is present.

The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present.

Neither of these screening tests for prostate cancer is perfect. Screening tests check for disease in a person who shows no symptoms. Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers.

The doctor may order other exams, including ultrasound and x-rays, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope.

If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope.

One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors.

Source: http://nihseniorhealth.gov/prostatecancer/symptomsanddiagnosis/

Prostate Cancer Causes and Risk Factors

admin — Tue, 07 Jul 2009 16:53:52 +0000

Scientists don’t know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease.

Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65.

Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men.

A man’s risk for developing prostate cancer is higher if his father or brother has had the disease.

Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

Scientists have wondered whether an enlarged prostate, a condition also known as benign prostatic hyperplasia or BPH, might increase the risk for prostate cancer. They have also studied obesity, lack of exercise, smoking, radiation exposure, and a sexually transmitted virus to see if they might increase risk. But at this time, there is little evidence that any of these factors contribute to an increased risk.

Source: http://nihseniorhealth.gov/prostatecancer/causesandriskfactors/

Prostate Cancer Defined

admin — Thu, 18 Jun 2009 20:07:08 +0000

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong — cells become abnormal and form more cells in an uncontrolled way.

These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Prostate cancer occurs when a malignant tumor forms in the tissue of the prostate, a gland in the male reproductive system. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive.

The prostate is about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate’s main function is to make fluid for semen, a white substance that carries sperm.

Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 60 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age.

Source: http://nihseniorhealth.gov/prostatecancer/

How does a patient decide what the best treatment option is for localized prostate cancer?

megdilts — Wed, 13 May 2009 19:10:01 +0000

Choosing a treatment option involves the patient, his family, and one or more doctors. They will need to consider the grade and stage of the cancer, the man’s age and health, and his values and feelings about the potential benefits and harms of each treatment option. Since both surgery and radiation therapy are options for localized disease, consultation with both a urologist and a radiation oncologist is recommended. Often it is useful to seek additional opinions—from the same type of doctor, an internist, a family practice physician, or a medical oncologist. Because there are several reasonable options for most patients, patients may hear different opinions and recommendations and the decision can be difficult. However, patients should try to get as much information as possible and allow themselves enough time to make a decision. There is rarely a need to make a decision without taking time to discuss and understand the pros and cons of the various approaches.

Source: the National Cancer Institute

How is localized prostate cancer treated?

megdilts — Tue, 12 May 2009 16:27:52 +0000

Three treatment options are generally accepted for men with localized prostate cancer: Radical prostatectomy, radiation therapy (with or without hormonal therapy), and active surveillance (also called watchful waiting).

* Radical prostatectomy is a surgical procedure to remove the entire prostate gland and nearby tissues. Sometimes lymph nodes in the pelvic area (the lower part of the abdomen, located between the hip bones) are also removed. Radical prostatectomy may be performed using a technique called nerve-sparing surgery that may prevent damage to the nerves needed for an erection. However, nerve-sparing surgery is not always possible.

* Radiation therapy involves the delivery of radiation to the prostate. Radiation therapy is usually administered in an outpatient setting using an external beam of radiation. Radiation can also be delivered in a technique known as brachytherapy, which involves implanting radioactive seeds directly into, or very close to, the tumor using a needle. Patients with high-risk prostate cancer are candidates for adding hormonal therapy to standard radiation therapy.

* Active Surveillance (watchful waiting) may be an option recommended for patients with early-stage prostate cancer, particularly those who have low-grade tumors with only a small amount of cancer seen in the biopsy specimen. These patients have regular examinations, PSA tests, and, sometimes, scheduled biopsies. If there is evidence of cancer growth, active treatment may be recommended. Older patients and those with serious medical problems may also be good candidates for active surveillance.

Source: the National Cancer Institute

How is prostate cancer diagnosed?

megdilts — Sun, 10 May 2009 22:40:48 +0000

A diagnosis of prostate cancer can be confirmed only by biopsy. During a biopsy, a urologist (a doctor who specializes in diseases of urinary and sex organs in men, and urinary organs in women) removes tissue samples, usually with a needle. This is generally done in the doctor’s office with local anesthesia. Then, a pathologist (a doctor who identifies diseases by studying tissues under a microscope) checks for cancer cells.

Men may have blood tests to see if the cancer has spread. Some men also may need the following imaging tests:

* Bone scan: A doctor injects a small amount of a radioactive substance into a blood vessel, and it travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones on a computer screen or on film. The pictures may show cancer that has spread to the bones.

* Computerized tomography (CT) scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside the body. Doctors often use CT scans to see the pelvis or abdomen.

* Magnetic resonance imaging (MRI): A strong magnet linked to a computer is used to make detailed pictures of areas inside the body.

Prostate cancer is described by both grade and stage.

* Grade describes how closely the tumor resembles normal glandular tissue of the prostate. Based on the microscopic appearance of the tumor tissue, pathologists may describe it as low-, medium-, or high-grade cancer. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. In both systems, the higher the score, the higher the grade of the tumor. High-grade tumors generally grow more quickly and are more likely to spread than low-grade tumors.

* Stage refers to the extent of the cancer. Early prostate cancer, stages I and II, is localized. It has not spread outside the prostate gland. Stage III prostate cancer, often called locally advanced disease, extends outside the gland and may be in the seminal vesicles. Stage IV means the cancer has spread beyond the seminal vesicles to lymph nodes and/or to other tissues or organs.

Source: the National Cancer Institute

Does prostate cancer screening save lives?

megdilts — Sun, 10 May 2009 22:39:42 +0000

The benefits of screening and local therapy (surgery or radiation therapy) for early prostate cancer remain unclear, and it is not known for certain whether prostate cancer screening saves lives. Because of this uncertainty, NCI, which is part of the National Institutes of Health, is supporting research to learn more about screening for prostate cancer. Currently, researchers are conducting a large randomized clinical trial, called the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, to determine whether screening with PSA tests and DREs reduces the death rate from this disease. The researchers are also assessing the risks of screening. Specifically, men who have an elevated PSA level or a suspicious DRE are more likely to have a biopsy, which is an invasive procedure, and, if the biopsy is positive, the risks of surgery, radiation therapy, and even active surveillance (also called watchful waiting) must be taken into account.

Source: the National Cancer Institute

How reliable are the screening tests for prostate cancer?

megdilts — Sat, 09 May 2009 22:51:51 +0000

Neither of the screening tests for prostate cancer is perfect. Most men with an elevated PSA level do not have prostate cancer (false positives), and some men with prostate cancer have a low PSA level (false negatives). The DRE is also associated with false positives and false negatives. Using the DRE and PSA together will miss fewer cancers (greater sensitivity) but also increases the number of false positives and subsequent biopsies in men without cancer (lower specificity).

The National Cancer Institute’s (NCI) Early Detection Research Network (EDRN) has a Prostate Collaborative Group that is exploring a variety of strategies to find better ways to detect prostate cancer early. In addition, NCI’s prostate cancer Specialized Program of Research Excellence (SPORE) is funding projects to identify new diagnostic and prognostic biological markers, or biomarkers, of prostate cancer besides PSA.

Source: the National Cancer Institute