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Prostate Cancer

Prostate cancer is a serious condition and the most common cancer in men in the United States. It affects millions, 1 in 9, and is the 2nd leading cause of cancer deaths. However, it is highly treatable in the early stages.

The prostate is a gland that assists with fertility and urine control. The prostate gland produces the fluid that transports and nourishes sperm.

What are the symptoms of prostate cancer?

In many cases men may not have any symptoms. When symptoms do occur; however, they are similar or the same as the symptoms of benign prostate hyperplasia (BPH). These include:

  • Trouble urinating – pain, burning or weak flow
  • Frequent urinating
  • Weight loss
  • Blood in Urine
  • Painful Ejaculation
  • Blood in semen
  • Pelvic area discomfort
  • Erectile Dysfunction
  • Bone pain

What are the causes and risk factors for prostate cancer?

The exact causes or how prostate cancer starts is not known. However, over time a large percentage of men will have some cancer cells in the prostate. There are known risk factors that include:

  • Age – it is rarely found in men under the age of 40
  • Ethnicity – black men are at a greater risk than other ethnicities
  • Genetic predisposition or family history – men in the family who have had prostate cancer or strong history of breast cancer (BRCA1 or BRCA2)
  • Diet and obesity
  • Environmental exposure
  • Smoking – prostate cancer risks double for heavy smokers and patients are more likely to die from it
  • Location – American men are more likely to die from prostate cancer than others

How do you screen for prostate cancer?

Early diagnosis of prostate cancer greatly improves the prognosis.

Men who have a family history of prostate cancer should begin screening at age 40. Otherwise screening can begin at age 55 up to age 69. Since black men are at a much higher risk for prostate cancer screenings are recommended at age 45. Men over 70 generally are not screened.

These are general guidelines. It is important that you work together with your doctor to determine when prostate cancer screening is right for you.

How is prostate cancer diagnosed?

  • PSA Blood Test
  • Physical exam
  • Prostate ultrasound
  • MRI of the prostate
  • Biopsy

Once prostate cancer is diagnosed the next step is to determine which stage you are in. Tests may include:

  • Bone scan uses a radioactive drug that allows visual observation of cell activity in the bones. It is often used to see if cancer is present.
  • Ultrasound is a diagnostic tool that uses high frequency sound waves to produce images in your body. It is commonly used to monitor pregnancy but is also a much used device for diagnosing diseases and tumors.
  • CT scan (computerized tomography) combines a series of X-ray images taken from different angles around your body to create cross-sectional images of bones, blood vessels and soft tissues. This is a much more detailed image than ordinary x-rays. It is often used to diagnose injuries and blood clots but is also effective at identifying tumors.
  • MRI (magnetic resonance imaging) scanners use strong magnetic fields and radio waves that create detailed images of the organs and tissues in the body.
  • PET (positron emission tomography) scan uses a radioactive drug that will allow visual observation of cell activity. This scan can often detect disease sooner than other tests.

What are the stages of prostate cancer?

Once the diagnosis is prostate cancer how aggressive the cancer is (grade of the cancer) and which stage of it is in are determined.

Grading:

A scale from 2-10 is used to score cancer with 2 being nonaggressive and 10 being very aggressive. This is called the Gleason score. The stages are:

  • 2-5 are generally not used
  • 6 is low-grade cancer
  • 7 is medium grade cancer
  • 8-10 is high grade cancers

Staging:

The stage of the cancer depends on whether the cancer cells have spread to other organs of your body and by how much.

The stages of cancer range from Stage I to Stage IV. Stage I is when the cancer has remained only in the prostate. Stage IV indicates the cancer has spread to other parts of the body.

What are the survival rates?

99% of men will survive for at least 5 years after diagnosis. Most prostate cancer is slow growing, and men will likely die of other causes prior to prostate cancer. 1 out of 3 men will survive after 5 years from being diagnosed.

What treatments are used for prostate cancer?

Many factors will determine what sort of treatment will be best. It depends on the patients age, medical history, overall health and at what stage the cancer is.

  • Active surveillance: Prostate cancer is slow growing and in the early stages with low-risk treatment may not be necessary or can be postponed. In this situation, the doctor will monitor cancer growth with regular blood tests, exam and biopsies.
  • Surgery to remove the prostate.
  • Radiation therapy
    • External beam radiation: radiation that comes from outside of your body and is directed at cancer cells. These typically will be done 5 days per week for a period of time determined by your physician.
    • Brachytherapy is radiation that is placed inside the body. Small radioactive seeds will be placed into the prostate tissue. This will deliver low doses of radiation over time and eventually stop emitting radiation.  Side effects of radiation therapy include painful urination, frequency or urgency and possible rectal symptoms and erectile dysfunction.
  • Hormone therapy (Androgen Deprivation Therapy – ADT) – the use of medications or drugs to lower testosterone and other male sex hormones.
  • Chemotherapy – the use of drugs to destroy cancer cells anywhere in the body. This is used in the more advanced stages of prostate cancer meaning it has spread to other parts of the body. Side effects of chemotherapy can be very unpleasant. They include fatigue, nausea, vomiting, hair loss, diarrhea, and sensory changes.
  • Immunotherapy – is the process of enhancing immunity and attacking the cancer cells. Most of these methods are still in clinical trials and are not commonly used.

What are the effects following treatment for prostate cancer?

  • Incontinence – both the cancer and its treatment can cause incontinence which is loss of control of the bladder and urinary leakage.
  • Erectile dysfunction can occur as a result from prostate cancer or treatment including surgery, radiation or hormone treatments.

Although these effects are life changing and can negatively impact quality of life, there are treatments available.

If you have concerns about prostate cancer, please schedule an appointment by calling us at 425.454.8968.

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