Prostate Cancer Treatment

Again, it can’t be stressed enough, early detection is imperative in combating prostate cancer. The challenge is that in the early stages there are no symptoms of prostate cancer. By the time symptoms appear in the form of urinary complications, the cancer has spread beyond the prostate.

Treatment options vary depending upon several factors such as age, overall health of the patient and whether there is evidence of bladder infection or kidney damage resulting from an enlarged prostate.

Don’t Panic

Gleason Scores

The Gleason grading system assigns a grade to each of the two largest areas of prostate cancer in a tissue sample. Grades range from 1 to 5, with 1 being the least aggressive and 5 the most aggressive. Grade 3 tumors, for example, seldom have metastases, but metastases are common with grade 4 or grade 5.

The two grades are then added together to produce a Gleason score. A score of 2 to 4 is considered low grade; 5 through 7, intermediate grade; and 8 through 10, high grade. A tumor with a low Gleason score typically grows slowly enough that it may not pose a significant threat to the patient in his lifetime.

Once the grade is established, your physician will need to have additional information before determining a course of treatment. He will need to “stage” your tumor which is dependent upon the size and how far it has spread.

There are two systems used for “staging” the tumor. One of them is TNM and the other is ABCD Rating. They both evaluate the size of the tumor and the spread in reference to nearby lymph nodes and if the cancer has spread beyond those parameters.

The staging system determines whether the tumor is “Localized,” “Regional” or Metastatic. Within each of these categories are divided into categories that are more precise.

Pelvic Lymph Node Dissection

Considered to be the “final check” to determine if cancer has spread, this procedure can be completed through normal open surgery but more often is conducted using a fiber optic probe that is inserted through a small incision in your abdomen.

All of these diagnostic tests are tools to determine whether there is a possibility of cancer present in the prostate and if so, just how invasive it may be.

However, there is only one way certain method to determine the presence of cancer cells and that is by examining the tissue itself.

Based on the findings of the tests we have discussed, if a physician determines that there may be cancer cells he will recommend a biopsy. It is done by a urologist and the procedure is normally done right in his office. Here is where the ultrasound we discussed previously comes into play.

Using a transrectal ultrasound (TRUS), the doctor will image the prostate by using sound waves by inserting an instrument into your rectum. This allows the doctor to “image” the prostate. He will use biopsy needles that are hollow into any area of the prostate that looks or feels suspicious. Small bits of tissue are extracted through the needle. You may feel a stinging sensation.

CAT and other scans for Prostate Diagnosis

Computed Axial Tomography (CAT)

This is another test that could identify cancer in remote areas of the body. Without probable cause, like the Radionuclide Bone Scan above, it is probably unnecessary just as the

Magnetic Resonance Imaging (MRI)

This test may be unnecessary, especially if the prostate cancer is localized.

Radionuclide Bone Scan

A test that can be used if staging indicates that cancer has spread into the lymph nodes. If the tumor has spread to the lymph nodes, bone commonly follows. However, if PSA levels are under 10ng and there is no indication of bone pain, physicians find that the presence is so unlikely that this procedure is skipped.

Prostate Specific Antigen (PSA)

In the mid-1980s’ the FDA approved the use of monitoring blood levels for prostate specific antigen (PSA). At that time, this was considered a major breakthrough in the diagnosis and treatment for prostate cancer.

Here’s why. PSA readings specifically target prostate cells. A healthy prostate gland produces a constant level, usually 4 nanograms per milliliter which is considered as a PSA reading of “4” or less.
Cancer cells produce growing amounts that escalate. They correlate with the severity of cancer. A PSA level greater than 4 will give the doctor some cause for investigation. If the level reaches 10 he will have cause to consider the presence of prostate cancer. An amount over 50 may indicate that the cancer has spread to other parts of the body.

A PSA test usually measures the total amount that is attached to blood proteins. However, later research gained an FDA approval for a test called the Tandem R test. This test also gives a measure of the total PSA and reads another component called free PSA. Free PSA floats unbound in blood.

Have these two tests to compare helps to rule out prostate cancer in men whose PSA is just mildly elevated due to other causes. A 1995 study in the Journal of the American Medical Association shows that a free PSA test reduces unnecessary prostate biopsies by 20% in certain patients whose PSA is between 4 and 10.

Prostate Cancer Diagnosis

Prostate cancer can occur in any man, but there are certain “risk groups.” Younger African American men appear to have twice the risk and fatalities of Caucasians. Sadly, many are diagnosed before they reach the age of 50.

Another risk group is men who have a family history of prostate cancer, placing them in the same group who may contract the disease before the age of 50.

The only method to determine whether you are at risk for prostate cancer is diagnostic testing. The earlier you are screened the higher your chances of survival. Let’s explore some of the screening options.

Digital Rectal Exam (DRE)

Testing begins with a digital rectal exam (DRE). This examination has been the benchmark for discovering cancer as well as BPH. Your doctor can determine the condition and size of the prostate by inserting a gloved finger into the rectum.

Urine Test

A standard urine test can also help to diagnose prostate problems by screening for blood or infection. The chemical tests will also check for liver, diabetes or kidney disease.

Hyperplasia INTRAVENOUSPYELOGRAM (IVP)

This test is actually an X-ray. Dye is injected into one of the major veins. While the dye is circulating, pictures of vital organs are taken. This test will record the progress of the dye through the kidneys, bladder and ureter tubes (the tubes that drain the kidneys). This test is more or less optional since most men who have enlargement of the prostate usually have no abnormalities of the ureter tubes or kidneys in a normal urinalysis.

Symptoms of Prostate Cancer

Prostate cancer starts of by cells found in the prostate mutating and multiplying causing cancerous cells to develop in the prostate; the prostate is a gland that produces fluid to help carry semen during ejaculation in males.

Once the cancerous cells have taken control of the prostate they can find their way into other parts of the body, the most common places are parts of the bone structure and lymph nodes.

A person who has cancer would not know it unless they have had a prostate specific antigen test which is done by taking a blood sample or having a physical test, which is normally carried out by checking inside the rectum as the prostate sits against the rectums outer wall.

There are symptoms to watch out for that can be a sign of prostate cancer, although they can also be signs of other, less dangerous conditions. The symptoms you need to be aware of are

    • Pain while urinating
    • Difficulty urinating

Prostate Health

The first step toward understanding how the prostate affects your health is to learn what the prostate is and how it functions. It is surprising how little many men know about such an important part of their anatomy.

The prostate is an important segment of the male reproductive system. It is a gland that is located in the lower abdominal cavity, just below the bladder, in front of the rectum and behind the pubic bone. It partially surrounds the urethra. The urethra is the channel that carries urine to the penis from the bladder and it runs right through the prostate.

A healthy prostate is about the size of a walnut, weighs approximately 1 ounce and is shaped similar to a donut.

There are “seminal vesicles” that are attached to the prostate. They produce a protein that mixes with prostatic fluid which forms semen. How this works is that tubes from the testicles carry sperm up to the prostate where sperm is mixed with the seminal vesicle and prostatic fluids.

This fluid is ejaculated during orgasm through ejaculatory ducts that connect to the urethra. In addition, the prostate helps to control the flow of urine.