Prostate Cancer Questions and Answers (2)

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11. What tests are available for men who have prostate problems?

The results from these tests will help the doctor decide whether to check the patient further for signs of cancer:

A digital rectal examination (DRE) is the only direct and simple way to examine your prostate.
A PSA blood test will test the amount of prostate-specific antigen (PSA) in a sample of your blood.
Note: A newer test called AMACR is more sensitive for determining the presence of prostate cancer than the PSA test
In a prostate biopsy, your doctor will surgically remove a small piece of tissue using a needle.
CT (computerised axial tomography), MRI (magnetic resonance imaging) and bone scans

More details here: Prostate Cancer Diagnosis

13. How do doctors describe how far the cancer has spread?

There are two main ways urologists and oncologists grade prostate cancer: one, called the Gleason system, uses scores of 2 to 10. Another system (see below) uses G1 through G4. The higher the score, the higher the grade of the tumour. High-grade tumours grow more quickly and are more likely to spread than low-grade tumours. Doctors may also refer to the stages using Roman numerals I-IV or capital letters A-D.

Stage I or Stage A: The cancer is too small to be felt during a rectal exam and causes no symptoms. There is no evidence that the cancer has spread outside the prostate.
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. The person may be experiencing symptoms, such as problems with urination.
Stage IV or Stage D: The cancer has spread (metastised) to lymph nodes or to other parts of the body. There may be problems with urination, fatigue, and weight loss.

14. What are my treatment options for prostate cancer?

The choice of treatment mostly depends on the stage of the disease, advanced or early stage cancer, and the grade of the tumour. Treatments for prostate cancer may involve watchful waiting, surgery, radiotherapy, brachytherapy, chemotherapy, hormone therapy and others. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early.

Full details here (3 pages): Prostate Cancer Treatment

15. What are some of the side effects of these treatments?

Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently.

Impotence and leakage of urine from the bladder or stool from the rectum may occur in men treated with surgery. The risk of impotence (inability to get an erection) can be as high as 70%, while the risk of incontinence (inability to fully control leakage of urine) can range from 2% to as high as 30%.

Hormone therapy can cause hot flushes, loss of desire for sex and erections, sweating, mood swings, disturbed sleep, loss of energy and personal motivation, body hair loss, weight gain and breast development or tenderness, and weakened bones.

16. What is "watchful waiting" and why would I choose it as a treatment?

Sometimes, particularly for slow-growing tumours, no treatment, just active monitoring or "watchful waiting" is the best course of action. "Watchful waiting" means closely monitoring a patient’s condition without giving any treatment until symptoms appear or change.

It is popular with men over 70, sometimes with other medical problems, who.have been diagnosed with low grade or early-stage prostate cancers. If you're younger and only have a lowest grade cancer you may want to go this way, at least for a while, for life-style or family reasons. However, some experts say that even slow growing cancers may progress quickly and affect a man's health.

17. What types of surgery are available for men with prostate cancer?

Surgery is a common treatment for prostate cancer, but has unavoidable side-effects that might be distressing. It is most suitable for otherwise healthy men (usually, those under 70) whose cancer has not spread beyond the prostate. It involves four to five days in hospital and another four to six weeks recuperating at home.

More details here: Surgery options for prostate cancer

18. How is radiation used to treat prostate cancer?

Radiotherapy (Radiation therapy) is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells and shrink tumours.

Brachytherapy (radiation seed therapy) is a newer form of radiation treatment usually most suitable for men with a small, slow growing cancer, especially early prostate cancer. The procedure involves implanting radioactive seeds into, or next to, the tumour in your prostate.

More details here: Radiotherapy and Brachytherapy for prostate cancer

19. How is hormonal therapy used to treat prostate cancer?

Hormone therapy used alone can only control, not cure prostate cancer, but it may hold back its growth for several years. Essentially, it blocks the action of male sex hormones that help cancer grow. This can slow the growth and spread of prostate tumours but will not kill the cancer cells. It's usually employed when cancer has spread to other parts of the body

More details here: Hormone therapy to treat prostate cancer

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