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EXPLORE THE OPTIONS BEFORE CHOOSING THERAPY
Cancer of the prostate is a health concern for both middle-aged and older men. However, many men do not seek a diagnosis because they fear the treatment, or what they perceive to be the treatment, as much as the disease itself.
If the treatment does not appear threatening, the side effects from the therapy may. For years, men have heard about "prostate surgery," castration, and use of hormones for treating prostate cancer. With the variety of treatments available for different stages of the disease, many men are confused about which therapies they might receive.
The confusion can be minimized if the patient has some basic knowledge. Once a man understands the various available therapies, he can discuss them with his doctor and participate in the choice of treatment.
WHAT IS THE PROSTATE?
WHAT IS CANCER?
Cancer is a disease of the body's cells. Normal cells reproduce themselves by dividing in an orderly fashion to replace worn - out or damaged tissue. Cancer is characterized by uncontrolled growth and spread of abnormal cells. These cells grow into a tissue mass known as a tumor. Some tumors are benign, or noncancerous, and others are malignant, or cancerous.
Benign tumors may interfere with body functions, but they do not invade other tissues, and generally are not life - threatening. On the other hand, malignant tumors will spread, or metastasize, to other parts of the body. Sometimes cancer grows and spreads rapidly, and sometimes the process is slow.
WHAT IS PROSTATE CANCER?
Prostate cancer is a slow-growing malignant tumor that starts in the prostate gland. The tumor can be present but not noticed for years. Often, it is first diagnosed when a man seeks medical attention for painful or frequent urination or aches and pains in the bones or joints.
A disease of older men, this form of cancer is rare in men under age 55. The rate of occurrence increases with each decade of life.Prostate cancer is more prevalent in blacks than whites, and more married men than singles develop it.The cause of prostate cancer is unknown.About 191,930 cases are diagnosed each year, according to estimates by the American Cancer Society
WHAT ARE THE SYMPTOMS OF PROSTATE CANCER?
When the prostate enlarges, It can squeeze the urethra and Interfere with urination.A man with an enlarged prostate may experience pain or burning during urination.Frequency or urgency may be the first symptoms he notices.His urinary stream may be weak, or he may encounter difficulty in starting the stream.Blood or pus may colour the urine.In rare cases, a man may actually experience an inability to urinate.
Mild or pronounced pain in the pelvis, back, or ribs can be a warning signal.The pain results from the spread of the cancer cells to other parts of the body.
Prostate cancer tends to grow and spread slowly, so symptoms may not become apparent for years.
Some of the symptoms of prostate cancer can also be symptoms of other nonmalignant conditions.Benign prostatic hypertrophy (BPH) and prostatitis are common examples of other conditions caused by an enlargement of the prostate.Each of these conditions can cause urinary difficulties or other symptoms associated with prostate cancer.Any of these symptoms should be evaluated by a physician.
HOW IS PROSTATE CANCER DIAGNOSED?
HOW IS PROSTATE CANCER TREATED?
Treatments vary, depending on the stage when the tumor is discovered and the patient's age and medical history. Before beginning treatment, it is wise to seek a second opinion on the diagnosis and recommendation for therapy. Several treatment options are available, including radiation, surgery, hormonal manipulation, and other therapies when the tumor no longer responds to the first three.
A tumor that is discovered early will be treated differently than one that has already metastasized.A tumor found and treated in the early stages can be cured.However, if a man's age or medical condition requires a conservative approach, observation - with no immediate treatment - may be the best option.
Radiation therapy offers one alternative.The tumor can be irradiated from outside the body, or radioactive materials can be placed in or near the tumor.Unfortunately, radiation therapy causes some men to become incontinent (lose control of their urine) or sexually impotent.
A prostatectomy, surgical removal of the prostate, is another treatment for prostate cancer that has been detected early.Two different procedures now exist.
In a complete or radical prostatectomy, the entire prostate is removed through a surgical incision into the abdomen, or perineum, and the urethra is reconnected to the bladder.With a radical prostatectomy, some patients become incontinent and / or impotent.A new surgical procedure can reduce the risk of impotence and Incontinence, but this operation may not be performed by all surgeons.
A transurethral resection prostatectomy (TURP) allows the doctor to remove part of the prostate gland through a tube inserted in the urethra.
If a tumor is discovered later in its development, the treatment choices are different.Scientists have linked the growth of prostate cancer cells to testosterone, a male hormone produced primarily by the testicles.If the amount of testosterone produced can be reduced, the prostate cancer cells will not be nourished.
For years, doctors have advocated surgical removal of the testes (Orchiectomy or Castration) to remove the primary source of testosterone production Orchiectomy causes impotence, and many men equate their masculinity with intact genitals.For this reason, the possible psychological effects should be considered before opting for Orchiectomy.
ARE THERE ALTERNATIVES TO SURGERY?
Another treatment option involves the use of estrogens, or female hormones.Administration of female hormones reduces a man's testosterone to castrate levels, producing the same results as an Orchiectomy.
The most common form of estrogen used is diethylstilbestrol (DES), a synthesized hormone.Estrogens at varying dosages, can lead to serious cardiovascular (heart and blood vessel) abnormalities.Female hormones can also cause pain and enlargement of the male breasts and impotence.
Recently, another alternative has become available for men with advanced prostate cancer Luteinizing hormone - releasing hormone (LH-RH) analogs, synthetic adaptations of a naturally occurring hormone, can be used.Like female hormones, with continued use, the LH - RH analogs cause the body to "down - regulate" its production of sex hormones.Simply stated,after an initial rise, a man's testosterone level decreases to castrate levels.
By depriving the body of testosterone, an LH - RH analog has the same effect as surgical castration or estrogen therapy.The difference is, a man choosing LH - RH analog therapy need not undergo the psychological and / or physical trauma of castration or be concerned with the serious cardiovascular or feminizing side effects of estrogen therapy.
Treatment with an LH - RH analog can cause hot flashes as well as impotence.During the first few weeks of therapy.symptoms may increase temporarily because of the way the drug works.This form of therapy is administered by injection,
Currently, only one LH - RH analog is commercially available.Leuprolide acetate has been approved by the Food and Drug Administration for treatment of prostate cancer in its later stages Leuprolide acetate offers a safe alternative to surgery or estrogen therapy.
WHAT CAN A MAN DO?
All men over age 40 should have regular medical checkups, including an annual rectal examination and seek immediate medical advice if experiencing any of the symptoms of prostate cancer.
Prostate cancer can be treated.The individual should take an active role in his treatment, asking his doctor about treatment alternatives, learning about his condition, and seeking a second opinion before undergoing surgery or other therapies.The quality of life must be considered when evaluating possible therapies.
A man should explore and understand all of the treatment options available to him at his stage in the disease process.Each therapy has pros and cons.Any treatment should be based on a decision made by both the man and his doctor.
The chances of surviving this form of cancer are better today than ever before, and the quality of life for those who have it has been dramatically Improved.The key to fighting prostate cancer is to detect and treat the condition in its early curable stages, before it spreads.A man can protect his health by learning the warning signs of prostate cancer and having regular checkups.
DIAGNOSIS OF PROSTATE CANCER
Biopsy | MRI Fusion Biopsy | PCA3 test
Transrectal Ultrasound | Bone Scan | PETCT