About one in six men will be diagnosed with prostate cancer during his lifetime, but only one in 32 will die of this disease.
Fortunately, for many men diagnosed with this very common and usually slow-growing form of cancer, the news is encouraging. It is often responsive to treatment, especially if the cancer is caught at an early stage. In addition, the effects of treatment are usually manageable.
| What is the prostate? | What is prostate cancer? | How common is prostate cancer? | What causes prostate cancer? | What are common symptoms of prostate cancer? | How is prostate cancer detected? | What are the stages of prostate cancer? | What are the treatment options for prostate cancer? | Who treats prostate cancer? | How do I cope with prostate cancer? | What Rising PSA Means |
The prostate is a gland of the male reproductive system. It produces fluid for semen, which transports sperm during the male orgasm.
Normally, the prostate is quite small — it is nearly the same size and shape as a chestnut.
It is located in front of the rectum, just below the bladder, and wraps around the urethra, the tube that carries urine from the bladder out through the tip of the penis.
The prostate is made up of approximately 30% muscular tissue, and the rest is glandular tissue.
Prostate cancer is a malignant tumor that begins growing in the prostate gland. Early prostate cancer usually does not cause any symptoms.
As the tumor grows, it may spread from one part of the prostate to surrounding areas.
Patients may experience a change in urination, including increased frequency, hesitancy or dribbling of urine.
Prostate cancer can spread from the prostate to nearby lymph nodes, bones or other organs. This spread is called metastasis.
For example, as a result of metastasis to the spine, some men experience back pain.
It is the second leading cause of cancer death in men.
More than 70% of all prostate cancers are diagnosed in men over age 65. Men with family history (first-degree relatives, i.e., father, brother) have shown up to an 11-fold increase in the risk of developing prostate cancer.
The death rate for prostate cancer is more than 2 times higher in African-American men than in Caucasian men.
Because of additional risk, earlier screening for prostate cancer is recommended for men at high risk.
Prostate cancer is the most common type of cancer, men aged 50 and older, and those over the age of 45 who are in high-risk groups, such as African-American men and men with a family history of prostate cancer, should have a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) once every year.
No single cause of prostate cancer has been identified. There are likely a variety of causes and contributing factors that lead to prostate cancer. The major known risk factors for prostate cancer are age, race and family history.
Although there are no conclusive data, diet and other environmental factors may play a role as well.
Age is the single most important factor in the development of prostate cancer. It is extremely rare for a man under the age of 40 to develop detectable prostate cancer.
However, early growth of precancerous or cancerous cells in the prostate may actually begin before that time. Detectable prostate cancer takes time to develop. The chance of having prostate cancer increases rapidly after age 50. In fact, about 80% of all prostate cancers are diagnosed in men over the age of 65.
A man in his mid-to-late seventies is 130 times more likely to develop prostate cancer than a man in his mid-to-late forties. It is still unclear why prostate cancer rates increase with age; however, the genetic mutations that have been linked to development of cancer occur gradually over time.
A wide variation in incidence has been reported among different races and ethnic groups. While Caucasian-Americans comprise the largest group of men that develop prostate cancer in raw numbers, more African-American men develop prostate cancer than Caucasian-American men.
In fact, African-American men are 65% more likely to develop prostate cancer than Caucasian-American men. Moreover, African-American men appear to get more severe forms of prostate cancer and are more than twice as likely to die from it as Caucasian-American men.
The reasons for this are unknown. However, diet, genetics and, possibly, inadequate exposure to vitamin D may all play a role.
Asian men living in Asia have the lowest incidence; however, their prostate cancer risk appears to rise, the longer they live in Western culture.
Prostate cancer is most common in North America and northwestern Europe. It is less common in Asia, Central America and South America. While genetics may play a role, diet is suspected to be a major factor in these racial differences. Because of additional risk, earlier screening for prostate cancer is recommended for African-American men.
Approximately 25% of men with prostate cancer have a history of the disease within their family. However, it is believed that only 9% of all prostate cancers are purely hereditary.
The picture may be more complex for those patients with a family history since family members typically share other risk factors, including race, diet and other environmental factors. The risk of prostate cancer doubles among men having a first-degree relative with the disease.
With two close relatives, a man's risk increases fivefold, and with three or more close relatives, the risk for developing prostate cancer is alarmingly high – close to 100%.
Men aged 50 and older, and those over the age of 45 who are in high-risk groups, such as African-American men and men with a family history of prostate cancer, should have a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) once every year.
Diet, Obesity & Nutrition
Diet and weight may play a role in the development of prostate cancer.
High intake of animal fats, such as those found in red meat, and polyunsaturated fats (corn oil, safflower oil, margarine, etc.) may be associated with higher rates of prostate cancer; however, it is unclear exactly how dietary fat might relate to increased risk.
It is unclear whether animal fats themselves cause the problems or if it is the way red meat is often cooked. Scientists have shown that charred meats (as in barbecuing) can create potent cancer-promoting chemicals.
Additionally, men with a high dietary fat intake may be less likely to eat fruits and vegetables, and it is unclear whether high fat or low fruit and vegetable intake (or a combination of both) is responsible for increasing risk.
Recent studies have shown that men who are overweight or obese are at significantly higher risk for developing prostate cancer. Moreover, early weight gain in life is negatively correlated with survival for men who go on to develop prostate cancer.
In other words, a man who develops prostate cancer at age 55 who became overweight at age 25 and stayed overweight is likely to have a more aggressive form of prostate cancer and shorter survival than a man who develops prostate cancer at age 55 who has not been overweight.
Nutrition may play an important role in the prevention of prostate cancer.
Fruits and vegetables, especially cooked tomatoes, contain key sources of cancer-fighting agents, such as lycopene, antioxidants and fiber (Prostate Cancer Nutrition).
Researchers are investigating how a low-fat diet high in soy protein and fiber may reduce the risk of prostate cancer.
Vitamin D & Sunlight
Vitamin D is known to protect the body against cancer.
While vitamin D is contained in milk and some fish, the main source is from the skin, which forms vitamin D when it is exposed to sunlight.
Studies have shown that people living in regions that get less sunlight have higher rates of prostate cancer. This may also help to explain some of the racial differences in the incidence of prostate cancer. People with dark skin absorb less sunlight and are known to have lower levels of vitamin D.
Lifetime risk of prostate cancer may be linked to the amount of the male hormone testosterone circulating in a man's body as early as puberty or even in utero, although direct evidence of this link remains to be shown.
Prostate cancer cell growth may be fueled by the presence of testosterone. Therefore, one of the most common treatments for prostate cancer, especially if it returns after first-line treatment, is the complete suppression of testosterone production and action in the body. (Hormone Therapy).
It has also been shown that men who have their testicles surgically removed (orchiectomy; castrated) before puberty rarely develop prostate cancer. However, these observations do not prove that prostate cancer is caused by high levels of testosterone in the body.
As the tumor grows, it may spread from one part of the prostate to surrounding areas.
Early stages of prostate cancer may not cause any symptoms. However, men with more advanced disease may experience a need to urinate frequently, especially at night:
You should speak with your doctor immediately if you have experienced any of the above symptoms or if you are a man over 50 who has not had a recent prostate cancer screening.
If you have a family history of prostate cancer, or are an African-American male, you should consider screening at age 45.
Stopping testicular production of testosterone may relieve many of these symptoms.
Determining whether you have prostate cancer generally involves a series of steps. Your doctor will first ask you questions about your medical history and any symptoms you may be having.
Next, your doctor will most likely perform a digital rectal examination (DRE) by inserting a gloved, lubricated finger into the rectum to feel the size and texture of your prostate.
A prostate-specific antigen (PSA) test, used in addition to DRE, increases the likelihood of cancer detection.
A PSA test measures the level of prostate-specific antigen, a substance produced mainly by the prostate cells, in the bloodstream.
A high level of PSA in the bloodstream can be a warning sign that prostate cancer may be present.
Finally, the results of either or both tests (DRE and PSA) may suggest the need for a biopsy. Only a biopsy can definitively confirm the presence of prostate cancer. Read more about how prostate cancer is diagnosed.
Staging is the assessment of the size and location of prostate cancer (that is, how far the cancer has already spread).
Staging is necessary for the patient and physician to decide what type of treatment is most appropriate.
The major treatment options for prostate cancer include hormonal therapy, such as Lupron Depot® (leuprolide acetate for depot suspension), surgery, radiation, chemotherapy, and watchful waiting (observation).
Treatment options will depend on several factors, including your age, the stage of your disease and the advice of your physician.
If prostate problems are discovered, your doctor may refer you to a urologist, a doctor who specializes in disorders of the urinary system and the male reproductive system.
In some cases, a patient may be referred to an oncologist, a specialist in the treatment of cancer, for additional consultation.
You may want to speak to your doctor to learn if there are support groups in your area.
Prostate cancer is a group of cancerous cells (a malignant tumor) that begins most often in the outer part of the prostate. It is the most common type of cancer (excluding skin cancer) diagnosed in American men.
Early prostate cancer usually does not cause any symptoms. However, as the tumor grows, it may spread from the prostate to surrounding areas. Change in urination, including increased frequency, hesitancy or dribbling of urine may be experienced.
Prostate cancer can spread from the prostate to nearby lymph nodes, bones or other organs. This spread is called metastasis. For example, as a result of metastasis to the spine, some men experience back pain.
The value of early detection
The overall prognosis for prostate cancer patients has dramatically improved compared with years ago. Over the past 20 years, the overall survival rates for all stages of prostate cancer combined have increased from 67% to 97%. This means more men are living longer after diagnosis.
Some of the possible reasons for this increase in survival rates include public awareness and early detection.
Determining whether you have prostate cancer generally involves a series of tests and exams. Before starting the testing process, your physician may ask you questions about your medical history, your family history of cancer and any symptoms you may be having, particularly problems with urination. Then, your doctor will most likely proceed to one or more of the tests described below.
The Gleason Grade refers to the degree of aggressiveness of a particular tumor based on the appearance of the tissue under a microscope; that is, how fast it is growing and the likelihood of its spreading.
The Gleason grading system assigns a numerical score to each of the two largest areas of cancer in the tissue samples. The lowest possible combined Gleason Grade is 2, and the highest possible Gleason Grade is 10.
The staging estimates the size and location of the cancer (including how far it has spread). Grading and staging will help determine what type of treatment, if any, is most appropriate.
How Is It Determined & Calculated?
The Gleason grading process assigns a number ranging from 1–5 based on the degree of “cell differentiation” within the tissue sample from very well differentiated (i.e., least cancerous, most normal looking [grade 1] to very poorly differentiated and most cancerous [grade 5]).
Gleason Grades 1 and 2 closely resemble normal prostate tissue – in which the cells appear round, orderly and with defined borders.
In grade 2, the cells are more loosely aggregated.
In Gleason Grade 3 cells are beginning to lose their defined borders and are starting to group together into clumps.
Gleason Grade 4 is identified by loss of normal cell structure and a more pronounced clumping together of cancerous cells.
Gleason Grade 5 means that the cells have lost most or all of their normal characteristics are very poorly differentiated and have essentially merged together into cancerous islands of cells.
The Combined Gleason Grade or Gleason Sum
The final Gleason Grade is the combination of two numbers, derived from adding the two highest grades assigned to two tissue areas extracted during the biopsy.
The pathologist will assign patterns to each section of tissue samples, a most common pattern in one sample and a second most common pattern in another specimen.
Assigning a combined grade to the two most common patterns allows for a better prediction about the prognosis.
The lowest possible Gleason Grade is 2 (1 + 1), where both the primary and secondary patterns have a Gleason Grade of 1.
A typical Gleason Grade might be 5 (2 + 3), where the primary pattern has a Gleason Grade of 2 and the secondary pattern has a grade of 3.
Another typical Gleason Grade might be 7 (4 + 3), where the primary pattern has a Gleason Grade of 4 and the secondary pattern has a grade of 3.
The highest possible Gleason Grade is 10 (5 + 5), when the primary and secondary patterns both have the most disordered Gleason Grades of 5.
Risk Relative to Gleason Grade
The Gleason Grade can help a physician to determine a man's stage of cancer.
In general, the Gleason can be an indicator of how aggressive the cancer is or will behave in the future.
However, the Gleason Grade does not determine how far the cancer has spread, whether it is confined to the prostate or to which part of the body the cancer may have spread.
Nonetheless, a high Gleason Grade (8–10) indicates a greater chance that the cancer has spread beyond the prostate and is a more aggressive form of cancer.
A very high Gleason Grade (i.e., 10) is strongly predictive for aggressive cancer that has likely grown outside of the prostate.
Conversely, a lower Gleason Grade indicates a better prognosis.
Some scientists believe that very low Gleason Grades (i.e. 2–4) may be misleading.
When prostates removed from patients with low Gleason Grades are evaluated by pathologists, the Gleason Grade is often restated because higher-grade cancers are found within the prostate that were not pinpointed with the original biopsy.
Prostate cancer is a very complex disease, and the Gleason Grade alone cannot predict the future course of disease.
Some men with low Gleason Grades have been known to do poorly, while some other men with high Gleason Grades have been known to do well.
By combining the patient's Gleason Grade with the PSA level and the clinical stage, it is possible to use prognostic tools such as the “Partin coefficient tables” to estimate the likelihood that that patient has localized or locally advanced prostate cancer of different types. This factor – whether the cancer has spread – is an important consideration in determining the optimal treatment.
Staging & Prognosis
Staging determines the extent of prostate cancer and provides an idea of how the cancer should be treated.
The best-case scenario is that the cancer is identified at an early stage, when the tumors are very small and confined within the prostate.
Staging is based on where the cancer is in the body and where it may have spread if it has grown beyond the prostate.
Doctors use a variety of techniques to accomplish this, including feeling the prostate itself via a digital rectal exam (DRE), magnetic resonance imaging (MRI) and other techniques to visualize what is going on within the body.
Terminology you may hear:
Cancer may be described as “indolent” or “aggressive.”
Prostate cancer is a heterogenic disease, in that some prostate cancers progress very rapidly while some grow slowly.
The aggressiveness of tumors appears
to correlate directly with the proportion of higher Gleason Grade cells, but it
may still be difficult to determine the prognosis and the best treatment and how
responsive a particular cancer might be to treatment.
The following describes some of the
tests and procedures that may be used by a physician to determine the extent of
the prostate cancer.
Lymph Node Biopsy (Lymphadenectomy)
The best way to determine whether the cancer has spread beyond the prostate is to remove tissue from areas where prostate cancer is known to spread.
When prostate cancer is suspected to have spread, a lymph node biopsy is commonly taken. Lymph nodes are often assessed during surgery when the prostate is removed.
A bone scan, which is similar to an X-ray, is used to determine if prostate cancer has spread to the bones.
In this procedure, a physician will first inject a harmless radioactive substance (“radioisotope”), which is attracted specifically to bones.
Normal bones absorb the radioactive substance at a lower rate than bone that is in a process of regeneration – such as in a bone fracture or when cancer is present.
Thus, if cancer is present in the bone, the radioisotope accumulates in those locations and shows up as a “hot spot” on the X-ray-like image taken during the bone scan.
It is important to note that bone scans are not perfect tools for identifying whether prostate cancer has spread to the bone. There may be microscopic deposits of prostate cancer cells in bones that do not show up on the bone scan image – giving a “false negative” test result.
Conversely, any type of bone problems such as a current (or old) bone fractures, arthritis and infections can show up as hot spots on a bone scan – giving a “false positive” test result.
However, regular X-rays can help separate these other bone problems from suspicious sites of cancer in the bone.
Magnetic Resonance Imaging (MRI)
MRI uses a high-powered magnetic field to create an image of the prostate. The MRI can show whether the cancer has spread outside the gland into the lymph nodes or other areas around the prostate.
However, because prostate cancer tumors can be so small, MRI may miss some small or microscopic tumors that are either extending from the wall of the prostate or are in surrounding areas.
Computed Tomography (CT)
CT forms a picture out of multiple cross-sectional X-ray images put together by a computer.
It is similar to an MRI, but with less clarity. It shows the prostate and other nearby parts of the body. The drawbacks to CT are similar to MRI in that micro-metastases may easily be missed by CT images.
A chest X-ray image can show whether cancer has spread to the lungs or other parts of the chest. However, chest X-rays are not commonly used since the lungs are not a common site of early prostate cancer metastases.
Intravenous Pyelogram (IVP)
An X-ray of the kidneys, ureters and bladder taken after the patient has been injected with a dye that can be seen by X-ray.
This test uses antibodies with radioactive molecules attached to detect the presence of prostate cells throughout the body.
The radioactive antibodies are designed to attach to prostate cancer cells themselves so that they can be imaged through an X-ray-like process.
If the test detects the cells outside
of the prostate, it indicates that the prostate cancer has spread.
In other words, the test results are highly subjective or open to interpretation. This makes decision-making based upon the test results challenging.
Efforts are underway to improve the accuracy and interpretability of the ProstaScint scan technology through improvements in imaging technology.
These results are highly encouraging,
especially for determining if the cancer has locally progressed.
After a series of diagnostic approaches that may include biopsies, surgery and/or imaging procedures, the physician will typically assign a “stage” to the cancer that will describe the extent and location of the cancer in the body.
Currently there are two different systems used to stage prostate cancer. The traditional method classifies the disease into four clinical categories rated A through D.
The second system is called TNM, which stands for Tumor-Nodes-Metastases.
A-D Staging System
The TNM score can be combined, along with the Gleason Grade, in a process called stage grouping.
The overall stage can then be expressed in Roman numerals from I (the least advanced) to IV (the most advanced). This is done to determine the prognosis for survival or cure.
The stage groups that combine TNM score and Gleason Grade are:
Traditional Cancer Staging
A widely used staging system is called the TNM System. It is also known as the Staging System of the American Joint Committee on Cancer (AJCC).
TNM staging takes into consideration tumor size (T) and whether the cancer has spread to lymph nodes (N) or metastasized (M) to distant sites in the body.
Tumor size is assessed on a scale of 1 to 4.
Generally, tumors graded T1 are confined to the prostate gland but are so small that they cannot be felt during a DRE or detected during ultrasound.
T2 prostate cancer is confined to the prostate, but it is large enough to be detected during a DRE.
T3 and T4 prostate cancers have expanded beyond the prostate into surrounding tissues.
Lymph node involvement is graded on a scale of 0 to 3.
N0 means that the cancer has not spread into the lymph nodes.
The number and size of lymph nodes involved dictates whether the cancer is N1, N2 or N3.
Metastasis is rated 0 or 1.
M0 means no metastasis has occurred; M1 indicates metastasis to a distant location.
Scientists have developed tools that are used by clinicians to predict the prognosis (or outcome) of a particular man’s prostate cancer based on the various information that is accumulated during the diagnosis and staging process.
The ultimate goal is to predict the
probability that the recently diagnosed primary prostate cancer is localized and
treatable by surgical or radiation procedures or is advanced and will require
systemic (whole body) treatment.
This prognostic tool was originally developed by a group of urologists at The Johns Hopkins University.
The Partin coefficient tables combine data on the PSA value, Gleason Grade and clinical stage of a specific patient in order to try to predict the specific risk for that patient.
They are used to estimate four different outcomes that are important in deciding how a man with prostate cancer should be treated.
Over the years, a wide array of treatments for prostate cancer have been developed including surgery, radiation, hormone deprivation therapy, chemotherapy, dietary changes and the use of various herbal supplements.
Deciding which of these treatments to select is a difficult decision. Prostate cancer is a complex heterogeneous disease that acts differently in different men. Fortunately, for most men, most prostate cancer grows very slowly.
Earlier diagnosis of prostate cancer has increased since the introduction of the PSA blood test. As a result, the overall prognosis for prostate cancer patients has dramatically improved compared with years ago. Over the past 20 years, the overall survival rates for all stages of prostate cancer combined have increased from 67% to 97%.
Over the years, a wide array of treatments for prostate cancer have been developed including surgery, radiation, hormone deprivation therapy, chemotherapy, dietary changes and the use of various herbal supplements.
Deciding which of these treatments to select is a difficult decision. Prostate cancer is a complex heterogeneous disease that acts differently in different men.
Since there is no “one size fits all” treatment, each man must learn as much as he can about various treatment options and, in conjunction with his doctor, make his own decision about what is best for him. Fortunately, for most men, most prostate cancer grows very slowly.
At this time, it is virtually impossible to know how rapidly or slowly a particular man’s prostate cancer will grow – because at the time of diagnosis it is not known how long the prostate cancer cells have been developing.
The slow rate of growth, coupled with the widely varied presentation, has made it difficult, if not impossible, to determine scientifically which treatment is best for which man.
If the cancer has been found to be contained within the prostate, it could take years for a tumor to double in size.
In fact, the cancer might stay within the confines of the prostate indefinitely and never cause problems. Alternatively, the cancer might be growing very rapidly and might spread to other parts of the body quickly.
It may be reassuring to know that 86% of all prostate cancers are diagnosed in the local and regional stages and that the 5-year relative survival rate for men whose prostate cancer is diagnosed at this early stage is nearly 100%.
Additionally, according to the most recent data, the relative 10-year survival rate is 86%, and the 15-year survival rate is 56% (ACS Cancer Facts & Figures, 2004).
A variety of factors that must be considered and evaluated before deciding on a treatment plan (or no treatment at all) include the stage of the prostate cancer, age, other health issues and the patient's willingness to undergo certain procedures or therapies – some of which may have side effects.
These options are not listed in any particular order. The options selected for your treatment will depend on several factors, including your age, the stage of your disease and the advice of your physician.
Testosterone is a concern for those diagnosed with prostate cancer. The goal of hormonal therapy for prostate cancer is to lower the production of testosterone and/or block its effects. Testosterone, a male sex hormone produced primarily by the testicles, can stimulate the growth of hormone-dependent prostate cancer. There are three major types of hormonal therapy:
Doctors also use LH-RH agonist therapy to slow the spread of cancerous cells and help alleviate or ease the symptoms associated with advanced prostate cancer. However, LH-RH agonists are not a cure for prostate cancer.
Orchiectomy, also known as castration, is a surgical procedure that completely removes the testicles. It is usually an outpatient procedure. Orchiectomy produces an immediate and permanent reduction in testosterone and has modest surgically-related complications. Hot flashes, impotence and loss of interest in sex are side effects associated with orchiectomy. Although this procedure is not a cure, it may delay the advance of the disease.
Another treatment alternative for advanced prostate cancer involves the use of hormone-blocking drugs called antiandrogens. Antiandrogens block the body's ability to use androgens, such as testosterone. However, antiandrogens are not a cure for prostate cancer.
Examples of antiandrogens include:
Eulexin®, Casodex® and Nilandron® are
not trademarks of TAP Pharmaceutical Products Inc.
For some men with prostate cancer, hormonal therapy may not be the appropriate choice of therapy. Other options include surgery, radiation, chemotherapy, or watchful waiting (observation).
Lupron Depot is indicated for the palliative treatment of advanced prostate cancer. The most common side effect associated with Lupron Depot is hot flashes. Like other treatment options, LH-RH agonists may cause impotence.
Symptoms may worsen over the first few weeks of treatment. Periodic monitoring of PSA and serum testosterone levels is recommended. The -4 Month 30 mg, -3 Month 22.5 mg and 7.5 mg dosage forms are not indicated for use in women.
The goal of surgery is to remove all the cancer. Techniques that may be used by surgeons to remove the prostate are described below.
Alternatives to surgery
Other options include hormonal therapy, radiation, chemotherapy, or watchful waiting (observation).
For some men with prostate cancer, surgery may not be the appropriate choice of therapy.
Radiation therapy uses high-energy x-rays, either beamed from a machine (external beam radiation) or emitted by radioactive seeds (internal radiation) implanted in the prostate, to kill cancer cells.
During external radiation, the region around the prostate, as well as the area around the pelvis, receive varying doses of radiation, although the primary target is the prostate gland itself. Side effects may include diarrhea, frequent and painful urination, rectal irritation or bleeding, and impotence.
Internal radiation therapy makes use of tiny radioactive seeds or implants, placed directly into or next to the prostate gland to kill cancerous cells. This is also known as interstitial implantation or Brach therapy.
Compared with external beam radiation, Brach therapy may offer certain advantages:
Side effects include post-implant discomfort, urinary incontinence and impotence.
Alternatives to radiation therapy
Other options include hormonal therapy, surgery, chemotherapy, or watchful waiting (observation).
Chemotherapy is treatment with drugs to destroy cancer cells. These drugs work by destroying those cells that divide or turnover rapidly. However, chemotherapy can also affect normal cells that actively divide, such as those in bone marrow, gastrointestinal mucosa (lining) and hair follicles.
Different chemotherapy drugs cause different side effects. The most common side effects are feeling tired, nausea and vomiting, mouth sores, hair loss and a low white blood-cell count. To minimize the side effects, chemotherapy drugs are carefully monitored by your physician according to the amount and number of times that they are administered.
Alternatives to chemotherapy
Other options include hormonal therapy, surgery, radiation, or watchful waiting (observation).
Another option is watchful waiting, also known as "observation" or "surveillance." These patients receive no active treatment unless symptoms appear. They may be asked to schedule regular medical checkups and report any new symptoms to the doctor immediately.
Alternatives to watchful waiting
Other options include hormonal therapy, surgery, radiation, or chemotherapy.
If PSA levels rise again after surgery or radiation, it commonly means that the prostate cancer has returned or is growing.
If one PSA test after local therapy shows detectable or rising levels, be sure to have the test repeated again immediately to be sure the test is accurate as laboratories sometimes make mistakes.
If the detectable or rising PSA is confirmed, remember that prostate cancer is usually a very slow-growing cancer and you have some time to carefully consider the treatment path that is best for your particular situation.
A rising PSA does not mean that you will necessarily develop symptoms soon or that the cancer will spread rapidly.
There are a number of treatment options that exist to treat prostate cancer that has returned after initial treatment.
These include hormonal therapy, treatments to help prevent spread of prostate cancer to the bone and possibly chemotherapy.
The above opinionated views and information serves to educated and informed consumer . The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. .It should not replaced professional advise and consultation. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions
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