Learn about screening and diagnosis for prostate cancer. Recent news and research on prostate cancer is also provided. Finally, who’s most at risk and how can prostate cancer be treated.
Staging and grading
Treatment for prostate cancer is usually determined by the “stage” and “grade” of cancer. Staging of prostate cancer indicates how far the cancer has spread (within the prostate, to nearby tissues or to other organs) and the size and location of the tumor. Grade of prostate cancer is based on how the prostate cancer biopsy differs compared to normal prostate tissue when looked at under the microscope. Your age, other medical conditions for which you are being treated and other factors that are important to you — such as maintaining your urinary and sexual functioning — may be considered when treatment is recommended by your doctor.
Surgical treatments are used when the goal is to remove the cancer. A radical prostatectomy involves the removal of the entire prostate gland and surrounding tissue. This operation is performed only if the cancer is confined to the prostate gland itself. The surgery involves making an incision into the abdomen to gain access to the prostate gland. A urinary catheter will be in place after surgery so that urine can be drained from the body. The catheter is left in place for a few weeks.
Once it is removed, there may be problems with dribbling and incontinence. This usually improves over time and can sometimes be corrected with medication or with other procedures. Impotence or the inability to sustain an erection may result after radical prostate surgery because of impairment of the nerves that control erection. This condition may be temporary or, in some cases, permanent. Discuss these issues with your doctor before consenting to this type of treatment.
Transurethral resection of the prostate (TURP) is another surgical option that may be used for men who are not candidates for radical prostate surgery. During this procedure, an instrument is inserted through the urethra and into the prostate, where tissue is removed through cauterization. No incision is needed, and a catheter will be left in place for a few days until any urinary bleeding resolves. Incontinence and impotence are not generally associated with a TURP. The surgery, however, will not cure the patient, since the prostate gland is not removed.
Cryosurgery is a relatively new treatment for prostate cancer that involves inserting tiny rods into the prostate and killing the cancer cells by freezing them.
Two types of radiation treatments can be used to treat prostate cancer. External beam radiation is similar to getting an X-ray. Treatments, given daily, last several minutes, and the entire course of therapy may take six or seven weeks. New technology is more exact, using CT scan localization called three-dimensional conformal radiation therapy, which offers a 3-D computerized image.
Internal radiation or brachytherapy, uses radioactive seeds placed directly into the prostate gland. The pellets emit radiation for a few months and then are no longer active.
Radiation therapy does have side effects. Many patients complain of fatigue during the treatments. Others report gastrointestinal symptoms like diarrhea and nausea. Some patients may have difficulty with urinating and maintaining erections.
What support groups are available to help in dealing with a diagnosis of prostate cancer?
Many hospitals or universities offer local support groups for patients and families affected by prostate cancer. Ask your physician for a referral or contact your local chapter of the American Cancer Society.
- Take the American Urological Association (AUA) Symptom Index at home before each doctor visit to monitor your symptoms.
- Write down in your diary any times when you notice unusual urinary symptoms, blood in your urine, or changes in the pattern of urination. Discuss them with your doctor.
- Adopt a diet low in fat and rich in vegetables, soy and tomato products.
AUA Symptom Index