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Posts tagged ‘Prostate’


by Logan

Learn more about Prostate Cancer. Part Two

This is Part Two of Prostate Cancer.  In Part One we looked at the prostate gland and some risks of getting prostate Cancer. We also began to look at Diagnosis Prostate Cancer. Diagnosis is a very important aspect of Prostate Cancer. It should be done starting at age 50.  Today we will look at diagnosing prostate cancer. In addition, we will also look at the management, treatment, and prognosis of this disease.

Classification of Prostate Cancer

If prostate cancer is found, it is very important to classify it.  Not all prostate cancers are the same. Some are more concerning than others. It is also important to see where, if at all, the cancer had spread. We talked about this at the beginning as Metastasis.  By classifying we are essentially trying to understand the prognosis.

Most Common system of Diagnosis is the TNM system.

T  –  describes the size of the tumor and if it has invaded nearby tissue

N –   describes the lymph nodes surrounding the area and if they are involved

M –  describes the amount and severity, if any, of the metastasis that is involved.

Each letter has 4 or 5 categories that explain the amount of size, lymph node involvement, or metastasis.  Each patient could have a different score, depending on what was happening.

For the prostate, the most important thing is to identify if the cancer is still found only in the prostate.  The prognosis is dramatically better if the cancer remains in the prostate.

 

Management and Treatment of Prostate Cancer

The first thing that is discussed when prostate cancer is found and depending on where it is and what the age of the pateint,  is if it needs to be treated at all.

Low grade forms [less concerning or invasive] types are found often in the elderly patient. The cancer grows so slowly that no treatment is required.  And in this type – there is relatively no risk for the patient.

If there are serious health concerns – treatment may not be a reasonable option either. With serious heath concerns, things could only get worse in most of these patients.

Therefore treatment is dependent on age, health of the patient, and staging of the cancer. Concerns for side effects of treatment should also be considered.

Treatment of Surveillance only

This is typically for those with low-risk prostate cancer. The goal is to watch the tumor over time. This allows for the possibility that something could change in the future where more aggressive treatment may be needed.

This means that a curative procedure may be something that will be considered down the road. It does not mean that no treatment will ever be given.

This approach is often used, but should not be used in more aggressive cancers.

 

Treatment for Aggressive Prostate Cancer

1.)    Surgery

2.)    Radiation Therapy

3.)    Chemotherapy

4.)    Oral medications

5.)    Hormonal therapy

6.)    Combination of treatments

7.)    Other

In most cases, prostate cancer is found only in the prostate. Therefore removing the prostate is curative in most cases.  There are a number of side effects including sexual problems, urinary problems, bowel problems and more. The problem is that in slow moving cancers, removal of the prostate does not always change life expectancy. This is because it was so slow moving that the risk of dying from prostate cancer was so low anyways. The risks though, of removing the prostate are high, and therefore surgery should be done in more aggressive forms of prostate cancer.

If the cancer has spread beyond the prostate it is considered very aggressive.

A variety of treatments are required to help treat this patient. Hormonal therapy, chemotherapy, and even radiation therapy are often seen in cancers that have gone beyond the prostate.

 

Overall and Prognosis

Prostate cancer is serious and should be treated as such. But the understanding that most cases of the prostate cancer are never found until after the autopsy. These patients died of something else and happened to have prostate cancer. If prostate cancer if found, diagnosis should be done to understand what the best treatment options are available.  Prostate cancer is the second most commonly diagnosed cancer and the sixth leading cancer death of males worldwide.

This cancer is seen more often in developed countries.   If a patient undergoes treatment, and the stages of cancer are higher, the poorer the prognosis. This means, the worse the cancer, the worse the prognosis.

Since this cancer primarily develops in men over the age of fifty, the diagnostic procedures are started near that age. This should be something that is done for every man as they approach this age. Even though most prostate cancers are low risk, this should not cause someone to push on being evaluated for the risk of prostate cancer.

In the long run, it is important not to overlook prostate cancer.


by Logan

Learn more about Prostate Cancer. Part One.

Today were are going to look at Part One on understanding prostate cancer. We will look at the prostate itself and describe what prostate cancer is. We will also look at some of the more well known causes of prostate cancer and we will look at the important steps of diagnosing prostate cancer. In Part Two we will also look at the management, treatment, and prognosis of this disease.

Prostate Cancer is a very common cancer that affects the prostate. It is something that is often highly publicized. It is often seen as the cause of some deaths and can be found in many cases on autopsy.  It has similar symptoms as other prostate problems such as prostatitis and benign hyperplastic prostate or BPH.

Prostate cancer is often a very slow growing cancer.  In most cases, the cancer remains in the prostate but in some cases it can move to the surrounding tissues.  Metastasis is when is spreads to different tissues. In rare cases the cancer can move to the brain, bone, and other parts of the body. These more invasive cancers have a worse outcome.

 

What is the Prostate?

The prostate is a gland that is needed in producing the fluid in semen. The prostate , along with other glands, produce a mucus fluid that helps keep sperm alive. This gland is a large part of the male reproductive system.  It is located near the bladder. It is only found in male, but a similar type of organ is found in women.  Women though, can not get prostate cancer.

 

Causes of Prostate Cancer

Many different elements play into causing prostate cancer. It is likely that not everything is known. Age seems to be the primary cause. As men age, the likelyhood of prostate cancer increases dramatically.  Other important risk factors are obesity, family history, diet, sexual activity [or lack of].  High blood pressure can also be a risk factor and there may be a small risk with lack of exercise.  Even, high alcohol intake may increase your risk.

1.)     Genetic

With a first degree relative that has prostate cancer, your risk increases directly.

It is unknown of a specific gene is causative for prostate cancer. But additional research is looking at specific chromosomes. Mutations that occur in these genes may lead to an understanding at the connection between genetics and cancer0..

2.)     Dietary

This is an area that is not very well known. In some circles, it is believed that a good diet with plenty of fiber will help prevent prostate cancer. But just as interesting, is the belief that some foods has a risk of getting prostate cancer.  It is currently being studied the possible link of certain such as fruits, vegetables, red meat, lack of vitamin D, excess taking of multivitamins, folic acid supplements, and high alcohol intake.  These are still being studied and are currently just risks rather than a direct correlation.

3.)     Medications

Some studies point to some medications at causing a risk.  Medications for cholesterol such as statins may actually decrease the risk of prostate cancer.

Agent Orange – was a chemical that some US war veterans came into contact with. It is believed that a double increase in risk and a possible risk for re-occurance was seen.

Elevated Testosterone levels may also increase the risk for prostate cancer. Therefore, consideration must be taken in when excess testosterone is given in a patient.  Obesity is also a risk.

4.)     Virus

This risk is just being studied.  A possible link may exist with a retrovirus that may cause a protein to be produced that is found in prostate cancer. This is just in the beginning stages of being tested.  No significant hard data can confirm this possibility.

 

Diagnosis of Prostate Cancer

This is where things can get debatable in regards to prostate cancer. Prostate cancer is slow growing and the current belief is that early diagnosis is not necessarily worth the risks of testing and treatment.

This means that early diagnosis, although occurs, is not something that is a prime concern. Starting at age 50 – this is when diagnosis is really something that should be addressed.

The American Cancer Society has discussed this when they said, “Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment.”

The age of diagnosis may be lowered to 45 if a few conditions or concerns are met:

1.)     African American – increased risk is seen and diagnosis is often begun earlier

2.)     Prostate cancer in brother before the age of 65

3.)     Prostate cancer in father before the age of 65.

(These are not AND but rather OR – which means that if you fall into any one of these three – diagnosis should begin earlier.)

The only test that can confirm prostate cancer is a prostate biopsy.  This is when several small pieces of the prostate are removed for examination under a microscope.

Other diagnostic procedures may include:

1.)     A urine test to check for a protein.

2.)     Another test is a blood work for PSA.

3.)     A digital rectal examination or DRE is a relatively non invasive way for a medical provider to examine the prostate.

4.)     A cytoscopy allows a camera that is flexible to travel through the urethra

5.)     Ultrasound

6.)     MRI is another way to take a close look at the prostate. It allows for evaluation of the tissue of the prostate. A clinical suspicion of prostate cancer can be seen. At this point, confirmation is done through a biopsy.

Tune in to Part Two for more information on Prostate Cancer.


by Logan

Can an Increase in Sexual Activity Really Help Prevent You From Prostate Health Problems?

Many men would just love to come home from the Doctor’s office with great news. This news would be… that an increase in sexually active may really prevent them from getting Prostate Cancer. Of course, the number one problem would be the validity of this information, whether it was true or not. Let’s dive into the two camps of thought.

First, let’s look at the Prostate itself.  The prostate is a gland, an exocrine gland, of the reproductive system of men.  Exocrine means that it secretes a chemical or hormone. In this case, it is an alkaline fluid that makes up a third of the fluid involved with semen that is produced within the prostate and then released.  The prostate, along with the spermatozoa and seminal vesicle help create semen.  For the prostate to work properly, you need androgens or male hormones.  The primary hormone is testosterone.

In some cases the prostate can become a cancer. As illustrated in the picture above. Prostate cancer can be a seen in a large majority of men. Though often symptoms do not present themselves. A large amount of research has been done to look at possible prevention of Prostate Cancer.

Now back to the dilemma. The real problem is that in the past, there has been so much conflicting information on whether increase sexual activity can really prevent cancer of the prostate.  Some have even hypothesized that sexual activity would lead to problems with the prostate, causing damage and even increasing the risk of prostate cancer. Often these cases deal with increased risk of infection and STD’s.  But often the risks, in these studies, had little to do with the actual ejaculation process.

In other studies, they speculated that increased sex drive means increased male hormones and this increase is a risk, in of itself, for prostate cancer.  Since hormones are associated with the function of the prostate, and hormones also seem to play a role in cancer, the two became linked. The jury seems to still be out on this aspect of the debate.

In 2005 it was produced through Johns Hopkins Medical Institution that a massive study, overlooked by epidemiologist Michael Leitsmann at Harvard. It appears that this was a decade long study. They studied nearly 30,000 men.  Most of the men in the study where white, middle-aged, and very few had history of a sexually transmitted disease.

The main question asked was the typical number of ejaculations per month in their twenties, forties, and during the past year. This information, at least immediately, was minimally helpful. The group of men was followed for the next eight years.  During the next eight years – 1,500 of the 30,000 went on to develop prostate cancer.

The findings were equally important to note. When men, on average, had more than 21 ejaculations per month for their lifetime, had ¼ or 25% the risk of men who reported few ejaculations per month (4-7).

Elizabeth Platz who also had difficulty with conflicting theories organized the Harvard study felt this study was more credible than other studies.  She pointed out that they had asked questions, especially about average monthly ejaculations, prior to the diagnosis of prostate cancer.  The other item is the large number of men that took apart in this study.  The last item of importance was that the men in the study had been without a large amount of sexually transmitted diseases.  This essential eliminated this risk from their group.

Additional studies have looked at the correlation of increased ejaculations with prostate cancer and have thus far found no relationship. Elizabeth Platz has indicated that the next step in her research will be to identify the protective reasoning behind increased ejaculations and prostate cancer.

It can be assured that new information may shed light on this debate.  Even though a somewhat recent study has suggested that there is a link between sexual activity and decreased risk for prostate cancer. I feel that the debate will rage on.  So, if your husband does suggest increased sexually activity to protect against sexually activity, you’ll know that the jury is still out. But, it might not hurt!

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