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.