Prostate Cancer
Introduction
Prostate cancer is the most common cancer in men and the second most common cause of cancer-related death in men. The prostate is a gland that sits just below the bladder and just in front of the rectum and the male pelvis. It is important in the reproductive functions of men.
Causes
For most men, prostate cancer does not have a clear cause. In rare cases, there is a definable genetic mutation that predisposes men in the same family to develop prostate cancer. The most common and well-known genes associated with prostate cancer are mutations in the BRCA 1 and 2 genes.
While many prostate cancers are driven by the male hormone testosterone, it is unclear if supplemental testosterone replacement therapy increases the risk of developing this type of cancer
Clinical Manifestations and Diagnosis
Typically, there are no symptoms for men who are found to have prostate cancer. Men with benign prostatic hyperplasia (BPH) may have difficulty with their urinary stream. However the symptoms are typically not due to prostate cancer.
Often, your primary care physician will order a prostate specific antigen (PSA) blood test. If this is elevated, you may be referred to a urologist for consideration of biopsy of the prostate.
Your PSA level, your Gleason score from the biopsy, and other clinical factors will help determine your prostate cancer risk group. Your risk group will help your urologist and oncologist determine if you need additional testing and what types of treatment are most appropriate for your cancer.
Treatment Strategies
Men with localized prostate cancer often have multiple, good treatment options. National guideline-recommended treatments typically include either surgical removal (prostatectomy) or radiation therapy.
Here in Gadsden, we offered to different types of radiation treatment, external beam radiation therapy (EBRT) and low-dose rate (LDR) brachytherapy. Depending on your risk group, you may be a candidate for either treatment alone, or you may require a combination of both of these types of radiation delivery to optimize your chance of cure.
Men with localized prostate cancer rarely need chemotherapy. However, your urologist may discuss androgen deprivation therapy (ADT). This is often given as an injection just below the skin which releases a medicine that decreases your testosterone and can slow the growth of prostate cancer.
Men with metastatic prostate cancer may eventually need chemotherapy. Typically, they begin with combination hormone blocking therapies. Even in patients with metastatic prostate cancer, radiation therapy may help improve your survival or decrease the symptoms of your disease.
Prognosis and prognostic factors
Each patient has a unique cancer type and stage with different underlying risk factors. During a oncology consultation visit, your oncologist will discuss what to expect from treatment. Ask your doctor about the expected outcomes.
Treatment Side Effects
Radiation treatment side effects tend to affect the tissues that are close to the tumor where the radiation is directed. Some side effects can be more pronounced during and shortly after radiation treatment (acute side effects). While other side effects may occur many months or years after treatment (chronic or late side effects).