Prostate Cancer
Question: What are the signs and symptoms of
prostate cancer? Does slow urinary flow indicate cancer?
Answer: Actually, in its early stages, prostate
cancer often does not cause any symptoms. It does not even cause pain. When
symptoms of prostate cancer do occur, the cancer is usually advanced. Possible
symptoms include urinary problems such as a need to urinate frequently,
especially at night; difficulty starting urination or holding back urine;
inability to urinate; weak or interrupted flow of urine; and painful or burning
urination. Other symptoms include painful ejaculation, blood in urine or semen,
or frequent pain or stiffness in the lower back, hips, or upper thighs.
Though these symptoms may be
caused by prostate cancer, they can also be caused by other noncancerous
conditions, such as enlargement of the prostate (benign prostate hypertrophy)
or infection of the prostate (prostatitis). A man who has symptoms like these
should see his doctor to determine their cause.
Question: I understand that prostate cancer is
divided into "stages." What are they, and what does it mean to have
each of these stages of the disease?
Answer: Prostate cancer is the most common type
of cancer in men in the United States except for skin cancer. Once prostate
cancer is found, tests can be done that will tell whether the cancer cells have
spread from the prostate to nearby tissues or to other parts of the body. The
process of figuring out how far the cancer has spread is called
"staging."
Prostate cancer has been divided
into four main stages:
- Stage I (sometimes also called stage A) prostate cancer cannot be
felt, and it doesn't cause any symptoms. Stage I disease is found by
accident during surgery for other prostate problems. At this stage, the
cancer occupies less than 5% of the prostate.
- Stage II (or stage B) prostate cancer is only in the prostate, but
it is in more than 5% of the prostate. The cancer may be felt in the
prostate during a rectal examination (placing a gloved finger into the
rectum to feel the prostate).
- Stage III (or stage C) prostate cancer has spread to the covering
("capsule") of the prostate or the nearby glands that produce
semen (seminal vesicles).
- Stage IV (or stage D) prostate cancer has spread beyond the
prostate capsule to the lymph nodes (glands that contain
infection-fighting cells) or to other tissues that can include the bone,
liver, and lungs. Cancer that spreads beyond its original site is called
metastatic cancer.
Men worried
about their risk for prostate cancer or interested in screening for prostate
cancer should discuss their concerns with their doctors.
Question: If prostate cancer has spread to the
bone, how can it be treated?
Answer: When prostate cancer spreads
(metastasis) to the bone, the most common problem is pain. The pain of bone
metastasis can be treated with drugs like morphine and oxycodone, which work
well and carry little risk for addiction.
Doctors may also try to kill the
cancer or slow its growth. Male hormones like testosterone, which is produced
in the testicles, promote the growth of prostate cancer. To reduce bone pain,
doctors may remove the testicles or give drugs that cancel out testosterone's
effects.
If hormone therapy does not
work, radiation can be given. Radiation therapy uses high-energy rays or
particles to destroy cancer cells or slow their growth. The most common way to
give radiation therapy is to focus a beam of radiation at the tumor cells. Some
radioactive matter like strontium 89 can be injected into the bloodstream. The
radioactive matter in the blood is then attracted to cancer cells in the bone.
Scientists are still studying
other treatments for bone metastasis. Men with prostate cancer should talk
about treatment options with their doctor.
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