Archive for the ‘Prostate Cancer Prognosis’ Category

Radiation Seeds for Prostate Cancer

If the cancer is detected early, it is easy to treat and can be cured. However, in the advanced stages treatment is difficult, and it is incurable if the disease spreads to organs such as bones and lymph nodes. There are many treatment options for prostate cancer. Each option needs to be considered carefully, taking into consideration the individual‘s age, overall health and so on.



Treatment Options


The treatment methods that have been traditionally used include Watchful waiting (without any treatment), Surgery (radical prostatectomy), and External beam therapy (EBT). However, there are modern treatment methods developed and used in the last 10-15 years. These newer methods are more effective, and minimize the unpleasant side effects you may face with the traditional therapies.

One of these methods, Radiation Therapy is often used to treat pancreatic cancer, mostly in advanced cases and older patients (to avoid surgery).There are several different forms of radiation therapy, such as external beam, brachytherapy or seed implantation, high dose interstitial radiation, and several forms of combined therapy.

Seed Implantation or Brachytheraphy

In seed implantation or Brachytheraphy, radiation oncologists place (under anesthesia) small radioactive seeds, about the size of a grain of rice, into your prostate. This is done by inserting needles containing the seeds, using ultrasound guidance, through the skin of your perineum (the area between the scrotum and anus). These seeds irradiate and kill the cancer cells, and remain in your prostate for a number of months. Either radioactive Iodine (I -125) or palladium (Pd-103) is used for the radioactive seeds.

Brachytheraphy Procedure

Seed implantation is an effective treatment when the cancer is localized to the prostate, requires no surgical incision, and requires a short recovery time. It can be an outpatient procedure and most men go home the same day. Also, you can return to your normal activities a few days after treatment. The biggest advantage is that two to three times as much radiation can given to you compared to external beam therapy, with very less radiation affecting the surrounding tissues. The success rate is often very high because of these reasons.

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End Stage Prostate Cancer

The prostate is a small gland located below the bladder, found only in the male reproductive system. Prostate cancer occurs when the cells of the prostate mutate and multiply without control. It is one of the most common cancers found among men and is typically found among older men above the age of 50. Men with a family history of this cancer are also under a great risk, and should get tested regularly.. Increasing the intake of fruits and vegetables and reducing the consumption of red meat and saturated fats can prevent prostate cancer to a great extent.



Symptoms

The most common symptoms of prostate cancer are the following:


  • Difficulty and pain while urinating
  • Passing urine often, particularly at night
  • Blood in the urine
  • Pain in the lower back, hips, and thighs
  • Bone pain in the spine, pelvis, or ribs
  • Problems in sexual intercourse


Advanced Prostate Cancer


If the cancer is detected early, it is easy to treat and can be cured. However, in the advanced stages treatment is difficult, and it is incurable if the disease has spread to organs such as bones and lymph nodes. When the cancer reaches the end stages, the person may suffer weight loss, pain in various parts of the body such as lower back, hips, and thighs. Treatment in the advanced stage aims generally at reducing pain and improving the quality of life.


Treatment Options


A multidisciplinary team of doctors, which includes a urologist, radiotherapy specialist, hormone therapy specialist, chemotherapy specialist, surgeons, and oncologists help you in deciding the course of your treatment. Before deciding on the type of treatment, various factors related to the patient have to be taken into consideration, which include:


  • Your Age
  • Overall health
  • The extent of spread of the cancer
  • The symptoms that are visible
  • Possible side effects of the treatment


Hormonal therapy is the preferred method of treatment in advanced prostate cancer. Chemotherapy may be used if hormone therapy is not effective in controlling the disease. Surgery to remove the prostate gland is not a viable option in case of advanced cases. However, a trans-urethral resection of the prostate can relieve problems with passing urine in advanced cases. Painkillers may be given in some cases and Radio therapy may be used to relieve bone pain in others.

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Prognosis of Metastatic Prostate Cancer

Prostate Cancer Prognosis for Stage III

Stage III prostate cancer is the third in the common four stage TNM (Tumor/Nodes/Metastases) prognosis system.  If your cancer has received a stage III diagnosis, this is characterized by a regionalized tumor than has spread beyond the prostate.  At this point, the tumor has moved through the capsule that encloses the prostate and possibly into the seminal vesicles.  While it has moved beyond the prostate, stage III prostate cancer generally has not yet reached the lymph nodes or any other distant sites in the body (such as bone metastases).  Tests such as computed tomography, bone scans, and endorectal coil magnetic resonance imaging can determine if the cancer has spread elsewhere in the body and help classify the stage in which the prostate cancer is in.

Tumors that have been classified as Stage III tumors can often cause many difficulties including difficulties with urination due to their large size and bone pain.  Common methods of treating difficulties with urination include surgical transurethral resection of the prostate (TURP), radiation therapy, surgery, or hormonal therapy.  Bone pain can be lessened by radiation therapy.

One of the most common methods of treating stage III cancers is external beam radiation. External beam radiation uses a linear accelerator which produces high-intensity x-rays.  These x-rays are then concentrated in a beam toward the prostate.  This method is less invasive than alternatives such as surgery, but is a more effective option for larger, ?bulky? tumors.  Radiation therapy can be used at all stages, both before surgery or if surgery fails.  At this point, if the patient has not undergone surgery, some patients may opt for surgery, and still others may simply wait.

If surgery has occurred, and it is found that the cancer has spread through the capsule or into the lymph nodes, the tumor is reclassified as stage III.  At this point, patients may go on to have postoperative radiation therapy.  At this time, studies are being conducted to evaluate the effectiveness of this procedure.

The prognosis for men with stage III prostate cancer varies depending on the extent of the spread of the disease.   The chances of progression once the cancer has broken through the prostate capsule are about 50/50. If the cancer has been found to have spread to the seminal vesicles the chances of reoccurrence are significantly increased.   One study was conducted where cases of men who were treated with radiation therapy for prostate cancer were revisited 20 years later found that nearly half of the men in the study had eventually succumbed to the disease.  At the same time, nearly as many of the studies? patients had died of other causes with no evidence of a prostate cancer recurrence.

Prostate Cancer Prognosis for Stage IV

Once the cancer has spread to the lymph nodes or other distant parts of the body, it is reclassified as Stage IV or metastatic prostate cancer.  At this point in the disease, hormone therapy can be used to improve the symptoms for the patient and slow down the progress of the cancer for 2 or 3 years.   If just the lymph nodes are involved, hormonal therapy can have even better success- possibly delaying the progress even further.   Once the lymph nodes have been positively identified as cancerous, the majority of patients will remain at high risk of developing additional metastatic disease in the 10 years following the application of hormonal treatment.   If bone metastases occur they may be less responsive to the hormonal therapy treatments.  Radiation therapy, however, can be used to treat the often painful bone metastases common with stage IV prostate cancer.

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Prognosis of Prostate Cancer

If you have been diagnosed with prostate cancer, you are no doubt wondering what your chances of survival are, and what your options are.  You have probably made inquiries about the growth rate of your cancer, and whether it needs to be treated.  You may be considering a variety of treatment options, such as seed implants, removal, or a combined approach involving several procedures.  What is the best way to decide?  You and your doctor will have to examine the particulars of your case, and the direction those variables typically tend to lead.

Because cancer is a systemic disease, it is not possible to determine its precise location within the prostate, or how quickly it is growing.  Your doctor will not be able to say if the cancer has spread, or what the outcome will be.  MRI and bone scans are not able to register very small metastatic tumors, so  the only information you will truly know is what the likelihood is, what the averages indicate.  Your doctor can give you a picture of your situation only in terms of how your symptoms and test results relate to those of other people.

You may be told your chances of  undergoing treatment successfully as a percentage.  However, the outcome is cut and dry.  You will not be cured up to a certain point.  Treatment will be successful or it will not.  The percentages give you an indication of your likelihood, based on research and your doctor’s personal knowledge of how the disease progressed in other cases.  Your PSA level is one indicator your doctor will use.  Comparison of PSA levels and five year survival rates can be one way in which your doctor can help you understand the severity of your situation.

Another variable to consider is the Gleason score.  Even if PSA levels are low and carry a high survival rate, a high Gleason score can indicate that the outlook is not so good.  Determining a proper prognosis is a matter of taking into account as many variables as possible.  Because medical studies typically only concern themselves with one or two variables, your doctor’s combined knowledge is very important.  Research results must be compared with your own test results, and the doctor must make an educated guess as to the seriousness of your situation, and which treatment options are most likely to produce results.  You are probably finding this a very uncomfortable idea, but this is as close to an answer as is possible.

There are certain variable which are standardly used in making this determination.  PSA, Gleason score, and the stage of the cancer are all used to determine the risk level associated with prostate cancer.  Low risk patients typically possess a PSA below 10, Gleason scores from 2 to 6, and Stages T1-T2a.  Intermediate risk patients have PSA levels between 10 and 20, Gleason scores of 7, and Stages T2b-T2c.  High risk patients exhibit PSA levels above 20, Gleason scores 8-10, and Stages T3-T4.

You need to be aware of your PSA, Gleason, and Stage.  If you do not already know, ask your doctor, and keep a careful eye on these numbers.  Your PSA level may fluctuate, so bear in mind the PSA level you had prior to beginning any treatment.  We have put together three variables to determine three risk classifications.  Low risk indicates a high survival rate with a good likelihood that treatment will result in a cure.  The cancer is probably still localized.  High risk is a poor prognosis  I maintain that high risk patients should pursue aggressive and comprehensive treatment regimens utilizing a combination of several treatments.  Patients in the intermediate risk category should be carefully tested, and must take great care when selecting the treatment option they wish to pursue.

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