Prostate cancer: diagnosis, treatment options, and more
Understanding Prostate Cancer
Prostate cancer is often detected through specific tests and symptoms. For patients who have risk factors such as older age or a family history, your doctor may have instituted screening with a blood test called PSA (prostate-specific antigen) and interval DREs (digital rectal exams), which is a physical exam.
Patients who develop symptoms of prostate cancer, often report trouble urinating or frequent urination, incomplete bladder emptying, blood in urine or semen, impotence, and bone pain. These usually show up when the cancer is more advanced.
If PSA or DRE results are unusual, doctors may order more tests like an MRI or a prostate biopsy to confirm the diagnosis.
Staging Prostate Cancer
Staging helps doctors understand how far the cancer has spread. It looks at the tumor's size (T), lymph node involvement (N), and if it's spread to other parts of the body (M). The PSA level and the tumor's grade (how it looks under a microscope) also help determine the best treatment. To do this, doctors will typically order imaging studies such as MRI or PET scans to get a sense of the spread of disease.
Treating Prostate Cancer
Active Surveillance: For early-stage and low-risk prostate cancer, doctors may choose active surveillance. This means regular check-ups, including PSA tests, digital rectal exams, and repeat biopsies.
Surgery: Surgery can remove the prostate gland, nearby tissues, and lymph nodes. It's done either robotically or laparoscopically. This isn't the same as TURP (transurethral resection of the prostate), which treats a benign enlarged prostate, not cancer.
Radiation: Radiation can treat prostate cancer externally (from outside the body) or with tiny radioactive seeds placed inside the prostate (brachytherapy).
Hormone Therapy: Sometimes, hormone therapy is given along with radiation to reduce testosterone levels. This helps slow cancer growth. There are different types of hormone therapy drugs.
Chemotherapy: Chemotherapy is used for more advanced prostate cancer or when it doesn't respond to hormone therapy. Common drugs include docetaxel and cabazitaxel.
Novel Therapies: Newer treatments target specific factors in cancer cells. These include olaparib for BRCA-positive cancers, sipuleucel-T as an immunotherapy, and radiopharmaceuticals like Radium-223 and PSMA-receptor targeting therapies.
Observation: For slow-growing, early-stage prostate cancer, sometimes doctors choose to closely monitor the cancer instead of immediate treatment. Regular tests help track any changes.
Remember to discuss your specific diagnosis and treatment options with your doctor.
