prostate cancer

 What is prostate cancer?

• The most common type of cancer in men and second most frequent cause of cancer-related death in men .
•  A malignant (cancerous) tumor that begins in the prostate gland 
• Some prostate cancers grow very slowly and may not cause problems for years 
• Prostate cancer is somewhat unusual in that many men with advanced cancer respond to treatment 

What is prostate?

The prostate is a walnut-sized gland located behind the base of the penis, in front of the rectum and below the bladder .

It surrounds the urethra, the tube- like channel that carries urine and semen through the penis 

The primary function of the prostate is to produce seminal fluid, the liquid in semen that protects, supports, and helps transport sperm.

Risk Factor for prostate cancer

• 􏰀 Age
• Race/ethnicity 􏰀
• Family history 􏰀 
• Diet
• Hormones 

Prostate Cancer and Early Detection

• Prostate-specific antigen (PSA) test 
• Digital rectal examination (DRE) 
• Discuss screening with your doctor 

Symptoms of Prostate Cancer

• Frequent urination, or weak or interrupted urine flow
• Pain or burning during urination or blood in the urine
• The urge to urinate frequently during the night
• Different symptoms if the cancer has spread: pain in the back, weight loss, fatigue 
• Sometimes, people with prostate cancer do not show any of these symptoms, or these symptoms may be similar to symptoms of other medical conditions
  

Prostate Cancer Examination

• PSA test
• DRE
• Diagnosis is confirmed with a biopsy
• Transrectal ultrasound (TRUS) 
• Imaging tests can determine if the cancer has spread 

Prostate Cancer  staging

• Staging is a way of describing a cancer, such as the depth of the tumor and where it has spread.
• Staging is the most important tool doctors have to determine a patient’s prognosis 
• Staging is described by the TNM system: the size of the Tumor, whether cancer has spread to nearby lymph Nodes and whether cancer has Metastasized (spread to organs such as the liver or lungs).

• Another staging system assigns letter (A,B,C,D) to Describe the cancer.
• The type of treatment a person receives depends on the stage of the cancer.

Prostate cancer grading

• Grade describes how much cancer cells look like normal cells (for example, do the cells look almost normal or very abnormal?) 
• The grade of the cancer can help the doctor predict how quickly the cancer will spread.
• The Gleason System is the most common grading system and describes the cell patterns seen under the microscope.

Stage I(stage A) Prostate cancer

Stage I cancer is found only in the prostate and usually grows slowly 

Stage II(stage B) Prostate cancer

Stage II cancer has not spread beyond the prostate gland, but involves more than one part of the prostate, and may tend to grow more quickly. 

Stage III(stage C) Prostate cancer

Stage III cancer has spread beyond the outer layer of the prostate into nearby tissues or to the seminal vesicles, the glands that help produce semen.

Stage IV(stage D) Prostate cancer

Stage IV cancer has spread to other areas of the body such as the bladder, rectum, bone, liver, lungs, or lymph nodes. 

Treatment

• Treatment depends on stage of cancer
• More than one treatment may be used
• Surveillance (watchful waiting) for some early stage
• cancers Surgery
• Radiation therapy
• Hormone therapy
• Chemotherapy 

Cancer treatment: with watchful waiting

• A way to monitor early stage, slow-growing, prostate cancer 
• Appropriate when treating cancer would cause more discomfort than the disease itself 
• Mostly used in older men or men who are unwell from other illnesses 
• Treatment begins when the tumor shows signs of growing or spreading 

Cancer treatment: Surgery

• Used to try to cure cancer before it spreads outside the prostate 
• Usually the prostate and nearby lymph nodes are removed 
• Urinary incontinence and sexual side effects may result from surgery.These side effects are treatable 
• Cryosurgery (destroying cancer cells by freezing) is still experimental
  

Cancer treatment: Radiation therapy

• The use of high-energy x-rays or other particles to destroy cancer cells 
• Used to try to cure disease or control symptoms 
• External-beam: outside the body 
• Brachytherapy: the insertion of radioactive pellets into the prostate 
• Intensity-modulated radiation therapy (IMRT): small beams of radiation are aimed at a tumor from many angles 
• Side effects may include rash and dry, reddened, or discolored skin 

Cancer treatment: Hormone therapy

• Reduces level of male sex hormones to slow growth of cancer 
• Used to treat prostate cancer that has grown after surgery and radiation therapy or to shrink large tumors before surgery and radiation therapy 
• Can be done surgically or through medication 
• Hormone therapy may cause a variety of side effects
• More information can be found in the ASCO Patient Guide: Hormone Therapy for Advanced Prostate Cancer
  

Cancer treatment: Chemotherapy

• Drugs used to kill cancer cells 
• No standard chemotherapy for prostate cancer 
• Mitoxantrone (Novantrone) and docetaxel (Taxotere) are both used in men with prostate cancer that is resistant to hormone therapy
• Paclitaxel (Taxol), estramustine (Estracyte), doxorubicin (Adriamycin), and cyclophosphamide (Cytoxan, Neosar) have shown promise in treating advanced prostate cancer