Prostrate Cancer

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Prostrate Cancer is one which develops in the Prostrate Gland. This is one of the most common forms of cancer in men.

One thing you can do that may lower the risk for prostate cancer is eat more low-fat, high-fiber foods and foods with omega-3 fatty acids After a diagnosis of cancer, people often look at changing their diet. Generally, men should follow a healthy diet . This is important for your general health as well as helping you recover from cancer. It can also help you stay at a healthy weight and lower your risk of developing other conditions.

Apart from a healthy diet, there isn’t any evidence that you should eat or avoid particular foods. Research is looking into how diet can affect cancer. Treatment for prostate cancer can cause problems with your diet, such as diarrhoea after radiotherapy. And some men find it difficult to maintain a healthy weight, they might be over or under weight. Your doctor can refer you to a dietitian if you have problems.

What Are the Symptoms of Prostate Cancer?

There are no warning signs of early prostate cancer. Once a tumor causes the prostate gland to swell, or once cancer spreads beyond the prostate, the following symptoms may happen:
• A frequent need to urinate, especially at night
• Difficulty starting or stopping a stream of urine
• A weak or interrupted urinary stream
• Leaking of urine when laughing or coughing
• Inability to urinate standing up
• A painful or burning sensation during urination or ejaculation
• Blood in urine or semen

These are not symptoms of the cancer itself; instead, they are caused by the blockage from the cancer growth in the prostate. They can also be caused by an enlarged, noncancerous prostate or by aurinary tract infection.

Symptoms of advanced prostate cancer include:
• Dull, deep pain or stiffness in the pelvis, lower back, ribs, or upper thighs; pain in the bones of those areas
• Loss of weight and appetite, fatigue, nausea, or vomiting
• Swelling of the lower extremities
• Weakness or paralysis in the lower limbs, often with constipation

Call Your Doctor About Prostate Cancer If:
• You have trouble urinating or find that urination is painful or different from normal; your doctor should examine your prostate gland to determine whether it is enlarged, inflamed with an infection, or cancerous.
• You have chronic pain in your lower back, pelvis, upper thighbones, or other bones. Pain in these areas can be caused by different things, including the spread of prostate cancer.
• You have unexplained weight loss.
• You have swelling in your legs.
• You have weakness in your legs or difficulty walking, especially if you also have constipation.

Staging Prostate Cancer

While the grade tells you how fast your cancer is growing, the stage lets you know how advanced the cancer is. Most doctors use the TNM staging system. It uses a number system to show how big the tumor is and how far the cancer has spread.

TNM System
• T (Tumor): The extent of the primary tumor is determined by describing its size and location. If the tumor can’t be assessed, the stage is TX. If no tumor is found, the stage is T0.

As the size and spread increase, so does the stage -- T1, T2, T3, or T4. In addition to the basic categories, doctors may use subcategories like T1a or T1b to add more description.

• N (Nodes): This determines if the cancer has spread to the lymph nodes near your bladder. If the nodes can’t be assessed, the stage is NX. If no nodes are affected, the stage is N0. If there is cancer in the nodes, the stage is N1.

• M (Metastasis): The cancer has either spread to the bones or other organs (M1) or hasn’t (M0). Doctors may also use subsets like M1a for distant lymph nodes or M1b for bones, or M1c for other sites.

Stage Grouping
Doctors combine the T, N, and M results with the Gleason score (grade) and PSA level in a process called stage grouping. The overall stage is expressed in Roman numerals from I (the least advanced) to IV (the furthest along). Doctors use the stage to help determine the best course of treatment for you.

Stage I
• The cancer is growing in your prostate, but hasn’t yet spread beyond it.
• In most cases, the tumor can’t be felt during a digital rectal exam (DRE) or seen in imaging tests.
• The Gleason score is 6 or less and the PSA level is less than 10.
• The tumor is in one-half or less of only one side of the prostate.

Stage IIA
• The cancer is growing in your prostate, but hasn’t spread beyond it.
• The doctor may or may not be able to feel the tumor during the DRE or see it on an imaging test.
• The tumor can touch more than half of one lobe of the prostate but doesn’t involve both lobes.
• The Gleason score is 7 or less and the PSA level is less than 20.

Stage IIB
• The cancer is growing in the prostate, but hasn’t spread beyond it.
• The doctor may or may not be able to feel the tumor during the DRE or see it on an imaging test.
• The tumor can be in one or both lobes of the prostate.
• The tumor can have any Gleason score and the PSA can be any level.

Stage III
• The cancer has spread outside the prostate but hasn’t made it to the lymph nodes or anywhere else in your body.
• The tumor can have any Gleason score and PSA can be any level.

Stage IV
• The cancer has spread outside the prostate to other tissues -- usually lymph nodes, bones, liver, or lungs.
• The tumor can have any Gleason score and PSA can be any level.

Your Treatment Options

There's no single option that’s right for every man with prostate cancer. Some tumors grow very slowly or not at all, so you may never need treatment. Others grow faster and spread to different places in your body. In either case, you and your doctor will work together to decide what's best for you.

The treatment you need will depend on a few things:
• Your age, health, and lifestyle
• How serious your prostate cancer is (how large the tumor is and if it has spread in your body)
• Your thoughts (and your doctor’s opinion) about if you need to treat the cancer right away
• Possible side effects
• The chance that a treatment will help or cure your cancer

The most common prostate cancer treatments are:

Watchful waiting;
If you have a small, slow-growing tumor, you and your doctor may decide to just keep a close eye on your disease. This is sometimes called active surveillance or observation. You may have regular PSA (prostate-specific antigen) blood tests, rectal exams, ultrasounds, and biopsies to see if the cancer is getting worse. If it starts to grow or spread, you can explore other treatments.

Surgery : It’s an option if you're healthy and your cancer hasn't spread. There are several types. Your doctor may only remove your prostate gland. Or he might take it and the tissue around it. The most common side effects from an operation are problems controlling your urine and trouble getting and keeping an erection. Sometimes they go away on their own after surgery, especially bladder control issues. Talk to your surgeon beforehand to see if he thinks he'll be able to protect the nerves around your prostate to prevent these side effects. Radiation therapy. This treatment uses high-energy beams (similar to X-rays) to kill the cancer. It's often a choice for older men and for those with other health problems. You also might have it after surgery to get rid of any cancer cells left behind. It also helps for cancer that has spread to the bone.

There are two types of radiation:
• External: A machine outside your body directs rays at the cancer. • Internal (brachytherapy): A doctor does surgery to place small radioactive "seeds" into or near the cancer.

• Sometimes, a mix of both treatments works best. • Hormone therapy :
Prostate cancer cells need male sex hormones, like testosterone, to keep growing. This treatment keeps the cancer cells from getting them. Your doctor might call it called androgen deprivation therapy. Some hormone treatments lower the levels of testosterone and other male hormones. Other types block the way those hormones work.

• Cryotherapy : If you have early prostate cancer, your doctor might choose to kill cancer cells by freezing them. He’ll put small needles or probes into your prostate to deliver very cold gasses that destroy the cells. • It’s hard to say for sure how well it works. Scientists haven’t done much long-term research that focuses on using it to treat prostate cancer. It's usually not the first treatment option a doctor recommends.

• High-intensity focused ultrasound : This device produces sound waves that deliver heat energy to kill cancer cells. It’s unclear how well it works as it hasn’t yet been compared with other standard prostate cancer treatments.

• Chemotherapy : This treatment uses drugs to shrink or kill prostate cancer cells. You can take the drugs by mouth or have them injected into your bloodstream. Most men with early prostate cancer don’t get chemo. It’s usually only for advanced cases or when the cancer has spread to other parts of the body.

• Cancer vaccine Most work by boosting your body's defenses so it can fight an infection. The prostate cancer vaccine gets your immune system to attack cancer cells. This treatment works best if you’ve tried hormone therapy and it isn't working anymore. The vaccine is custom-made for you. Scientists don’t know if it stops or slows down the cancer’s growth, but it does seem to help men live longer with prostate cancer.

• Bone-directed treatment : If the cancer reaches your bones, drugs called bisphosphonates can help ease pain and prevent breaks. Your doctor may also suggest a medication given in your veins that sends radiation directly to bones.

• You may start with one of these treatments and change it, or your doctor might mix different treatments. You’ll work together to find the best plan.

Prostate Cancer - Prevention

One thing you can do that may lower the risk for prostate cancer is eat more low-fat, high-fiber foods and foods with omega-3 fatty acids, such as:
• Soy products, like tofu and soy beans.
• Tomatoes and foods that contain tomato sauce.
• Vegetables like broccoli, cauliflower, and cabbage.
• Fish, like salmon, albacore tuna, and sardines.
• Walnuts and flaxseed, and their oils.

Being physically active and staying at ahealthy body weight also can help reduce the risk of prostate cancer.

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