https://www.sandiegohealthdirectory.com/kb en-us Adult brain tumors are diseases in which cancer (malignant) cells begin to grow in the tissues of the brain. The brain controls memory and learning, senses - hearing, sight, smell, taste, and touch, and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels. Tumors that start in the brain are called primary brain tumors. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=175 Fri, 04 Aug 2006 08:35:05 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=175
Often, tumors found in the brain have started somewhere else in the body and spread (metastasized) to the brain. These are called metastatic brain tumors.

A doctor should be seen if the following symptoms appear:
1. Frequent headaches.
2. Vomiting.
3. Loss of appetite.
4. Changes in mood and personality.
5. Changes in ability to think and learn.

Tests that examine the brain and spinal cord are used to detect adult brain tumor. The following tests and procedures may be used:
1. CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
2. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Adult brain tumor is diagnosed and removed in surgery. If a brain tumor is suspected, a biopsy is done by removing part of the skull and using a needle to remove a sample of the brain tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery. An MRI may then be done to determine if any cancer cells remain after surgery. Tests are also done to find out the grade of the tumor.

The grade of a tumor refers to how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. The pathologist determines the grade of the tumor using tissue removed for biopsy. The following grading system may be used for adult brain tumors:
1. Grade I
2. The tumor grows slowly, has cells that look similar to normal cells, and rarely spreads into nearby tissues. It may be possible to remove the entire tumor by surgery.
3. Grade II
4. The tumor grows slowly, but may spread into nearby tissue and may become a higher-grade tumor.
5. Grade III
6. The tumor grows quickly, is likely to spread into nearby tissue, and the tumor cells look very different from normal cells.
7. Grade IV
8. The tumor grows very aggressively, has cells that look very different from normal cells, and is difficult to treat successfully.
9. The chance of recovery and choice of treatment depend on the type, grade, and location of the tumor and whether cancer cells remain after surgery and/or have spread to other parts of the brain.

No one knows the exact causes of brain tumors. Doctors can seldom explain why one person develops a brain tumor and another does not. However, it is clear that brain tumors are not contagious. No one can "catch" the disease from another person.

Research has shown that people with certain risk factors are more likely than others to develop a brain tumor. A risk factor is anything that increases a person's chance of developing a disease.

The following risk factors are associated with an increased chance of developing a primary brain tumor:
1. Being male—In general, brain tumors are more common in males than females. However, meningiomas are more common in females.
2. Race—Brain tumors occur more often among white people than among people of other races.
3. Age—Most brain tumors are detected in people who are 70 years old or older. However, brain tumors are the second most common cancer in children. (Leukemia is the most common childhood cancer.) Brain tumors are more common in children younger than 8 years old than in older children.
4. Family history—People with family members who have gliomas may be more likely to develop this disease

Being exposed to radiation or certain chemicals at work:
1. Radiation—Workers in the nuclear industry have an increased risk of developing a brain tumor.
2. Formaldehyde—Pathologists and embalmers who work with formaldehyde have an increased risk of developing brain cancer. Scientists have not found an increased risk of brain cancer among other types of workers exposed to formaldehyde.
3. Vinyl chloride—Workers who make plastics may be exposed to vinyl chloride. This chemical may increase the risk of brain tumors.
4. Acrylonitrile—People who make textiles and plastics may be exposed to acrylonitrile. This exposure may increase the risk of brain cancer.

Scientists are investigating whether cell phones may cause brain tumors. Studies thus far have not found an increased risk of brain tumors among people who use cell phones.

Scientists also continue to study whether head injuries are a risk factor for brain tumors.

So far, these studies have not found an increased risk among people who have had head injuries.

Most people who have known risk factors do not get brain cancer. On the other hand, many who do get the disease have none of these risk factors. People who think they may be at risk should discuss this concern with their doctor. The doctor may be able to suggest ways to reduce the risk and can plan an appropriate schedule for checkups.

A tumor that begins in the brain is called a primary brain tumor. In children, most brain tumors are primary tumors. In adults, most tumors in the brain have spread there from the lung, breast, or other parts of the body. When this happens, the disease is not brain cancer. The tumor in the brain is a secondary tumor. It is named for the organ or the tissue in which it began.

Treatment for secondary brain tumors depends on where the cancer started and the extent of the disease.

The symptoms of brain tumors depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or damages a certain area of the brain. They also may be caused when the brain swells or fluid builds up within the skull.

These are the most common symptoms of brain tumors:
1. Headaches, usually worse in the morning.
2. Nausea or vomiting.
3. Changes in speech, vision, or hearing.
4. Problems balancing or walking.
5. Changes in mood, personality, or ability to concentrate.
6. Problems with memory.
7. Muscle jerking or twitching including seizures or convulsions.
8. Numbness or tingling in the arms or legs.

These symptoms are not sure signs of a brain tumor. Other conditions also could cause these problems. Anyone with these symptoms should see a doctor as soon as possible. Only a doctor can diagnose and treat the problem.

Living with a serious disease such as a brain tumor is not easy. Some people find they need help coping with the emotional and practical aspects of their disease. Support groups can help. In these groups, patients or their family members get together to share what they have learned about coping with the disease and the effects of treatment. Patients may want to talk with a member of their health care team about finding a support group. Groups may offer support in person, over the telephone, or on the Internet.

People living with a brain tumor may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.]]> Skin cancer is the most common form of cancer in the United States. The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=155 Fri, 28 Jul 2006 06:52:08 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=155
Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor involved in the development of skin cancer. When used consistently, sun-protective practices can prevent skin cancer. UV rays from artificial sources of light, such as tanning beds and sunlamps, are as dangerous as those from the sun and should also be avoided. Although both tanning and burning can increase a person's risk for skin cancer, most Americans do not consistently protect themselves from UV rays. A recent survey sponsored by the Centers for Disease Control and Prevention (CDC) found that approximately 43% of white children under age 12 had at least one sunburn during the past year.

In the United States, over 1,000,000 people are expected to get BCC or SCC this year. An additional 55,100 will develop melanoma. An estimated 7,910 individuals will die from melanoma.

To understand the significant increase in skin cancer rates, consider these facts. In the 1930s the lifetime risk of getting invasive melanoma was 1 in 1500. By contrast, the predicted lifetime chance for those living in the year 2000 was approximately 1 in 75, or 20 times the 1930s risk! People living in California have a greater risk for melanoma than the national average.

Sun exposure at any age can cause skin cancer. Be especially careful in the sun if you burn easily, spend a lot of time outdoors, or have any of the following physical features:
a. Numerous, irregular, or large moles.
b. Freckles.
c. Fair skin.
d. Blond, red, or light brown hair.

More Hazards From too Much Sunlight.

Since sun exposure is understood to be the major cause of skin cancer, it is extremely important to protect children and youth from too much sunshine. This caution is reinforced by the fact that up to 50 percent of an individual’s lifetime contact with sunshine occurs before adulthood - at least for children who, as adults, acquire indoor occupations. A teacher or parent’s efforts to help children adopt sun-safe behaviors are much preferred to treating skin cancer later in life.
The sun’s role in skin cancer results from its emission of invisible UV rays, which includes UVA and UVB. These two sectors of UV rays enter the skin cells causing both visible and invisible injuries. During the middle of the day, outdoor areas can be likened to a radiation chamber.

Sunburn is an example of visible injury. Childhood sunburns likely increase the risk that children will get melanoma in adulthood. Less well known is that tanning is actually an outward sign of internal damage as the skin desperately tries to protect itself. Unfortunately, a tan offers an inadequate defense against future solar assault.

Ozone, a naturally occurring “sunscreen” in the stratosphere above us, partially filters out harmful UVB. Unfortunately, the ozone layer is thinning from the release of chlorofluorocarbons (CFCs) into the air, along with other factors. CFCs are used in refrigerants, insulating foams, and solvents, etc. To slow down ozone layer destruction, many countries have signed treaties such as the Montreal Protocol on Substances that Deplete the Ozone Layer, which phase out the use of CFCs and other like substances.

UV rays linked to skin cancer development are more intense (destructive) under certain timeframes or conditions, usually related to the sun’s angle to the earth and/or the depth of atmosphere through which the sun’s rays must pass:
1. From 10 a.m. to 4 p.m.
2. From mid-spring through mid-fall.
3. At geographical latitudes nearer the equator (like Australia).
4. At higher altitudes.
5. Absent thick cloud cover.
6. With highly reflective surfaces such as water, snow, or light-colored sand, etc.

Individuals should also understand that tanning parlors, sun lamps, and sun beds emit UV radiation that is often more damaging than natural sunlight. Remember there is no safe tan resulting from UV exposure!

The UV Index predicts the concentration of UV rays bombarding a given geographical area. Since early Autumn 2000, there is a new, free service on the Internet that allows individuals to enter their zip code and obtain their neighborhood's predicted UV Index for the day.

Sunshine is both friend and foe. The sun provides warmth and light, improves mental health, kills germs, and is essential for growth and development of most living things. Unfortunately, excessive sun exposure can cause blistering sunburns, premature aging (wrinkles and blotches), cataracts, a weakened immune system, and skin cancer. (A cataract is a loss of transparency in the lens of the eye that clouds vision.)

With over one million new cases each year, skin cancer is now considered epidemic. This year there will be more new cases of skin cancer than the total of new cancers of the prostate, breast, lung, and colon combined! One of every five Americans is expected to get skin cancer in his or her lifetime.
Sunlight is believed to cause 90 percent of all skin cancer. The number of skin cancer cases has dramatically risen, especially in the last two to three decades, from these and other factors:
1. Increase in leisure time devoted to outdoor activities.
2. Decrease in coverage of modern clothing.
3. The current erroneous view that tanned skin is healthy/desirable.
4. Decreasing amounts of stratospheric ozone, which partially protects the earth's surface from receiving cancer-producing ultraviolet (UV) radiation, principally from the sun.
5. National population migration to sunnier regions/states.
6. General aging of the population, nationwide.

During April 2000, the U.S. Department of Health and Human Services--for the first time--listed solar radiation as a "known human carcinogen" via the Ninth Report on Carcinogens. Thus the Department effectively stated that UV rays had officially joined the ranks of known cancer-causing elements like arsenic, asbestos, radon, and tobacco smoke. Building on this declaration, the Office of Safety and Health Administration-during July 2000 - released formal sun safety protection guidelines for outdoor workers.

Skin cancer can afflict any person regardless of skin color. Individuals most likely to get skin cancer will tend to have some of these characteristics:
1. Fair skin.
2. Blue, green, or hazel eyes.
3. Light-colored hair (non-black).
4. Freckles.
5. Tendency to burn rather than tan.
6. History of severe sunburns.
7. Have many moles (especially 50 or more).
8. Personal or family history of skin cancer.
9. Outdoor occupation.

Many medications also increase a person’s sensitivity to light and therefore the risk for skin cancer. Some common examples include Aleve, Advil, Motrin, and Tetracycline to name a few. Read the medicine label or ask your pharmacist or doctor about your circumstances.

How to Protect People from Getting Skin Cancer.

Here are the basic strategies to shield children and adults from excessive sun exposure:
1. Reduce sun exposure from 10 a.m. to 4 p.m., when UV rays are strongest. This is especially important from mid-spring through mid-fall.
2. Wear a wide-brimmed hat with at least a four-inch brim that produces a shadow that covers the nose, eyes, face, ears, and back of neck. A bandana covering the neck can also help.
3. Wear tightly woven, loose fitting clothing that covers as much of the body as possible.
4. Find shade (trees, physical structures) to shield you, especially from 10 a.m. to 4 p.m.
5. Use sunglasses that include a warranty stating they provide 100 percent UVA and UVB (broad-spectrum) protection.
6. Liberally apply sunscreen to exposed skin 20 minutes before venturing outdoors. 7. The sunscreen container should have a sun protection factor (SPF) rating of 15 or above and should state that it provides broad-spectrum (UVA and UVB) protection. 8. Lotion- or cream-based sunscreens tend to adhere to the skin longer, thus providing better protection.
9. PABA-free sunscreens are recommended for persons with sensitive skin. 10. Susceptible individuals may also want to avoid oxybenzone and dioxbenzone (check the label). To test if a given sunscreen will cause an allergic reaction, apply it on a small patch of skin on the underside of the forearm and monitor the skin's response for 24 hours. To reduce development of wrinkles and skin aging, look for sunscreens that contain either zinc oxide (z-cote), or Parsol 1789 (avobenzone). The June 2001 issue of Consumer Reports rates a number of sunscreen products.
11. Depending on outdoor conditions, sunscreen should be re-applied at least every two hours.
12. Warning: Don't depend on sunscreens alone to protect children and adults from skin cancer. Instead, rely as much as possible on a combination of all the guidelines here listed.
13. Please note that the SPF number on the sunscreen tube indicates how many times longer-under ideal conditions-a person can stay out in the sun without beginning to turn red in comparison with the amount of time totally unprotected skin would start to burn. 14. Research indicates these numbers are sometimes overstated.
15. Avoid tanning salons, beds, and sunlamps.

Skin Cancer Types.

There are actually over 200 types of cancer that can invade skin tissue. The three major forms of cancer that originate in the skin are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and the deadliest form - malignant melanoma.

Skin cancer can develop anywhere on the body but most often appears on surfaces receiving the greatest amount of sunshine. BCC and SCC often take the form of a pale, wax-like, pearly bump or a red, scaly, sharply outlined patch. The patches may crust, discharge pus, and sometimes bleed.

If not treated early, SCC may spread to other parts of the body. Less than one percent of people with SCC or BCC will die from skin cancer. For many people, these two skin cancers can cause some disfigurement based on the amount of damaged skin the physician must remove. Luckily, the negative effects of surgery can be greatly minimized when the diseases are treated in their early stages.

Malignant melanoma is the most serious form of skin cancer. It often arises from or near a mole. It often appears on parts of the body, which receive little direct sunlight.

There are four basic warning signs that should prompt individuals to visit their physician, especially a dermatologist. Examine moles or growths for:
1. Asymmetry: an imaginary line drawn through the mole produces two halves that do not match.
2. Border: the border of the mole has an irregular shape or notched (jagged) edges.
3. Color: the color is not uniform but has a mixture or "bleeding” of colors such as black, brown, red, and blue, etc.
4. Diameter: the distance across is larger than a standard pencil eraser.
NOTE: Melanoma rates have increased three to four percent each year since at least the early eighties.

Whether or not an individual practices the previously stated skin cancer prevention methods, it is wise to perform a self-skin examination using a hand mirror at least once every one to three months and to seek an annual medical examination. The possible first signs of developing skin cancer can often be self-observed according to the characteristics described earlier regarding moles and growths. See your doctor if you suspect any problems.

It's important to examine your body monthly because skin cancers detected early can almost always be cured. The most important warning sign is a spot on the skin that is changing in size, shape, or color during a period of 1 month to 1 or 2 years.

Skin cancers often take the following forms:
1. Pale, wax-like, pearly nodules.
2. Red, scaly, sharply outlined patches.
3. Sores that don't heal.
4. Small, mole-like growths - melanoma, the most serious type of skin cancer.
If you find such unusual skin changes, see a health care professional immediately.

Block Out UV Rays:
1. Cover up. Wear tightly woven clothing that blocks out light. Try this test: Place your hand between a single layer of the clothing and a light source. If you can see your hand through the fabric, the garment offers little protection.
2. Use sunscreen. A sun protection factor (SPF) of at least 15 blocks 93 percent of UV rays. You want to block both UVA and UVB rays to guard against skin cancer. Be sure to follow application directions on the bottle.
3. Wear a hat. A wide brim hat (not a baseball cap) is ideal because it protects the neck, ears, eyes, forehead, nose, and scalp.
4. Wear UV-absorbent shades. Sunglasses don't have to be expensive, but they should block 99 to 100 percent of UVA and UVB radiation.
5. Limit exposure. UV rays are most intense between 10 a.m. and 4 p.m. If you're unsure about the sun's intensity, take the shadow test: If your shadow is shorter than you, the sun's rays are the day's strongest. ]]> Prostate cancer means that cancer cells form in the tissues of the prostate. It is the most common cancer in American men after skin cancer. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=154 Fri, 28 Jul 2006 05:37:46 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=154
Prostate cancer tends to grow slowly compared with most other cancers. Cell changes may begin 10, 20, or 30 years before a tumor gets big enough to cause symptoms. Eventually, cancer cells may spread or metastasize throughout the body. By the time symptoms appear, the cancer may be more advanced.

By age 50, very few men have symptoms of prostate cancer, yet some precancerous or cancerous cells are present. More than half of all American men have some cancer in their prostate glands by the age of 80.

The prostate is a gland in the male reproductive system located just below the bladder, the organ that collects and empties urine and in front of the rectum - the lower part of the intestine. It is about the size of a walnut and surrounds part of the urethra - the tube that empties urine from the bladder. The prostate gland produces fluid that makes up part of the semen.

Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficulty in urination or can interfere with sexual function. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be similar to symptoms of prostate cancer.

These and other symptoms may be caused by prostate cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
1. Weak or interrupted flow of urine.
2. Frequent urination (especially at night).
3. Trouble urinating.
4. Pain or burning during urination.
5. Blood in the urine or semen.
6. A pain in the back, hips, or pelvis that doesn't go away.
7. Painful ejaculation.

Coping with Cancer
1. Fatigue.
2. Pain.
3. Side Effects/ Other Complications.
4. Nutritional Concerns.
5. Emotional Concerns.
6. End-of-Life Issues.
7. Treatment Related Issues.

The following tests and procedures may be used:

Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas.

Prostate-specific antigen (PSA) test: A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH - an enlarged, but noncancerous, prostate.

Transrectal ultrasound: A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Transrectal ultrasound may be used during a biopsy procedure.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will examine the biopsy sample to check for cancer cells and determine the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread. There are 2 types of biopsy procedures used to diagnose prostate cancer:

Transrectal biopsy: The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide the needle. A pathologist views the tissue under a microscope to look for cancer cells.

Transperineal biopsy: The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate. A pathologist views the tissue under a microscope to look for cancer cells.

The chance of recovery and treatment options depend on the following:
1. The stage of the cancer; whether it affects part of the prostate, involves the whole prostate, or has spread to other places in the body.
2. The patient’s age and health.
3. Whether the cancer has just been diagnosed or has recurred.
4. Prognosis also depends on the Gleason score and the level of PSA.

The process used to find out if cancer has spread within the prostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

Radionuclide bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

Seminal vesicle biopsy: The removal of fluid from the seminal vesicles (glands that produce semen) using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

The stage of the cancer is based on the results of the staging and diagnostic tests, including the original tumor biopsy. The biopsy is used to determine the Gleason score. The Gleason score ranges from 2-10 and describes how different the cancer cells look from normal cells and how likely it is that the tumor will spread. The lower the number, the less likely the tumor is to spread.

The following stages are used for prostate cancer:

Stage I
In stage I, cancer is found in the prostate only. It cannot be felt during a digital rectal exam and is not visible by imaging. It is usually found accidentally during surgery for other reasons, such as benign prostatic hyperplasia. The Gleason score is low. Stage I prostate cancer may also be called stage A1 prostate cancer.

Stage II
In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. The Gleason score can range from 2-10. Stage II prostate cancer may also be called stage A2, stage B1, or stage B2 prostate cancer.

Stage III
In stage III, cancer has spread beyond the outer layer of the prostate to nearby tissues. Cancer may be found in the seminal vesicles. The Gleason score can range from 2-10. Stage III prostate cancer may also be called stage C prostate cancer.

Stage IV
In stage IV, cancer has metastasized to lymph nodes near or far from the prostate or to other parts of the body, such as the bladder, rectum, bones, liver, or lungs. Metastatic prostate cancer often spreads to the bones. The Gleason score can range from 2-10. Stage IV prostate cancer may also be called stage D1 or stage D2 prostate cancer.

Recurrent prostate cancer is cancer that has recurred after it has been treated. The cancer may come back in the prostate or in other parts of the body.

There are different types of treatment for patients with prostate cancer.

Different types of treatment are available for patients with prostate cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Watchful waiting.
Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early-stage disease.(see Footnote.)

Surgery.

Patients in good health are usually offered surgery as treatment for prostate cancer. The following types of surgery are used:

Pelvic lymphadenectomy: A surgical procedure to remove the lymph nodes in the pelvis. A pathologist views the tissue under a microscope to look for cancer cells. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment.

Radical prostatectomy: A surgical procedure to remove the prostate, surrounding tissue, and seminal vesicles. There are 2 types of radical prostatectomy:

Retropubic prostatectomy: A surgical procedure to remove the prostate through an incision in the abdominal wall. Removal of nearby lymph nodes may be done at the same time.

Perineal prostatectomy: A surgical procedure to remove the prostate through an incision (cut) made in the perineum an area between the scrotum and anus. Nearby lymph nodes may also be removed through a separate incision in the abdomen.

Transurethral resection of the prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope - a thin, lighted tube with a cutting tool inserted through the urethra. This procedure is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. Transurethral resection of the prostate may also be done in men who cannot have a radical prostatectomy because of age or illness.

Impotence and leakage of urine from the bladder or stool from the rectum may occur in men treated with surgery. In some cases, doctors can use a technique known as nerve-sparing surgery. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Impotence and urinary problems may occur in men treated with radiation therapy.

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

Hormone therapy used in the treatment of prostate cancer may include the following:

1. Luteinizing hormone-releasing hormone agonists can prevent the testicles from producing testosterone. Examples are leuprolide, goserelin, and buserelin.
2. Antiandrogens can block the action of androgens, hormones that promote male sex characteristics. Two examples are flutamide and bicalutamide.
3. Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide.
4. Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, to decrease hormone production.
5. Estrogens, hormones that promote female sex characteristics can prevent the testicles from producing testosterone. However, estrogens are seldom used today in the treatment of prostate cancer because of the risk of serious side effects.

Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy.

New types of treatment are being tested in clinical trials. These include the following:

Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. This type of treatment is also called cryotherapy.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Biologic therapy:

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

High-intensity focused ultrasound:

High-intensity focused ultrasound is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves.

Stage I Prostate Cancer:

Treatment of stage I prostate cancer may include the following:
1. Watchful waiting.
2. Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery. It may be possible to remove the prostate without damaging nerves that are necessary for an erection.
3. External-beam radiation therapy.
4. Implant radiation therapy.
5. A clinical trial of high-intensity focused ultrasound.
6. A clinical trial of radiation therapy.
7. A clinical trial evaluating new treatment options.

Stage II Prostate Cancer:
Treatment of stage II prostate cancer may include the following:
1. Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery. It may be possible to remove the prostate without damaging nerves that are necessary for an erection.
2. Watchful waiting.
3. External-beam radiation therapy.
4. Implant radiation therapy.
5. A clinical trial of radiation therapy with or without hormone therapy.
6. A clinical trial of ultrasound-guided cryosurgery.
7. A clinical trial of hormone therapy followed by radical prostatectomy.
8. A clinical trial evaluating new treatment options.

Stage III Prostate Cancer:

Treatment of stage III prostate cancer may include the following:
1. External-beam radiation therapy with or without hormone therapy.
2. Hormone therapy.
3. Radical prostatectomy, usually with pelvic lymphadenectomy, with or without radiation therapy after surgery.
4 Watchful waiting.
5. Radiation therapy, hormone therapy, or transurethral resection of the prostate as palliative therapy to relieve symptoms caused by the cancer.
6. A clinical trial of radiation therapy.
7. A clinical trial of ultrasound-guided cryosurgery.
8. A clinical trial evaluating new treatment options.

Stage IV Prostate Cancer:

Treatment of stage IV prostate cancer may include the following:
1. Hormone therapy.
2. External-beam radiation therapy with or without hormone therapy.
3. Radiation therapy or transurethral resection of the prostate as palliative therapy to relieve symptoms caused by the cancer.
4. Watchful waiting.
5. A clinical trial of radical prostatectomy with orchiectomy.

Treatment Options for Recurrent Prostate Cancer.

Treatment of recurrent prostate cancer may include the following:
1. Radiation therapy.
2. Prostatectomy for patients initially treated with radiation therapy.
3. Hormone therapy.
4. Pain medication, external radiation therapy, internal radiation therapy with radioisotopes such as strontium-89, or other treatments as palliative therapy to lessen bone pain.
5. A clinical trial of ultrasound-guided cryosurgery.
6. A clinical trial of chemotherapy or biological therapy.


Checklist of Questions for Your Doctor.

What type of prostate problem do I have?
Is more testing needed and what will it tell me?
If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
What type of treatment do you recommend for my prostate problem?
For men like me, has this treatment worked?
How soon would I need to start treatment and how long would it last?
Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
What are the side effects of the medicine?
Are there other medicines that could interfere with this medication?
If I need surgery, what are the benefits and risks?
Would I have any side effects from surgery that could affect my quality of life?
Are these side effects temporary or permanent?
How long is recovery time after surgery?
Will I be able to fully return to normal?
How will this affect my sex life?
How often should I visit the doctor to monitor my condition?

FOOTNOTE:
Watchful waiting. The prostate-specific antigen (PSA) blood test can help detect prostate cancer at a very early stage. This allows many men to choose watchful waiting as a treatment option. In watchful waiting also known as observation, expectant therapy or deferred therapy, regular follow-up blood tests, rectal exams and biopsies may be performed to monitor for evidence of progression of your cancer.]]> The American Cancer Society estimates that there will be 93,800 new cases of colon cancer diagnosed in the US in 2006, with 47,700 resulting deaths. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=153 Thu, 27 Jul 2006 08:40:03 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=153
Colon cancer is one of the most common inherited cancer syndromes known. Among the genes found to be involved in colorectal cancer are: MSH2 and MSH6 both on chromosome 2 and MLH1, on chromosome 3. Normally, the protein products of these genes help to repair mistakes made in DNA replication. If the MSH2, MSH6, and MLH1 proteins are mutated and therefore don't work properly, the replication mistakes are not repaired, leading to damaged DNA and, in this case, colon cancer.

It is not clear why mutations in genes that are essential in all tissues preferentially cause cancer in the colon. However, studies on the equivalent genes in mice and brewer's yeast are helping to further our understanding of the mechanisms of DNA repair and the role that environmental factors might play in colon cancer incidence.

No one knows the exact causes of colorectal cancer. Doctors can seldom explain why one person develops the disease and another does not. However, it is clear that colorectal cancer is not contagious. No one can "catch" this disease from another person.

Research has shown that people with certain risk factors are more likely than others to develop colorectal cancer. A risk factor is anything that is linked to an increased chance of developing a disease.

Cancer of the colon or rectum is also called colorectal cancer. In the United States, colorectal cancer is the fourth most common cancer in men, after skin, prostate, and lung cancer. It is also the fourth most common cancer in women, after skin, lung, and breast cancer.

Studies have found the following risk factors for colorectal cancer:

1. Age: Colorectal cancer is more likely to occur, as people get older. More than 90 percent of people with this disease are diagnosed after age 50. The average age at diagnosis is in the mid-60s.
2. Colorectal polyps: Polyps are growths on the inner wall of the colon or rectum. They are common in people over age 50. Most polyps are benign - noncancerous, but some polyps - adenomas can become cancer. Finding and removing polyps may reduce the risk of colorectal cancer.
3. Family history of colorectal cancer: Close relatives (parents, brothers, sisters, or children) of a person with a history of colorectal cancer are somewhat more likely to develop this disease themselves, especially if the relative had the cancer at a young age. If many close relatives have a history of colorectal cancer, the risk is even greater.
4. Genetic alterations: Changes in certain genes increase the risk of colorectal cancer.
a. Hereditary nonpolyposis colon cancer (HNPCC) is the most common type of inherited (genetic) colorectal cancer. It accounts for about 2 percent of all colorectal cancer cases. It is caused by changes in an HNPCC gene. About 3 out of 4 people with an altered HNPCC gene develop colon cancer, and the average age at diagnosis of colon cancer is 44.
b. Familial adenomatous polyposis (FAP) is a rare, inherited condition in which hundreds of polyps form in the colon and rectum. It is caused by a change in a specific gene called APC. Unless familial adenomatous polyposis is treated, it usually leads to colorectal cancer by age 40. FAP accounts for less than 1 percent of all colorectal cancer cases.

Family members of people who have HNPCC or FAP can have genetic testing to check for specific genetic changes. For those who have changes in their genes, health care providers may suggest ways to try to reduce the risk of colorectal cancer, or to improve the detection of this disease. For adults with FAP, the doctor may recommend an operation to remove all or part of the colon and rectum.

Personal history of colorectal cancer: A person who has already had colorectal cancer may develop colorectal cancer a second time. Also, women with a history of cancer of the ovary, uterus (endometrium), or breast are at a somewhat higher risk of developing colorectal cancer.
1. Ulcerative colitis or Crohn's disease: A person who has had a condition that causes inflammation of the colon (such as ulcerative colitis or Crohn's disease) for many years is at increased risk of developing colorectal cancer.
2. Diet: Studies suggest that diets high in fat (especially animal fat) and low in calcium, folate, and fiber may increase the risk of colorectal cancer. Also, some studies suggest that people who eat a diet very low in fruits and vegetables may have a higher risk of colorectal cancer. More research is needed to better understand how diet affects the risk of colorectal cancer.
3. Cigarette smoking: A person who smokes cigarettes may be at increased risk of developing polyps and colorectal cancer.

Three types of standard treatment are used. These include the following:

A. Surgery.

Surgery - removing the cancer in an operation is the most common treatment for all stages of colon cancer. A doctor may remove the cancer using one of the following types of surgery:
1. Local excision: If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube through the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp that is a small bulging piece of tissue, the operation is called a polypectomy.

2. Resection: If the cancer is larger, the doctor will perform a partial colectomy, removing the cancer and a small amount of healthy tissue around it. The doctor may then perform an anastomosis, sewing the healthy parts of the colon together. The doctor will also usually remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer.

3. Resection and colostomy: If the doctor is not able to sew the 2 ends of the colon back together, a stoma - an opening is made on the outside of the body for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.

4. Radiofrequency ablation: The use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.

5. Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy.

Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

B. Chemotherapy.

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body - systemic chemotherapy. When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas - regional chemotherapy.

Chemoembolization of the hepatic artery may be used to treat cancer that has spread to the liver. This involves blocking the hepatic artery which is the main artery that supplies blood to the liver and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.

The way the chemotherapy is given depends on the type and stage of the cancer being treated.

C. Radiation therapy.

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Other types of treatment are being tested in clinical trials. These include the following:

Biologic therapy.

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

Follow-up exams may help find recurrent colon cancer earlier.

After treatment, a blood test to measure carcinoembryonic antigen (CEA; a substance in the blood that may be increased when colon cancer is present) may be done along with other tests to see if the cancer has come back.

People who think they may be at risk should discuss this concern with their doctor. The doctor may be able to suggest ways to reduce the risk and can plan an appropriate schedule for checkups. ]]> The prostate is part of a man's reproductive system. It is located in front of the rectum and under the bladder. It surrounds the urethra, the tube through which urine flows. A healthy prostate is about the size of a walnut. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=124 Wed, 28 Jun 2006 03:05:51 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=124
The prostate makes part of seminal fluid. During ejaculation, seminal fluid helps carry sperm out of the man's body as part of semen.

Male hormones make the prostate grow. The testicles are the main source of male hormones, including testosterone. The adrenal gland also makes testosterone, but in small amounts.

If the prostate grows too large, it squeezes the urethra. This may slow or stop the flow of urine from the bladder to the penis.

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.

Normally, cells grow and divide to form new cells, as the body needs them. When cells grow old, they die, and new cells take their place.

Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant.

Benign tumors are not cancer:
1. Benign tumors are rarely life-threatening.
2. Generally, benign tumors can be removed. They usually do not grow back.
3. Cells from benign tumors do not invade the tissues around them.
4. Cells from benign tumors do not spread to other parts of the body.

Malignant tumors are cancer:
1. Malignant tumors are generally more serious than benign tumors. They may be life threatening.
2. Malignant tumors often can be removed. But sometimes they grow back.
3. Cells from malignant tumors can invade and damage nearby tissues and organs.
4. Cells from malignant tumors can spread (metastasize) to other parts of the body.
5. Cancer cells spread by breaking away from the original/primary tumor and entering the bloodstream or lymphatic system. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.

When prostate cancer spreads, cancer is often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it is treated as prostate cancer, not bone cancer. Doctors call the new tumor distant or metastatic disease.

No one knows the exact causes of prostate cancer. Doctors often cannot explain why one man develops prostate cancer and another does not. However, we do know that prostate cancer is not contagious. You cannot catch it from another person.

Research has shown that men with certain risk factors are more likely than others to develop prostate cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for prostate cancer:
1. Age: Age is the main risk factor for prostate cancer. This disease is rare in men younger than 45. The chance of getting it goes up sharply as a man gets older. In the United States, most men with prostate cancer are older than 65.
2. Family history: A man's risk is higher if his father or brother had prostate cancer.
3. Race: Prostate cancer is more common in African American men than in white men, including Hispanic white men. It is less common in Asian and American Indian men.
4. Certain prostate changes: Men with cells called high-grade prostatic intraepithelial neoplasia (PIN) may be at increased risk for prostate cancer. These prostate cells look abnormal under a microscope.
5. Diet: Some studies suggest that men who eat a diet high in animal fat or meat may be at increased risk for prostate cancer. Men who eat a diet rich in fruits and vegetables may have a lower risk.
6. Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. You can help protect yourself by staying away from known risk factors whenever possible.

Scientists have also studied whether *BPH, obesity, smoking, a virus passed through sex, or lack of exercise might increase the risk for prostate cancer. At this time, these are not clear risk factors. Also, most studies have not found an increased risk of prostate cancer for men who have had a vasectomy. A vasectomy is surgery to cut or tie off the tubes that carry sperm out of the testicles.

*Note:
Benign prostatic hyperplasia (BPH) is the abnormal growth of benign prostate cells. The prostate grows larger and squeezes the urethra. This prevents the normal flow of urine. BPH is a very common problem. In the United States, most men over the age of 50 have symptoms of BPH. For some men, symptoms may be severe enough to need treatment.

Most men who have known risk factors do not get prostate cancer. On the other hand, men who do get the disease often have no known risk factors, except for growing older.

If you think you may be at risk, you should talk with your doctor. Your doctor may be able to suggest ways to reduce your risk and can plan a schedule for checkups.

Your doctor can check you for prostate cancer before you have any symptoms. Screening can help doctors find and treat cancer early. But studies so far have not shown that screening tests reduce the number of deaths from prostate cancer. You may want to talk with your doctor about the possible benefits and harms of being screened. The decision to be screened, like many other medical decisions, is a personal one. You should decide after learning the pros and cons of screening.

Your doctor can explain more about these tests:
1. Digital rectal exam: The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall. The prostate is checked for hard or lumpy areas.
Blood test for prostate-specific antigen (PSA): A lab checks the level of PSA in a man's blood sample. A high PSA level is commonly caused by BPH or prostatitis - inflammation of the prostate. Prostate cancer may also cause a high PSA level.

The digital rectal exam and PSA test can detect a problem in the prostate. They cannot show whether the problem is cancer or a less serious condition. Your doctor will use the results of these tests to help decide whether to check further for signs of cancer.

A man with prostate cancer may not have any symptoms. For men who have symptoms of prostate cancer, common symptoms include:
1. Urinary problems.
2. Not being able to urinate.
3. Having a hard time starting or stopping the urine flow.
4. Needing to urinate often, especially at night.
5. Weak flow of urine.
6. Urine flow that starts and stops.
7. Pain or burning during urination.
8. Difficulty having an erection.
9. Blood in the urine or semen.
10. Frequent pain in the lower back, hips, or upper thighs.

Most often, these symptoms are not due to cancer. BPH, an infection, or another health problem may cause them. Any man with these symptoms should tell his doctor so that problems can be diagnosed and treated as early as possible. He may see his regular doctor or an urologist. An urologist is a doctor whose specialty is diseases of the urinary system.

If you have a symptom or test result that suggests cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor will ask about your personal and family medical history. You will have a physical exam. You may have lab tests. Your visit may include a digital rectal exam, a urine test to check for blood or infection, and a blood test to measure PSA level.

You also may have other exams:
1. Transrectal ultrasound: The doctor inserts a probe into the man's rectum to check for abnormal areas. The probe sends out sound waves that people cannot hear (ultrasound). The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.
2. Cystoscopy: The doctor uses a thin, lighted tube to look into the urethra and bladder.
3. Transrectal biopsy: A biopsy is the removal of tissue to look for cancer cells. It is the only sure way to diagnose prostate cancer. The doctor inserts a needle through the rectum into the prostate. The doctor takes small tissue samples from many areas of the prostate. Ultrasound may be used to guide the needle. A pathologist checks for cancer cells in the tissue.

If the physical exam and test results do not suggest cancer, your doctor may suggest medicine to reduce symptoms caused by an enlarged prostate. Surgery also can relieve these symptoms. The surgery most often used in such cases is transurethral resection of the prostate (TURP or TUR). In TURP, an instrument is inserted through the urethra to remove prostate tissue that is pressing against the upper part of the urethra and restricting the flow of urine. You should talk to your doctor about the best treatment option.

If cancer is present, the pathologist studies tissue samples from the prostate under a microscope to report the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue. It suggests how fast the tumor is likely to grow. Tumors with higher grades tend to grow faster than those with lower grades. They are also more likely to spread.

One system of grading prostate cancer uses G1 through G4. Another way of grading is with the Gleason score. The pathologist gives each area of cancer a grade of 1 through 5. The pathologist adds the two most common grades together to make a Gleason score. Or the pathologist may add the most common grade and the highest (most abnormal) grade to get the score. Gleason scores can range from 2 to 10.

To plan your treatment, your doctor needs to know the extent (stage) of the disease. The stage is based on the size of the tumor, whether the cancer has spread outside the prostate and, if so, where it has spread.

You may have blood tests to see if the cancer has spread. Some men also may need imaging tests:
1. Bone scan: The doctor injects a small amount of a radioactive substance into a blood vessel. It travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones on a computer screen or on film. The pictures may show cancer that has spread to the bones.
2. CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside your body. Doctors often use CT scans to see the pelvis or abdomen.
3. MRI: A strong magnet linked to a computer is used to make detailed pictures of areas inside your body.

These are the stages of prostate cancer:
Stage I: The cancer cannot be felt during a digital rectal exam. It is found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate.
Stage II: The cancer is more advanced, but it has not spread outside the prostate.
Stage III: The cancer has spread outside the prostate. It may be in the seminal vesicles. It has not spread to the lymph nodes.
Stage IV: The cancer may be in nearby muscles and organs (beyond the seminal vesicles). It may have spread to the lymph nodes. It may have spread to other parts of the body.

Recurrent cancer is cancer that has come back after a time when it could not be detected. It may recur in or near the prostate. Or it may recur in any other part of the body, such as the bones.

Many men with prostate cancer want to take an active part in making decisions about their care. It is natural to want to learn all you can about prostate cancer and your treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything you want to ask your doctor. It often helps to make a list of questions before an appointment.

To help remember what the doctor says, you may take notes or ask whether you may use a tape recorder. You may also want to have a family member or friend with you when you talk to the doctor - to take part in the discussion, to take notes, or just to listen.

You do not need to ask all your questions at once. You will have other chances to ask your doctor or nurse to explain things that are not clear and to ask for more details.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat prostate cancer include urologists, urologic oncologists, medical oncologists, and radiation oncologists.

Before starting treatment, you might want a second opinion about your diagnosis and treatment plan. Many insurance companies cover a second opinion if you or your doctor requests it. It may take some time and effort to gather medical records and arrange to see another doctor. Usually it is not a problem to take several weeks to get a second opinion. In most cases, the delay in starting treatment will not make treatment less effective. To make sure, you should discuss this delay with your doctor. Some men with prostate cancer need treatment right away.

There are a number of ways to find a doctor for a second opinion:
1. Your doctor may refer you to one or more specialists. At cancer centers, several specialists often work together as a team.
2. NCI's Cancer Information Service, at 1-800-4-CANCER, can tell you about nearby treatment centers.
3. A local or state medical society, a nearby hospital, or a medical school can usually provide the names of specialists.
4. The American Board of Medical Specialties has a list of doctors who have had training and passed exams in their specialty. You can find this list in the Official ABMS Directory of Board Certified Medical Specialists. This Directory is in most public libraries.

Men with prostate cancer have many treatment options. The treatment that is best for one man may not be best for another.

Treatment may involve surgery, radiation therapy, or hormone therapy. You may have a combination of treatments. If your doctor recommends watchful waiting, your health will be monitored closely. You will have treatment only if symptoms occur or get worse.

Cancer treatment is either local therapy or systemic therapy:
1. Local therapy: Surgery and radiation therapy are local treatments. They remove or destroy cancer in the prostate. When prostate cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
2. Systemic therapy: Hormone therapy is systemic therapy. Hormones are given to control cancer that has spread.

The treatment that is right for you depends on the stage of the cancer, the grade of the tumor, your symptoms, and your general health. Your doctor will describe your treatment choices and the expected results.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each man, and they may change from one treatment session to the next.

You should consider both the expected benefits and possible side effects of each treatment option. You may want to discuss with your doctor the possible effects on sexual activity. You can work with your doctor to create a treatment plan that reflects your medical needs and personal values.

At any stage of disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns.

You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods.

Surgery is a common treatment for early stage prostate cancer. Your doctor may remove the whole prostate or only part of it. In some cases, your doctor can use a method known as nerve-sparing surgery. This type of surgery may save the nerves that control erection. But if you have a large tumor or a tumor that is very close to the nerves, you may not be able to have this surgery.

Each type of surgery has benefits and risks. Your doctor can further describe these types:
1. Radical retropubic prostatectomy: The doctor removes the entire prostate and nearby lymph nodes through an incision in the abdomen.
2. Radical perineal prostatectomy: The doctor removes the entire prostate through a cut between the scrotum and the anus. Nearby lymph nodes may be removed through a separate cut in the abdomen.
3. Laparoscopic prostatectomy: The doctor removes the entire prostrate and nearby lymph nodes through small incisions, rather than a single long cut in the abdomen. A thin, lighted tube called laparoscope is used to help remove the prostate.
4. Transurethral resection of the prostate (TURP): The doctor removes part of the prostate with a long, thin device that is inserted through the urethra. The cancer is cut from the prostate. TURP may not remove all of the cancer. But it can remove tissue that blocks the flow of urine.
5. Cryosurgery: This type of surgery for prostate cancer is under study at some medical centers.
6. Pelvic lymphadenectomy: This is routinely done during prostatectomy. The doctor removes lymph nodes in the pelvis to see if cancer has spread to them. If there are cancer cells in the lymph nodes, the disease may have spread to other parts of the body. In this case, the doctor may suggest other types of treatment.

The time it takes to heal after surgery is different for each man and depends on the type of surgery he has had. You may be uncomfortable for the first few days. However, medicine can help control the pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.

After surgery, the urethra needs time to heal. You will have a catheter. A catheter is a tube put through the urethra into the bladder to drain urine. You will have the catheter for 5 days to 3 weeks. Your nurse or doctor will show you how to care for it.

Surgery may cause short-term problems, such as incontinence. After surgery, some men may lose control of the flow of urine or urinary incontinence. Most men regain bladder control after a few weeks.

Some men may become impotent. Nerve-sparing surgery is an attempt to avoid the problem of impotence. If a man can have nerve-sparing surgery and the operation is a success, impotence may not last. In some cases, men become permanently impotent. You can talk with your doctor about medicine and other ways to help manage the sexual effects of cancer treatment.

If your prostate is removed, you will no longer produce semen. You will have dry orgasms. If you wish to father children, you may consider sperm banking or a sperm retrieval procedure.

Radiation therapy also called radiotherapy uses high-energy rays to kill cancer cells. It affects cells only in the treated area.

For early stage prostate cancer, radiation treatment may be used instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. In later stages of prostate cancer, radiation treatment may be used to help relieve pain.

Doctors use two types of radiation therapy to treat prostate cancer. Some men receive both types:
1. External radiation: The radiation comes from a large machine outside the body. Men go to a hospital or clinic for treatment. Treatments are usually 5 days a week for several weeks. Many men receive 3-dimensional conformal radiation therapy. This type of treatment more closely targets the cancer. It spares healthy tissue.
2. Internal radiation also called implant radiation or brachytherapy: The radiation comes from radioactive material usually contained in small seeds. The seeds are put into the tissue. They give off radiation for months. The seeds are harmless and do not need to be removed.

Side effects depend mainly on the dose and type of radiation. You are likely to be very tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
If you have external radiation, you may have diarrhea or frequent and uncomfortable urination. Some men have lasting bowel or urinary problems. Your skin in the treated area may become red, dry, and tender. You may lose hair in the treated area. The hair may not grow back.

Internal radiation treatment may cause incontinence. This side effect usually goes away. Lasting side effects from internal radiation are not common.

Both internal and external radiation can cause impotence. Internal radiation is less likely to have this effect.

Hormone therapy keeps prostate cancer cells from getting the male hormones - they need to grow. The testicles are the body's main source of the male hormone testosterone. The adrenal gland makes a small amount of testosterone.

Hormone treatment uses drugs or surgery:
Drugs: Your doctor may suggest a drug that can block natural hormones.
1. Luteinizing hormone-releasing hormone (LH-RH) agonists: These drugs can prevent the testicles from making testosterone. Examples are leuprolide and goserelin.
2. Antiandrogens: These drugs can block the action of male hormones. Examples are flutamide, bicalutamide, and nilutamide.
3. Other drugs: Some drugs can prevent the adrenal gland from making testosterone. Examples are ketoconazole and aminoglutethimide.

Surgery: Surgery to remove the testicles is called orchiectomy.
After orchiectomy or treatment with an LH-RH agonist, your body no longer gets testosterone from the testicles. However, the adrenal gland still produces a small amount of male hormones. You may receive an antiandrogen to block the action of the male hormones that remain. This combination of treatments is known as total androgen blockade. Studies have not shown whether total androgen blockade is more effective than surgery or an LH-RH agonist alone.

Doctors can usually control prostate cancer that has spread to other parts of the body with hormone therapy. The cancer often does not grow for several years. But in time, most prostate cancers can grow with very little or no male hormones. Hormone therapy is no longer helpful. At that time, your doctor may suggest other forms of treatment that are under study.

Hormone therapy is likely to affect your quality of life. It often causes side effects such as impotence, hot flashes, loss of sexual desire, and weaker bones. An LH-RH agonist may make your symptoms worse for a short time when you first take it. This temporary problem is called flare. The treatment gradually causes your testosterone level to fall. Without testosterone, tumor growth slows. Your condition may improve. To prevent flare, your doctor may give you an antiandrogen for a while along with the LH-RH agonist.

Antiandrogens such as nilutamide can cause nausea, diarrhea, or breast growth or tenderness. Rarely, they may cause liver problems (pain in the abdomen, yellow eyes, or dark urine). Some men who use nilutamide may have difficulty breathing. Some may have trouble adjusting to sudden changes in light.

If used for a long time, ketoconazole may cause liver problems, and aminoglutethimide can cause skin rashes. If you receive total androgen blockade, you may have more side effects than if you have just one type of hormone treatment.

Any treatment that lowers hormone levels can weaken your bones. Your doctor can suggest medicines or dietary supplements that can reduce your risk of bone fractures.

You may choose watchful waiting if the risks and possible side effects of treatment outweigh the possible benefits. Your doctor may offer this choice if you are older or have other serious health problems. Your doctor may also suggest watchful waiting if you are diagnosed with early stage prostate cancer that seems to be slowly growing. Your doctor will offer you treatment if symptoms occur or get worse.

Watchful waiting avoids or delays the side effects of surgery and radiation, but this choice has risks. It may reduce the chance to control cancer before it spreads. Also, it may be harder to cope with surgery and radiation therapy as you age.

You may decide against watchful waiting if you do not want to live with an untreated cancer. If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. A different approach is nearly always available.

Some men with prostate cancer use complementary and alternative medicine (CAM):
An approach is generally called complementary medicine when it is used along with standard treatment.

An approach is called alternative medicine when it is used instead of standard treatment.

Acupuncture, massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing are types of CAM.

Many men say that CAM helps them feel better. However, some types of CAM may change the way standard treatment works. These changes could be harmful. And some types of CAM could be harmful even if used alone.
NOTE: Some types of CAM are expensive. Health insurance may not cover the cost.

It is important for men with prostate cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.

You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy. Your doctor, dietitian, or other health care provider can suggest a healthy diet.

Many men find they feel better when they stay active. Walking, yoga, swimming, and other exercise can keep you strong and increase your energy. Exercise may reduce pain and make treatment easier to handle. It also can help relieve stress. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.

Follow-up care after treatment for prostate cancer is important. Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment. Your doctor will monitor your recovery and check for recurrence of the cancer. Checkups help ensure that any changes in your health are noted and treated if needed. Checkups may include lab tests, x-rays, biopsies, or other tests. Between scheduled visits, you should contact your doctor if you have any health problems.

Learning you have prostate cancer can change your life and the lives of those close to you. These changes can be hard to handle. It is normal for you, your family, and your friends to have many different and sometimes confusing feelings.

You may worry about caring for your family, keeping your job, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of your health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful if you want to talk about your feelings or concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.

Friends and relatives can be supportive. Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or online. You may want to talk with a member of your health care team about finding a support group.

You and your partner may be concerned about the effects of prostate cancer on your sexual relationship. You may want to talk with your doctor about possible treatment side effects and whether these are likely to last. Whatever the outlook, you and your partner may find it helps to discuss your concerns. You can find ways to be intimate during and after treatment. For some couples, it helps to talk with a sex counselor.

Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). They are studying new ways to prevent, detect, and treat prostate cancer.

Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to many advances, and researchers continue to search for more effective methods for dealing with prostate cancer.

Men who join clinical trials may be among the first to benefit if a new approach is effective. And even if people in a trial do not benefit directly, they still make an important contribution by helping doctors learn more about prostate cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.

You may want to ask the doctor these questions before having a biopsy:
Where will the biopsy take place? Will I have to go to the hospital?
What are the risks? What are the chances of infection or bleeding after the biopsy?
How long will it take me to recover?
How soon will I know the results?
If I do have cancer, who will talk to me about the next steps? When?

You may want to ask your doctor these questions before your treatment begins:
What is the stage of the disease? Do any lymph nodes show signs of cancer? Has the cancer spread?
What is the grade of the tumor?
What is the goal of treatment? What are my treatment choices? Which do you recommend for me? What are the risks and possible side effects of each treatment? How can side effects be managed?
What can I do to prepare for treatment?
Will I need to stay in the hospital? If so, for how long?
How will treatment affect my normal activities? Will it affect my sex life? Will I have urinary problems? Will I have bowel problems?
What will the treatment cost? Will my insurance cover it?
Would a clinical trial (research study) be appropriate for me?
What are the expected benefits of each kind of treatment?

You may want to ask your doctor these questions before choosing surgery:
What kinds of surgery can I consider? Is nerve-sparing surgery an option for me? Which operation do you recommend for me? Why?
How will I feel after the operation?
If I have pain, how can we control it?
Will I have any lasting side effects?
Is there someone I can talk with who has had the same surgery I'll be having?

You may want to ask your doctor these questions before choosing radiation therapy:
How will radiation be given?
When will treatment start? When will it end? How often will I have treatments?
What can I do to take care of myself before, during, and after treatment?
How will I feel during treatment? Will I be able to drive myself to and from treatment?
How will we know the treatment is working?
How will I feel after the radiation?
Are there any lasting effects?
What is the chance that the cancer will come back in my prostate?
How often will I need checkups?

You may want to ask your doctor these questions before choosing hormone therapy:
What kind of hormone therapy will I have? Would you recommend drugs or surgery? Why?
When will treatment start? How often will I have treatments? When will it end?
Where will I go for treatment? Will I be able to drive home afterward?
If I have surgery, how long will I need to stay in the hospital?
How will I feel during treatment?
What can I do to take care of myself during treatment?
How will we know the treatment is working?
Which side effects should I tell you about?
Will there be lasting side effects? ]]>