Methods

Today there are many methods of prostate cancer treatments. The choice depends on several factors: general health condition, age of the patient and stage when the growth was detected. Use your time to learn information about the existing methods of treatment. Do not take hasty decisions. Most popular methods of treatments are operation, radiation and hormonal therapy. Sometimes the most useful thing is waiting game.

Waiting game

In many cases prostate cancer is progressing very slow that is why patients over 70 years sometimes do not need treatment. In this case doctor suggests to wait little and to continue monitoring. If during regular examination it was detected that tumors are growing more quickly than doctor will recommend you intense therapy.

Operation

The aim of such operation is removal of cancerous growths. Heroic prostatectomy means removal of the whole prostate gland with circumflex tissues. This operation is possible just if the growth did not spread beyond the prostate gland. Access to the prostate is provided via cut underbelly. After operation a katheter is placed in patient's urethra to draw urine off. It should be removed in several weeks and after that may appear problems with incontinence of urine. In some cases this side effect do pass off alone, but sometimes there is a need of medication treatment or physiotherapeutic procedure. During operation may be affected nerves responding for erection. As a result may appear problems with erection or even impotence. Difficulties may be temporal or permanent. Discuss those questions with your doctor. There are gentle methods of surgical treatment of prostate cancer lowering risk of impotence.

Prostate transurethral resection is another kind of operation used in cases when it is impossible to make heroic prostatectomy. Via urethra is inserted a devise with help of which a particular area of prostate gland is burned. There is no need in a cut, urinary katheter is placed in urethra just for several days as long as flood stops. Impotence and incontinence of urine after such operation do appear quite rarely. The principal defect of this operation is that the greatest part of affected with cancer prostate is not removed, so here we cannot talk about full recovery.

Cryogenic Surgery

Cryogenic surgery is a quite new method of prostate cancer treatment. Very low temperatures in bars inserted in prostate destroy cancer cells.

Doctor has recommended you to make prostate examination. That idea makes you feel astrain, because you know where prostate gland is located and you understand that prostate examination will be not a very pleasant thing.

Prostate examination also is called digital rectal examination or rectal examination. The majority of men sooner or later face with the necessity of prostate examination. Rectal examination is performed during normal medical examination if patient complains on problems with urination or other unpleasant symptoms.

Procedure

You should have to take off your underclothing and pass paper tower round your waist so that you leave back naked. Prostate gland is located in front of rectum. You should bend down to let doctor examine it. You should stand up leaning your hands on the table, or settle on a side pressing knees to the chest.

Most likely, doctor will explain you what he is going to do and he will help you to relax. In order to fix your body in necessary position, doctor can put his hand underbelly. Then he spreads your buns to examines anus. The next step is insertion of finger in surgical glove with lubricant into anus. During insertion deep into rectum doctor makes pauses to let sphincter relax.

Stress during examination is a normal thing but you should maximally calm down. This will help you to fell less discomfort during rectal examination. To make sphincters relax doctor will ask you to retch (like during defecation). At that moment you should breath via mouth.

Doctor examines rectal paries and presses prostate gland in order to define its size, presence of tumors and indurations. At that moment you can feel desire to urinate. Some patients feel nausea and weakness. Do not worry, these are normal things. However if you feel giddiness you should immediately say it to the doctor. All examination takes a little more than a minute.

After rectal examination doctor looks at fecal masses that have remain on the glove if they have blood or not. It can be a sign of hemorrhoid, polypus or intestine cancer. Digital rectal examination can make you feel discomfort and not pain. If you feel pain say it to the doctor. Hypersensitivity to touching can be a sign of prostatitis (prostate inflammation).

Four useful tips:

1) if you have hemorrhoid you should say it to doctor

2) breath slowly via mouth, hold your breath

3) try to relax, think about something positive

4) say to doctor if you feel pain

After examination doctor will give you a napkin and he will say to you where can you make yourself smart, and then doctor will say you result oh the examination.

Myth #1. Diseased with prostate cancer die but not from it
In fact, every sixth man diseases with prostate cancer, but dies of it only every thirty fifth man. There is possible to live with some forms of cancer for years, but do not forget that prostate cancer is a second oncologic male disease with fatal cases.

Myth #2. There is no need to undergo examination because doctors do quarrel about its effectiveness
In fact, the main aim of examination is to detect disease at early stages. There are two kinds of examinations: blood test on Prostate-Specific Antigen (PSA) and digital rectal examination. Doctors do not quarrel the necessity of both those examinations.

Prostate-Specific Antigen (PSA) normally is detected in blood in small amounts. The level of PSA usually raises when prostate cancer, and also when prostatitis and innocent hyperplasia of prostate. As most of analysis, PSA-test does not guarantee 100% diagnostic accuracy. In some cases invasive methods are used for examination (prostate biopsy).

On the other side, results of PSA can be normal even when prostate cancer. Since 1990, when PSA was introduced in clinical practice, mortality from prostate cancer is lowered. However, some doctors are not sure that PSA is the reason of that.

Quarrels about necessity of men health examination with PSA still take place. However, the examinations to detect prostate cancer are recommended for men over 50. If your nearest relatives (father, brother, uncle) were diseased with prostate cancer, you should start examinations at 45. Is it worth or not is a personal question.

Myth #3. After prostate removal a man becomes impotent
In fact, prostatectomy is a surgical procedure to remove prostate gland affected with cancer. Sometimes during this operation nerves controlling erection can be affected. After operation most of men face with such a problem as erectile dysfunction. How long problems will last depend on the man's age, erection before operation and on kind of surgical intervention.

The operation allowing to avoid nerves damage lowers risk of erectile dysfunction progress. If necessary, it is possible to keep erection by using penile injections and special devices.

Myth #4. Men after prostatectomy suffer from uroclepsia
The main side effect of prostatectomy is uroclepsia. In most men it occurs after several weeks or months after operation. According to statistics, in 5 years after surgical intercourse about 1/3 of men suffer from high-stress uroclepsia (urine leak when coughing, physical exercises, laughing or sneezing). Only in 5% of cases was registered a serious uroclepsia.
Risk of uroclepsia is lowered when the operation in performed in big oncologic centers under the supervision of qualified specialists.

If you are diagnosed with prostate cancer you should know how this disease is progressing and you should understand medical terminology. This information should help you to take serious decisions when chosing appropriate methods of treatment.

Course of the disease.
In most cases cancer of the prostate is slow-growing. In fact, aged men do not need treatment because tumor does not influence life time and the disease courses without symptoms.

Condition connected with slight change of shape and size of cells of prostate is called prostatic intraepithelial neoplasia (PIN) and a half of men over 50 years are diagnosed with it. PIN is considered precancerous disease.

Rate of progression prostate cancer: Gleason staging system.
Gleason staging system is used to help to evaluate the prognosis of cancer of the prostate.
 - Biopsy. Tissue samples of prostate tumor are taken. Obtained material is going in laboratory for a microscopic examination.
 - In laboratory every sample assigns a grade from 1 to 5: one means that sample has only healthy cells and five means the sample has pathological cells.
 - The two grades of two most specific tumor samples are added together to get a Gleason score (from 2 to 10). Higher Gleason score means a worse prognosis.

Prostate cancer stages.
Stages do characterize where cancer have spreaded. Doctor needs this information to choose treatment. To define cancer stage the next examinations can be made:
 - Digital rectal examination
 - Blood tests
 - Bone scans
 - Computerized tomography
 - Magnetic resonance tomography
 - Biopsy of prostate and lymphatic glands

There are two systems of describing prostate cancer stages - Whitmore-Jewett staging
and TNM.

Whitmore-Jewett staging system
In this case to describe stage of disease are used letters of A, B, C, D:
A - the tumor has microscopic size and it is not detectable when palpation
B - the tumor or lump are felt (without metastasis)
C - the tumor with metastasis spreaded to the organs located near prostate
D - the tumor with great metastasis spreaded to lymphatic glands and other organs

TNM staging system
Cancer stages can be described also in TNM system. TNM stands for Tumor, Nodes, Metastases.
T - characterises process of primary tumor
  T1 - the tumor is not detectable while visual examination and on X-ray picture. Cancer cells are presented in tissue samples taken during prostate hyperplasia operation or during biopsy.
  T1a - cancer cells are detected in less than 5% of tissue that was removed. Gleason score is less than 7.
  T1b - cancer cells are detected in more than 5% of tissue that was removed. Gleason score is more than 7.
  T1c - cancer cells are detected in tissues taken during biopsy (performed due to an elevated serum PSA)

T2 - the tumor can be felt but it does not spread outside capsule covering prostate.
  T2a - the tumor is in less than 50% of one part of prostate.
  T2b - the tumor is in more than 50% of one part of prostate.
  T2c - the tumor is in both parts of prostate.

T3 - the tumor is spreaded on other organs including seminal vescile.
  T3a - the tumor is spreaded on other organs but not in seminal vescile.
  T3b - the tunor is spereaded on seminal vescile.

T4 - the tumor is spreaded on other organs near prostate, for example, on rectum.

To detect metastasis to other organs it is necessary to make some additional examinations. Prostate cancer often does metastasis to lymphatics glands, bones, lungs and other organs.

To describe metastasis marks of M and N are used.
N - characterises spreading of tumor on lymphatic glands.
  Nx - it is not clear if lymphatic glands are invaded or not.
  N0 - the tumor is not found in lymphatic glands.
  N1 - the tumor is found in one lymphatic gland in small pelvis caverna and it has size of not more than 2 sm.
  N2 - the tumor is found in one lymphatic gland in small pelvis caverna. It has size of more than 2 cm but less than 5 cm. The other variant is when the tumor is found in several lymphatic glands in small pelvis caverna but tumors have size of less than 5 cm.
  N3 - at least one tumor in lymphatic glands has a size of more than 5 cm.

M - describes spreading of tumor in other organs.
  Mx - it is not clear if there is metastasis to other organs.
  M0 - metastasis are detected only in prostate and in the nearest lymphatic glands.
  M1 - the tumor does metastasis to lymphatic glands beyond small pelvis and\or into other organs (bones, lungs, livers and brain).

Prognosis for prostate cancer.
Almost all cancerous growths of prostate (91%) are detected before they spread beyond prostate. If cancer is diagnosed being at this stage, in 99% of cases patients can live at least 5 years. But the prognosis of survival exacerbates when the tumor did metastasis to other organs.

The second detecting of prostate cancer after a year or more of treatment is called recurrence. Cancer can recur in prostate (even if it was removed) and in other organs including bones. To treat recurescence can be used methods different from those that were used for primary tumor treatment.