Prostate cancer – Diagnosis and treatment – Mayo Clinic

Diagnosis

Get answers to the most frequently asked questions about prostate cancer from Mayo Clinic urologist Mitchell Humphreys, M.D .

Hello. I ‘m Dr. Humphreys, a urologist at Mayo Clinic, and I ‘m here to answer some of the important questions you may have about prostate gland cancer .
How do you know how fast my cancer is growing?
If you have low to intermediate gamble prostate gland cancer, there are genomic tests that can better inform on the risk of developing a more aggressive cancer. These tests look at the deoxyribonucleic acid of your actual cancer cells to compare them to early men, to come up with an person hazard visibility for you and your cancer. none of it is 100 %, but it does provide the best evidence based on your specific prostate cancer.

Is prostate cancer sexually transmitted?
No, there ‘s no hazard to your partner from prostate gland cancer. There ‘s no gamble with sexual natural process. Prostate cancer is internal and does not spread through liaison .
Is prostate cancer hereditary?
Some prostate gland cancers are ancestral. If you have prostate cancer, all of your first-degree relatives — rear, sibling, or child — are at an raise risk for developing prostate gland cancer. If you are diagnosed when you ‘re unseasoned in your 40s and develop prostate cancer, you may want to consider a genic reference to see if there are any know genic risk factors that you and your family may have .
What can I do to prevent or slow prostate cancer?
There ‘s no one matter. A healthy life style with 30 minutes of drill a day has shown to be protective. besides, diet is important by limiting bolshevik kernel and eating bracing fruits and vegetables, low in sugars and carbohydrates. I would advise following a heart-healthy diet as inquiry has shown that it is healthy for the prostate gland as well .
Is there a risk of cancer spreading if I have a biopsy of my prostate?
No, prostate cancer does n’t spread that direction. And there have been millions of biopsies throughout the populace and never a individual incident of it being spread that manner has ever been reported .
When should I stop screening for prostate cancer?
not all prostate gland cancer is deadly and not all prostate gland cancer requires treatment. As a general predominate of hitchhike, if your life anticipation is 10 years or less, you credibly will not have to worry about prostate gland cancer affecting you in your life. however, you should discuss this with your wish team to determine how it specifically relates to you .
How can I be the best partner to my medical team?
The best thing you can do is be open and honest. Your medical team is here to be a resource to you, to support you and to help you in any way they can. Never hesitate to ask your checkup team any questions or concerns that you have being informed makes all the difference. Thank you for your time and we wish you well .

Screening for prostate cancer

Digital rectal exam

Digital rectal exam

Digital rectal exam

During a digital rectal examination, your sophisticate inserts a gloved, lubricate finger into your rectum and feels the back wall of the prostate gland for expansion, tenderness, lumps or hard spots .
Testing goodly men with no symptoms for prostate cancer is controversial. There is some disagreement among medical organizations whether the benefits of testing outweigh the electric potential risks .
Most medical organizations encourage men in their 50s to discuss the pros and cons of prostate gland cancer screening with their doctors. The discussion should include a revue of your hazard factors and your preferences about riddle .
You might consider starting the discussions sooner if you ‘re a Black person, have a kin history of prostate gland cancer or have other risk factors .
Prostate screen tests might include :

  • Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of the gland, you may need further tests.
  • Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that’s naturally produced by your prostate gland. It’s normal for a small amount of PSA to be in your bloodstream. However, if a higher than usual level is found, it may indicate prostate infection, inflammation, enlargement or cancer.

Diagnosing prostate cancer

Transrectal biopsy of the prostate

Prostate transrectal biopsy

Transrectal biopsy of the prostate

During a transrectal biopsy, a biopsy artillery cursorily projects a thinly needle into suspect areas of the prostate gland, and little sections of tissue are removed for analysis .
If prostate gland cancer screening detects an abnormality, your doctor may recommend far tests to determine whether you have prostate cancer, such as :

  • Ultrasound. During a transrectal ultrasound, a small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create a picture of your prostate gland.
  • Magnetic resonance imaging (MRI). In some situations, your doctor may recommend an MRI scan of the prostate to create a more detailed picture. MRI images may help your doctor plan a procedure to remove prostate tissue samples.
  • Collecting a sample of prostate tissue. To determine whether there are cancer cells in the prostate, your doctor may recommend a procedure to collect a sample of cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that’s inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.

Determining whether prostate cancer is aggressive

When a biopsy confirms the presence of cancer, the future step is to determine the level of aggressiveness ( grade ) of the cancer cells. A sophisticate in a lab examines a sample distribution of your cancer cells to determine how much cancer cells differ from the healthy cells. A higher rate indicates a more aggressive cancer that is more likely to spread promptly .
Techniques used to determine the aggression of the cancer include :

  • Gleason score. The most common plate used to evaluate the grade of prostate gland cancer cells is called a Gleason mark. Gleason scoring combines two numbers and can range from 2 ( unaggressive cancer ) to 10 ( very aggressive cancer ), though the lower separate of the range is n’t used equally often .
    Most Gleason scores used to assess prostate biopsy samples range from 6 to 10. A mark of 6 indicates a low-grade prostate gland cancer. A score of 7 indicates a medium-grade prostate gland cancer. Scores from 8 to 10 bespeak high-grade cancers .
  • Genomic testing. Genomic testing analyzes your prostate cancer cells to determine which gene mutations are present. This type of test can give you more information about your prognosis. But it’s not clear who might benefit most from this information, so the tests aren’t widely used. Genomic tests aren’t necessary for every person with prostate cancer, but they might provide more information for making treatment decisions in certain situations.

Determining whether the cancer has spread

once a prostate cancer diagnosis has been made, your doctor works to determine the extent ( stage ) of the cancer. If your doctor suspects your cancer may have spread beyond your prostate, one or more of the follow imagination tests may be recommended :

  • Bone scan
  • Ultrasound
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan

not every person should have every test. Your doctor will help determine which tests are best for your individual situation .
Your doctor uses the information from these tests to assign your cancer a phase. Prostate cancer stages are indicated by Roman numerals ranging from I to IV. The lowest stages indicate the cancer is confined to the prostate. By phase IV, the cancer has grown beyond the prostate gland and may have spread to early areas of the body .

Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your prostate cancer-related health concerns Start here

Treatment

Your prostate gland cancer discussion options depend on several factors, such as how fast your cancer is growing, whether it has spread and your overall health, vitamin a well as the electric potential benefits or side effects of the treatment .

Immediate treatment may not be necessary

low-grade prostate gland cancer may not need treatment right away. For some, treatment may never be needed. rather, doctors sometimes recommend active surveillance .
In active surveillance, regular follow-up lineage tests, rectal examination and prostate gland biopsies may be performed to monitor progress of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as operating room or radiation sickness .
active voice surveillance may be an option for cancer that is n’t causing symptoms, is expected to grow identical slowly and is confined to a small area of the prostate. active surveillance may besides be considered for person who has another serious health condition or who is of an advanced age that makes cancer treatment more unmanageable .

Surgery to remove the prostate

Prostatectomy incisions

Location of incisions for open prostatectomy compared with robotic prostatectomy

Prostatectomy incisions

During an open prostatectomy, one large incision is made in your abdomen ( left ). During a robotic prostatectomy, several smaller incisions are made in the abdomen ( properly ) .
operating room for prostate gland cancer involves removing the prostate gland ( group prostatectomy ), some surrounding tissue and a few lymph nodes .
operating room is an choice for treating cancer that ‘s confined to the prostate gland. It ‘s sometimes used to treat advanced prostate cancer in combination with early treatments .
To access the prostate gland, surgeons may use a proficiency that involves :

  • Making several small incisions in your abdomen. During robot-assisted laparoscopic prostatectomy, surgical instruments are attached to a mechanical device (robot) and inserted through several small incisions in your abdomen. The surgeon sits at a console and uses hand controls to guide the robot to move the instruments. Most prostate cancer operations are done using this technique.
  • Making one long incision in your abdomen. During retropubic surgery, the surgeon makes one long incision in your lower abdomen to access and remove the prostate gland. This approach is much less common, but may be necessary in certain situations.

Discuss with your doctor which character of surgery is best for your specific position .

Radiation therapy

External beam radiation for prostate cancer

External beam radiation for prostate cancer

External beam radiation for prostate cancer

During external beam radiation treatment for prostate cancer, you lie on a table while a linear accelerator moves around you to deliver radiation from many angles. The linear catalyst delivers the precise drug of radiation planned by your treatment team .

Permanent prostate brachytherapy

Permanent prostate brachytherapy

Permanent prostate brachytherapy

permanent prostate brachytherapy involves placing many radioactive seeds within the prostate to treat prostate cancer. During the operation, an sonography probe is placed in the rectum to help guide the placement of seeds. The seeds emit radiation that dissipates over a few months .
Radiation therapy uses high-octane energy to kill cancer cells. Prostate cancer radiotherapy therapy treatments may involve :

  • Radiation that comes from outside of your body (external beam radiation). During external air radiotherapy therapy, you lie on a mesa while a car moves around your body, directing high-powered energy beams, such as X-rays or protons, to your prostate gland cancer. You typically undergo external beam radiation sickness treatments five days a week for several weeks. Some checkup centers offer a shorter path of radiation sickness therapy that uses higher doses of radiation spread over fewer days .
    external beam radiotherapy is an choice for treating cancer that ‘s confined to the prostate gland. It can besides be used after operation to kill any cancer cells that might remain if there ‘s a risk that the cancer could spread or come spinal column. For prostate cancer that spreads to other areas of the body, such as the bones, radiation sickness therapy can help slow the cancer ‘s growth and take over symptoms, such as pain .
  • Radiation placed inside your body (brachytherapy). Brachytherapy involves placing radioactive sources in your prostate tissue. Most often, the radiation is contained in rice-sized radioactive seeds that are inserted into your prostate tissue. The seeds deliver a low dose of radiation over a long period of time. Brachytherapy is one option for treating cancer that hasn’t spread beyond the prostate.

In some situations, doctors may recommend both types of radiation therapy .

Freezing or heating prostate tissue

ablative therapies destroy prostate gland tissue with cold or heat. Options may include :

  • Freezing prostate tissue. Cryoablation or cryotherapy for prostate cancer involves using a very cold gas to freeze the prostate tissue. The tissue is allowed to thaw and the procedure repeats. The cycles of freezing and thawing kill the cancer cells and some surrounding healthy tissue.
  • Heating prostate tissue. High-intensity focused ultrasound (HIFU) treatment uses concentrated ultrasound energy to heat the prostate tissue and cause it to die.

These treatments may be considered for treating identical modest prostate cancers when operating room is n’t possible. They may besides be used to treat advanced prostate cancers if early treatments, such as radiation therapy, have n’t helped .
Researchers are studying whether cryotherapy or HIFU to treat one part of the prostate gland might be an option for cancer that ‘s confined to the prostate gland. Referred to as “ focal therapy, ” this scheme identifies the area of the prostate gland that contains the most aggressive cancer cells and treats that area alone. Studies have found that focal therapy reduces the risk of side effects. But it ‘s not clear whether it offers the same survival benefits as treatment to the entire prostate .

Hormone therapy

Hormone therapy is discussion to stop your body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the issue of testosterone may cause cancer cells to die or to grow more lento .
Hormone therapy options include :

  • Medications that stop your body from producing testosterone. Certain medications — known as luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists and antagonists — prevent your body’s cells from receiving messages to make testosterone. As a result, your testicles stop producing testosterone.
  • Medications that block testosterone from reaching cancer cells. These medications, known as anti-androgens, usually are given in conjunction with LHRH agonists. That’s because LHRH agonists can cause a temporary increase in testosterone before testosterone levels decrease.
  • Surgery to remove the testicles (orchiectomy). Removing your testicles reduces testosterone levels in your body quickly and significantly. But unlike medication options, surgery to remove the testicles is permanent and irreversible.

Hormone therapy is often used to treat advanced prostate gland cancer to shrink the cancer and slow its emergence .
Hormone therapy is sometimes used before radiation therapy to treat cancer that has n’t spread beyond the prostate gland. It helps shrink the cancer and increases the potency of radiation sickness therapy .

Chemotherapy

Chemotherapy uses drugs to kill quickly growing cells, including cancer cells. chemotherapy can be administered through a vein in your weapon, in pill form or both .
chemotherapy may be a discussion option for treating prostate cancer that has spread to other areas of the soundbox. Chemotherapy may besides be an choice for cancers that do n’t respond to hormone therapy .

Immunotherapy

Immunotherapy uses your immune system to fight cancer. Your body ‘s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process .
Prostate cancer immunotherapy can involve :

  • Engineering your cells to fight cancer. Sipuleucel-T (Provenge) treatment takes some of your own immune cells, genetically engineers them in a laboratory to fight prostate cancer and then injects the cells back into your body through a vein. It’s an option for treating advanced prostate cancer that no longer responds to hormone therapy.
  • Helping your immune system cells identify cancer cells. Immunotherapy drugs that help the immune system cells identify and attack the cancer cells are an option for treating advanced prostate cancers that no longer respond to hormone therapy.

Targeted drug therapy

Targeted drug treatments focus on specific abnormalities deliver within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die .
Targeted therapy drugs may be recommended to treat advanced or perennial prostate cancer if hormone therapy is n’t working .
Some targeted therapies only work in people whose cancer cells have certain genetic mutations. Your cancer cells may be tested in a testing ground to see if these drugs might help you .

Clinical trials

explore Mayo Clinic studies testing new treatments, interventions and tests as a mean to prevent, detect, dainty or wield this condition .

Alternative medicine

No complemental or alternative treatments will cure prostate gland cancer. however, complementary and option prostate gland cancer treatments may help you cope with the side effects of cancer and its treatment .
closely everyone diagnose with cancer experiences some distress at some point. If you ‘re distressed, you may feel deplorable, angry or anxious. You may experience difficulty sleeping or find yourself constantly thinking about your cancer .
several complementary medicate techniques may help you cope with your straiten, including :

  • Art therapy
  • Dance or movement therapy
  • Exercise
  • Meditation
  • Music therapy
  • Relaxation techniques
  • Spirituality

Discuss your feelings and concerns with your sophisticate. In some cases, discussion for straiten may require medications .

Coping and support

When you receive a diagnosis of prostate gland cancer, you may experience a roll of feelings — including unbelief, fear, anger, anxiety and depression. With time, each person finds his own way of coping with a prostate gland cancer diagnosis .
Until you find what works for you, try to :

  • Learn enough about prostate cancer to feel comfortable making treatment decisions. Learn as much as you need to know about your cancer and its treatment in order to understand what to expect from treatment and life after treatment. Ask your doctor, nurse or other health care professional to recommend some reliable sources of information to get you started.
  • Keep your friends and family close. Your friends and family can provide support during and after your treatment. They may be eager to help with the small tasks you won’t have energy for during treatment. And having a close friend or family member to talk to can be helpful when you’re feeling stressed or overwhelmed.
  • Connect with other cancer survivors. Friends and family can’t always understand what it’s like to face cancer. Other cancer survivors can provide a unique network of support. Ask your health care providers about support groups or community organizations that can connect you with other cancer survivors. Organizations such as the American Cancer Society offer online chat rooms and discussion forums.
  • Take care of yourself. Take care of yourself during cancer treatment by eating a diet full of fruits and vegetables. Try to exercise most days of the week. Get enough sleep each night so that you wake feeling rested.
  • Continue sexual expression. If you experience erectile dysfunction, your natural reaction may be to avoid all sexual contact. But consider touching, holding, hugging and caressing as ways to continue sharing sexuality with your partner.

Preparing for your appointment

If you have signs or symptoms that worry you, start by seeing your kin doctor of the church .
If your doctor suspects you may have a problem with your prostate gland, you may be referred to a urinary tract specialist ( urologist ). If you ‘re diagnosed with prostate cancer, you may be referred to a cancer specialist ( oncologist ) or a specialist who uses radiation therapy to treat cancer ( radiation oncologist ) .
Because appointments can be brief, and because there ‘s often a fortune of information to discuss, it ‘s a good theme to be prepared. here ‘s some information to help you get fix and what to expect from your sophisticate.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you’re taking.
  • Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Your clock with your repair is limited, so preparing a number of questions can help you make the most of your time together. List your questions from most important to least authoritative in subject time runs out. For prostate cancer, some basic questions to ask your doctor include :

  • Do I have prostate cancer?
  • How large is my prostate cancer?
  • Has my prostate cancer spread beyond my prostate?
  • What’s my Gleason score?
  • What’s my prostate-specific antigen (PSA) level?
  • Will I need more tests?
  • What are my treatment options?
  • Is there one treatment option you think is best for me?
  • Do I need cancer treatment right away, or is it possible to wait and see if the cancer grows?
  • What are the potential side effects of each treatment?
  • What is the chance that my prostate cancer will be cured with treatment?
  • If you had a friend or family member in my situation, what would you recommend?
  • Should I see a specialist? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?

In addition to the questions that you ‘ve prepared to ask your repair, do n’t hesitate to ask other questions during your appointment .

What to expect from your doctor

Your doctor is likely to ask you a act of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask :

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
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