Hormone therapy treatment for prostate cancer is designed to eliminate the male hormones (androgens) from the body. Androgens are necessary for the development and function of the male sexual organs and male sexual characteristics such hair growth and voice changes.
Androgens are primarily produced by the testicles, under control of various parts of the brain. A small amount of androgens is produced by the adrenal glands, which are small glands located above the kidneys and which produce many important chemicals. The most common androgen is testosterone.
Prostate cancer cells may be hormone sensitive, hormone insensitive, or hormone resistant. Cancer cells that are hormone sensitive require androgens for growth. Therefore hormone therapy for the treatment of prostate cancer only works in the former case.
It is important to note that hormone therapy treatment for prostate cancer does not eliminate prostate cancer cells, but rather it is “palliative therapy” in that its goal is to slow down the progression of prostate cancer. Hormone treatment for early stage prostate cancer, or hormone therapy for patients with metastatic disease may work effectively for several years. However over time, hormone-resistant cells will emerge, and the cancer will grow.
When Is Hormone Therapy For Prostate Cancer Used?
Hormone treatment for prostate cancer may be used as a primary, secondary, or neoadjuvant therapy. Hormone therapy for the treatment of prostate cancer is often used as a primary therapy in older men who are not candidates for surgery or radiation therapy and who are not interested in watchful waiting. It is also used in men who have metastatic disease at the time their prostate cancer is detected.
Men who experience a rise in their PSA after radical prostatectomy, radiation therapy, or cryotherapy are given hormone therapy to slow down the growth of the recurrent prostate cancer. Hormone therapy may be given for a period of time before radical prostatectomy or radiation therapy to shrink the prostate gland and make the procedure easier to perform. This is referred to neoadjuvant therapy.
Hormone treatment for prostate cancer comes with side effects such as fatigue, loss of libido, erectile dysfunction and even osteoporosis. Discuss with your doctor on what to expect, and research for ways to cope with the side effects before you undergo treatment.
There have been many attempts to establish links between various factors and the risk for prostate cancer. The factors listed below are what many would think are risk factors for prostate cancer, but in reality they have little or no effect on the risk for developing prostate cancer.
A vasectomy is a surgical procedure performed to make a man infertile. Some studies have suggested that men who had a vasectomy before the age of 35 may have a slightly increased risk for prostate cancer.
However, results of studies to establish this link have been mixed and are not strong enough to warrant recommendation that men wait to have this procedure or reverse the procedure.
As cigarette smoke contains cancer-causing chemicals (also called carcinogens), some scientists thought smoking may be a risk factor of prostate cancer. In reality, smoking increases your risk of developing lung cancer, as well as other cancers, such as prostate cancer.
Although men who smoke may have a higher mortality rate from prostate cancer than non-smokers, evidence does not suggest a link between smoking and the development of prostate cancer. Smoking has been clearly linked to other illnesses including cancers of the lung, mouth, throat, bladder, kidney, pancreas, and stomach, as well as heart disease, pneumonia, cataracts, and a serious from of gum disease called periodontitis.
This leads to many men asking if a man’s level of sexual activity has any impact on his risk for developing prostate cancer.
Different groups of men have been studied in an effort to establish if sexual activity is a prostate cancer risk factor. Studies on married men with or without children, unmarried men with one or more sexual partners, young men, older men and so on did not provide any strong evidence of a relationship between sexual activity or inactivity and the risk for prostate cancer.
Viruses And Other Infections
Many viruses can infect the prostate, just as they can infect any other tissue in the body. Viral infections can cause inflammation and problems with urination.
However, there are few reports of these infections resulting in higher risk of prostate cancer. Recent studies have looked at a potential relationship between HPV infections in men and the risk of prostate cancer. However, results are inconclusive and more studies are expected to be conducted over the next few years.
A digital rectal examination of the prostate allows a doctor or experienced health care professional to determine if the prostate is enlarged, hard, or see if there are any irregularities in it. The digital rectal examination procedure also gives your doctor an idea of how extensive any abnormality of the prostate might be and helps the doctor to plan and direct a potential biopsy, in which a sample of tissue is removed and examined under a microscope. Additional testing can determine the cause of any abnormality.
The prostate gland is located just in front of the rectum, which means that part of it can be felt through the rectum. The doctor gently places a gloved, lubricated finger into the rectum to feel the part of the prostate that is just under the skin of the rectum. A digital rectal examination (DRE) should be performed as part of any screening process for prostate cancer and should be performed by a physician, physician’s assistant, or nurse practitioner who is experienced in performing these procedures.
A digital rectal examination can help detect both prostate and rectal cancer. The digital rectal examination and standard screening is often part of a thorough physical examination of an adult man. The DRE is also used after a man is diagnosed with prostate cancer to help determine if the cancer has spread beyond his prostate gland and is used to detect cancer that has returned after treatment.
What Does A Digital Rectal Examination Involve?
The doctor may ask you to bend over the edge of the examination table or lie on the table on your side with your knees held close to your chest for this procedure. The procedure may cause some discomfort, but it is not painful and is usually very brief.
Why Is A Digital Rectal Examination Needed?
DRE and PSA testing are usually done together because neither test alone provides adequate testing for prostate cancer. About one fifth of prostate cancers do not produce enough PSA to make the blood PSA level abnomal. The PSA test therefore may not detect these cases.
DRE alone does not provide adequate screening for prostate cancer. It is difficult for a doctor’s finger to reach all parts of the prostate gland through the rectum, although it reaches the back part of the gland, where most prostate cancers begin. Small prostate cancers may be difficult to feel and therefore difficult to detect through DRE.
To give you a better idea of what is involved in a DRE, watch the digital rectal examination video by a doctor who explains what to expect from a DRE.
The prostate-specific antigen (PSA) test is commonly used to detect prostate cancer. PSA liquefies semen so sperm are better able to travel up the female reproductive tract.
When the prostate is healthy, very little PSA escapes into the bloodstream. Sometimes, due to diseases or an enlarged prostate gland, the walls between the prostate and the bloodstream may break down and allow more PSA into the blood. PSA can be detected by a blood test.
The PSA Test
Abnormal levels of prostate-specific antigen often indicate that a man has prostate cancer. Testing for high PSA levels allows doctors to assess a man’s prostate cancer risk. Generally, when cancer is present, the higher the PSA level is, the larger the prostate cancer is and the more likely it is to have spread beyond the prostate.
However, the PSA levels alone do not provide enough information to distinguish between benign prostate conditions and cancer. PSA testing only serves as a screening means to indicate if a prostate problem exists. The doctor takes the PSA test results into account, along with other factors, before deciding if additional testing is required.
Prostate PSA Levels – What Do They Indicate?
PSA is measured in terms of nanograms per milliliter, or ng/ml. A PSA of 4 to 10 ng/ml is considered slightly elevated, 10 to 20 is moderately elevated, and above 20 is highly elevated.
One high PSA reading does not necessarily require more tests. This is because certain factors can cause PSA levels to rise or fall. For example, bed rest may lead to a drop in PSA levels, while cycling may lead to a rise in PSA levels. Before having a PSA test, you may want to refrain from sexual activity for 1 to 2 days. If you have had a cystoscopy, schedule your PSA test only several weeks after your cystoscopy.
If your PSA level is slightly elevated, your doctor may choose to monitor your PSA levels to determine if they continue to rise over time. If levels continue to rise, he or she may suggest more extensive tests.
PSA test results alone is not sufficient to determine if a man has prostate cancer. Most men with abnormal PSA levels are not diagnosed with cancer. Only 25 to 30 percent of men with PSA levels higher than 4 ng/ml will be biopsied and diagnosed with cancer. 15 in 100 men over 50 will have elevated PSA levels but only 3 of these will have prostate cancer. Conversely, there are men with extremely low PSA levels who had biopsies showing cancer there is a way to treat erectile dysfunction with cialis.
Because of this, doctors generally recommend the use of the digital rectal examination (DRE) as well as the PSA test to detect prostate cancer.
What Are The Signs And Symptoms Of Prostate Cancer?
This blogpost explores the potential prostate cancer signs and symptoms that men may experience before prostate cancer is diagnosed. Seeing a doctor and arranging for prostate cancer screening when one experiences these symptoms will help save lives.
The Warning Signs Of Prostate Cancer
1) Weak Urination Or Inability To Urinate
As the prostate surrounds the urethra, obstructive urinary symptoms may mean prostate trouble. Having a weak urinary system, failing to empty the bladder, being unable to urinate, straining, waiting too long to start urinating or having the urine stream stop and start during urination are potential prostate cancer warning signs.
These symptoms may also indicate the occurrence of benign prostatic hyperplasia (BPH), the overgrowth of normal prostate cells which is not cancerous. BPH usually grows along the urethra (causing urinary symptoms) in what is called the transition zone. 80 percent of prostate cancer grow in the outer part of the prostate (the peripheral zone) and do not cause urinary symptoms.
2) Painful Or Frequent Urination
Frequent urination, an urgent need to urinate, and painful urination may also be physical symptoms of prostate cancer. However, they are also more likely to indicate an infection of the prostate or urinary tract.
Benign enlargement of the prostate, bladder cancer, or some other irritation in the bladder, such as a bladder stone, may also cause these symptoms.
3) Inability To Urinate Or Kidney Failure
If severe symptoms such as an inability to urinate and kidney failure are due to prostate cancer and not to BPH, the prostate cancer is typically larger and more likely to have spread locally or elsewhere.
Spread into the base of the bladder may have blocked the ureters that carry urine from the kidneys to the bladder. Or it may block the urethra where it courses through the prostate.
4) Blood In Urine
Blood in the urine may be caused by conditions other than prostate cancer. However, if prostate cancer is present, blood in the urine may signal that caner has spread to the urethra or bladder and that the disease is relatively advanced.
5) Erectile Dysfunction
Some men may be unable to have and maintain an erection. This will prompt your doctor to screen for prostate cancer although the erectile dysfunction may be unrelated to cancer. Some people take a drug called Cialis to have an erection although you should be careful of Cialis side effects if you have heart disease. If prostate cancer is present, erectile dysfunction could be due the invasion of the nearby nerves, that normally help a man achieve erections, by the cancer.
In rare cases, aggressive local spread of prostate cancer may also cause a prolonged painful erection known as priapism.
6) Blood In Semen
Blood in ejaculated semen is most commonly associated with prostatitis, an inflammatory conditions of the prostate. In men over the age of 55, this may occasionally be a sign that prostate cancer is present.
7) Abdominal Pain Or Digestive Symptoms
Locally advanced prostate cancer can invade or surround the rectum and produce obstructive symptoms similar to colorectal cancer symptoms, although this is rare.
A tough tissue separates the prostate from the rectum and tends to serve as a barrier to prevent prostate cancer from invading the rectum directly. When the invasion does happen, it may cause constipation, abdominal pain and cramping, rectal pain, bleeding or intermittent diarrhea.
Weight Loss, Fatigue, Or Generalized Weakness
As cancer advances, it metastasizes to other sites in the body. Five percent of prostate cancer cases are sometimes diagnosed because of the signs and symptoms of metastasis.
General symptoms of any advanced or metastasized cancer of any kind, as well as symptoms of metastasized prostate cancer, would include weight and appetite loss, tiredness and weakness.
9) Back Or Pelvic Pain
Back or pelvic pain are common symptoms of prostate cancer and a host of other different conditions. However, unrelenting pain in the back or pelvic region is one of the common signs and symptoms of advanced prostate cancer.
This is because prostate cancer typically first spreads to the bones, specifically the pelvis and spine. Besides low back pain, bone pain in other areas is also possible, as prostate cancer can also spread to the ribs and bones in the extremities.
In some cases, a broken bone is the first sign of bone metastasis. Fractures, especially in hip bones that have been weakened by cancer, cause pelvic pain.
10) Pain, Numbness Or Weakness In The Legs
Extensive metastases in the spine can compress the nerves in or near the spinal cord and cause pain, numbness, or weakness in the lower extremities, problems with bowel or urinary control, or even paralysis.
Nerves in or near the lower part of the spinal cord affect the legs, bladder, and intestines, which is why compression of the spinal cord can cause these problems.
11) Clotting Disorder
On rare occasions, men with advanced prostate cancer experience severe bleeding, usually from multiple sites. Release of substances from the prostate cancer into the bloodstream is believed to cause both clotting in the body as well as destruction of a substance necessary for clotting. As a result, the normal clotting process which normally prevents excessive bleeding is affected.
12) Mental Changes And Other Symptoms
Prostate cancer invading the bones can force large amounts of calcium out of the bones and into the bloodstream. Higher-than-normal levels of calcium in the blood (also known as hypercalcemia) can cause mental changes, nausea, vomiting, and abdominal pain.
How To Tell If Urinary Symptoms May Be Due To Prostate Cancer, And Not BPH
Symptoms due to prostate cancer may appear more suddenly over a matter of months. Urinary symptoms due to benign enlargement of the prostate tend to progress slowly over the years.
Younger men who have obstructive or irritative urinary symptoms should be evaluated for prostate cancer. This is because BPH usually appears after age 60. Several studies have also suggested that African-American men more often have obstructive symptoms at a younger age.
As benign prostatic hyperplasia (BPH) and prostate cancer share the same symptoms, be as specific as you can when you describe your symptoms to your doctor.