Prostate cancer is the most frequently diagnosed cancer for men counting for 1 in 3 of all male cancers. It can develop very slowly and have no symptoms or can spread quickly and invade surrounding tissue and metastasize. Prostate cancer that is diagnosed early has a very high chance of recovery. When cancer spreads beyond the prostate, it responds poorly to treatment. That is why early screenings for men over 50 are essential.
A diagnosis of prostate cancer can only be confirmed by biopsy. If you are given a definite diagnosis of prostate cancer, the extent of the disease must be determined to choose the best treatment option. Cancer is classified by clinical stage. The stages are classified according to a T-N-M scale. T – is for tumor – which categories the size and amount of tumors. N- is for Nodal Metastasis. M- is for other Metastasis.
Assigning a stage to a cancer tumor helps give a more accurate diagnosis and prognosis of the cancer. The T-N-M system helps physicians and patients understand which treatment options are possible and the outlook for recovery.
If the tumor is confined to the prostate, it will be classified as a T-1 or T-2 localized prostate cancer. There are no symptoms or signs in Stage T-1 and it may not be detected upon rectal exam. It would usually be detected by elevated PSA levels or by examining the tissue removed during the biopsy.
In the T-2 stage, the PSA score will be higher than normal, the biopsy would reveal the cancer and a rectal exam could detect a tumor due to one or more areas of firmness.
Advanced stages of prostate cancer will be categorized as stage T-3 or T-4 where tumor(s) may have spread outside the prostate and reached the seminal vesicles, other organs or bone. Your physician may order imaging studies including scans such as CT scans or MRI’s, to determine whether cancer has spread outside the prostate.
The past decade has seen a dramatic evolution in the way prostate cancer is diagnosed and treated. Better screening and tests means the disease can be diagnosed before prostate cancer becomes clinically evident. Early diagnosis and treatment of prostate cancer is important for a successful outcome. The problem is that with prostate cancer, the cell growth is typically outward and this becomes difficult to detect in the very early stages. Usually symptoms are only felt in later stages of cancer. This is why regular exams are recommended.
Prostate cancer treatment options include traditional treatments including radical prostatectomy (surgery) and radiation. Both carry certain risks and can lead to significant side effects including impotence and incontinence. As a matter of fact, recent studies performed in the U.K. suggest that there is no significant benefit of operating over watchful waiting.
There are also alternative treatment methods available including a concept known as watchful waiting, hormone therapy, Brachytherapy, Cryotherapy and HIFU. Hormone therapy is not considered a cure but a temporary solution to extend the life of a prostate cancer patient or to help improve the quality of life since other treatment options may not be viable. Brachytherapy involves implanting small radioactive seeds directly into the prostate gland using 20-40 needles. Cryotherapy involves freezing the prostate. It often results in a high incidence of urinary incontinence and impotence, and holes (fistulae) between the rectum and prostate can occur.
HIFU, or high intensity focused ultrasound, is gaining favor with patients and urologists since it is associated with fewer significant side effects, is non-surgical, non-invasive and has similar success rates to radiation and surgery. HIFU is available in Europe and was approved by Health Canada in 2003. Clinical studies and research published on prostate cancer treatment by HIFU show very positive results. HIFU is not available in the U.S. yet, but may be approved by the FDA as early as the beginning of 2013.
Depending on your diagnosis and what stage the cancer is in, it is wise to do your research on treatment options, consider success rates and potential side effects, and discuss the options with your urologist.
Visit our prostate cancer blog to read more about prostate cancer treatment options, prevention and information.