UNDERSTANDING PROSTATE CANCER

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Prostate cancer is the most common cancer in American men. One out of 6 men will develop the disease at some time in his life. Although it is the second leading cause of cancer deaths among men in the United States, if discovered early, prostate cancer can be treated successfully.

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As is the case for each man diagnosed with prostate cancer, you must decide with your doctor what kind of treatment to have. Making these decisions can sometimes be difficult and confusing. Each patient’s condition is different, and doctors do not always agree on the treatment.

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“When the doctor says that you have cancer, you may not hear anything else he says. Above all, don’t panic. I know from personal experience that it is frightening, terrifying, and dreadful. You have time . . . it probably took several years for the cancer to become large enough to be evi­dent. Get a second opinion, maybe a third one. They will probably be the same as the first one. Accept it, then start learning and planning on how you are going to combat this thing.”

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“A Revolutionary Approach to Prostate Cancer”

Dr. Aubrey Pilgram

Prostate Cancer Survivor

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What is Prostate Cancer?

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The prostate is a gland in the male reproductive system. It is a small, walnut-sized organ located between the bladder (the organ that stores urine) and the urethra (the tube that carries urine to the outside of the body). The prostate is made up largely of muscular and glandular tissues. Its main function is to produce fluid for semen, which transports sperm.

Prostate cancer originates in the prostate gland. Because of its location, a physician can directly examine the part of the gland where most tumors occur.

 

Cancer that is confined within the prostate and has not spread is called localized prostate cancer. Like other cancers, however, prostate cancer can spread (metastasize) to the tissues around the prostate or into the seminal vesicles (sac­like structures attached to the prostate). Locally advanced prostate cancers may spread to other parts of the body, such as the lymph nodes or bones.

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Symptoms of Prostate Disease

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Although many prostate cancers have no symptoms, talk to your doctor if you:

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• urinate frequently, especially during the night.

• have trouble starting your urine stream.

• have a weak or interrupted urine stream.

• feel like your bladder doesn’t empty completely.

• have blood in your urine.

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If you experience any of the above symptoms, it may be an indication of a potential prostate problem, and you are encouraged to see a physician.

 

Treatment Decision Considerations

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Cancer diagnosis often creates anxiety and urgency for patients. The outcomes of possible treatments can have a profound impact on your life, particularly for prostate cancer patients. Each individual, together with his partner or family and physician, should analyze his emotional needs in order to feel comfortable with a selected treatment. Rather than adopting a course of action in response to immediate fears, consider the following as you enter the decision-making process:

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• Don’t rush

Unless there is a compelling medical reason to act quickly, take the time to learn about your particular cancer, the risks and possible side effects of various therapies, and the impact they may have on your life. Remember, typically there is time for you to become informed.

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• Get the facts

Start learning what it is, how it acts, and what treatments are available. You will also need to know the language generally used in reference to prostate cancer.

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• Don’t play doctor

Alternative medicine has many advocates. Until more is known about the efficacy of various alternative treatments, consult with your doctor before subscribing to them.

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• Continually seek information

Because prostate cancer diagnosis and its treatments are changing rapidly, continually seek updated information. Discuss the information, ask questions and be honest with your doctor and healthcare team.

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• Become your own advocate

By educating yourself, you will become an advocate for your healthcare.

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• Form a partnership

Choose one that is mutually supportive and based on candid, honest dialogue. Embarrassment is not an excuse.

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• Consider a second opinion

Doctors understand getting a second opinion to confirm their diagnoses. When you seek a second opinion, urologists, radiologists, oncologists, and general practitioners may offer different perspectives.

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• Talk about your cancer

Prostate cancer is a family affair that affects those closest to you. Talk with your partner and family about your cancer.

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• Consider a support group

Get involved. Support groups put you in touch with peers who understand your situation because they’ve been there themselves. The Santa Cruz Prostate Cancer Support Group invites you to attend any of our meetings (times and locations can be found later in this pamphlet).

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• Seek the best option

It is your responsibility to seek the best choice for you by investigating the services covered by your insurance and what might be available through your healthcare providers. When you are ready to make a treatment decision, ask the doctor how many cases like yours he or she has treated.

While first-rate treatment is available at many hospitals throughout the United States, many may not be equipped or experienced in all treatment methods available. Be assured that local community hospital, as well large regional medical institutions, offer doctors who are experts in your type of cancer.

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• Maintain good records

Throughout this process, you need to maintain good records. First, this is important for your insurers. Second, it is important to have your medical reports available for review when seeking a second opinion. These reports provide a profile of your condition and will help you avoid having to undergo tests you have already taken, since the consulting doctor will know in detail what has already been tested.

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How is Prostate Cancer Diagnosed?

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Several tests are useful in detecting and staging prostate cancer. Not all of these tests are needed in all men.

 

The prostate-specific antigen (PSA) test is a blood test that can give indirect information about whether any prostate cancer is present and, if so, the amount of cancer and the chances of it spreading (or already having spread).

 

The digital rectal examination (DRE), a simple procedure, can help the doctor detect the cancer and judge whether the cancer is confined to the prostate or whether it may have spread to tissues around the prostate.

 

Transrectal ultrasonography (TRUS) is a safe and easy way to “see” the prostate. Ultrasound provides an image of the prostate that the doctor can use to measure the size of the prostate, look for cancerous tissue, and calculate the PSA density (the PSA level divided by the size of the prostate). Needle biopsy of the prostate is usually performed under ultrasound guidance.

 

A prostate biopsy analysis of tissue removed by biopsy gives important information about the cancer. The tumor grade is determined by examining the tissue under a microscope to measure the amount of disorganization of cells.

 

A computer tomography (CT) scan is an X-ray procedure that gives cross-sectional images of the body. The CT scan may help detect lymph nodes in the pelvis that are enlarged because of cancer.

 

A bone scan gives a nuclear image of the tumor. This test is used to detect the spread of cancer to the bones.

MRI/ultrasound Fusion is software that “fuses” detailed MRI scans with live, real-time ultrasound images of the prostate. Doctors use the fused image to guide the biopsy needles precisely to the lesion they want to sample. This technology lowers the risk of over diagnosis, reducing unnecessary treatment of non life-threatening prostate cancers. 

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Questions to Ask Your Physician

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• What are my chances of getting better?

• What are my treatment options? Is having no treatment an option?

• Would a clinical trial be appropriate for me?

• What are the expected benefits of each kind of treatment?

• What are the risks, possible side effects, and recovery times for each treatment?

• How may the various treatment options affect my sex life?

• If I have pain, how will we manage it?

• How may my day-to-day activity level change with each kind of treatment?

• What is the follow-up care required for each treatment?

• What is the mortality rate?

• How many of these procedures have you performed?

• If you had my condition, what would you do?

• How much will this cost?

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Tips from Survivors of Prostate Cancer

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• Prostate cancer is very treatable.

• Prostate cancer is not a death sentence.

• Never give up!

• Get a second, or even a third, opinion.

• Join a support group.

• See a board-certified urologist and oncologist.

• Keep learning every day; new information becomes available all the time.

• Share your experiences and feelings.

• Research your diagnosis.

• Take some control of your situation.

• Partner with your healthcare providers.

• Open yourself to a new perspective on life.

• Contemplate and write down your medical questions before your office visit.

• Write your physician’s answers down on paper or bring a tape recorder when you meet with him.

• Prostate cancer is a family disease — don’t shut them out.

• Enlist your loved ones for your support system.

• Join a national prostate cancer organization.

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Prevent Prostate Cancer

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Adopting simple dietary habits now can greatly reduce your risk of ever developing the disease at all. The two diets known to be associated with longevity and reduced risks for prostate cancer are the traditional Japanese diet and a Southern Mediterranean diet. The Japanese diet is high in green tea, soy, vegetables, and fish, as well as low in calories and fat. The Mediterranean diet is high in fresh fruits and vegetables, garlic, tomatoes, red wine, olive oil, and fish. Both are low in red meat.

 

DIET: Avoid red meat, processed meats, deep-fried foods, and reduce the amount of dairy products you eat each day. Avoid burning and charring grilled or cooked meat. These foods are linked to prostate cancer. Eat fatty fish such as salmon, sardines, tuna several times a week. Fish and fish oil reduce the occurrence and progression of prostate cancer as well as promote heart health. Use olive oil instead of vegetable oil. Olive oil has a favorable impact on the prostate gland. Avoid canola and flaxseed oil as they almost double your risk of developing prostate cancer. Eat a variety of fruits and vegetables. Drink 2 to 4 cups of green tea a day. Try adding soy foods to your diet, such as soymilk and tofu.

 

LIFESTYLE: Exercise for 30-40 minutes at least 3 times a week. Exercise helps you lose weight: obesity is a precursor to cancer, diabetes, and cardiovascular disease. Make time every day to relax. Stress relief and a positive outlook are linked to longevity.

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Credits

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Certain excerpts are from the Prostate Cancer Research Guide, published by the American Foundation for Urologic Disease.

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