Prostate Cancer is the second most common cancer in men in the United States. About one in nine men will be diagnosed with prostate cancer during their lifetime. Prostate cancer is more likely to develop in older men and in African American men. Learning you have advanced prostate cancer may be unsettling. You may have a lot to think about, including treatment choices and your future.
“It can be scary to be diagnosed with any type of cancer, including prostate cancer, but it’s important to know you’re not alone. Gathering information about prostate cancer may help you during your prostate cancer journey,” said Daniel W. Lin, MD, a urologist at the University of Washington and Fred Hutchinson Cancer Research Center in Seattle, Washington.
You are not alone during your prostate cancer journey. Your journey may include a team with a primary care physician, oncologist, urologist, pharmacist, social worker and other health care providers, as well as your family and friends.
Men may work with nurse navigators. These health care professionals help a person with cancer “navigate” the hospital and human services that come along with a cancer diagnosis. This may include assisting with decision-making, coordinating services and advocating for the patient with other members of the health care team. Navigators strive to identify barriers to care and eliminate or reduce them to help the patient avoid delays in treatment.
Learning about your prostate, prostate cancer, tests, treatments and side effects may help you during this journey. Your treatment choices should be based on your personal health and age and should be fully discussed with your health care team.
What is Prostate Cancer?
Cancer is the result of abnormal cell growth that takes over the body’s normal cell function, making it harder for the body to work the way it should. Prostate cancer develops when abnormal cells form and grow in the prostate gland. When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Prostate cancer is often grouped into four stages, with stages III and IV being more advanced prostate cancer.
Stages of Prostate Cancer
Early Stage | Stages I & II: The tumor has not spread beyond the prostate.
Locally Advanced | Stage III: Cancer has spread outside the prostate, but only to nearby tissues.
Advanced | Stage IV: Cancer has spread outside the prostate to other distant parts such as the lymph nodes, bones, liver or lungs.
Signs of Prostate Cancer
Men with prostate cancer usually do not have any symptoms, but in more advanced stages may have some signs of sickness. Symptoms depend on the size of the growth and where the cancer has spread in the body. In more advanced stages, you may have problems passing urine or see blood in your urine and some men may feel tired, weak or lose weight. When prostate cancer spreads to bones, you may have bone pain. Tell your doctor and nurse about any pain or other symptoms you feel. There are treatments that they can discuss with you.
The following tests are used to diagnose and track prostate cancer.
PSA blood test measures a protein in your blood called the prostate-specific antigen (PSA). Only the prostate and prostate cancers make PSA. A rapid rise in PSA may be a sign something is wrong.
Digital rectal exam is a physical exam used to help your doctor feel for changes in your prostate. This test is also used to screen for cancer, stage cancer and track how well treatment is going.
Imaging and scans help doctors learn more about your cancer. Some types are:
Magnetic resonance imaging (MRI) can give a very clear picture of the prostate and show if the cancer has spread into the seminal vesicles or nearby tissues.
Computed tomography (CT) scan is used to see cross-sectional views of tissue and organs.
Positron emission tomography (PET) scan may help your doctor better see where and how much the cancer is growing.
Bone scan can help show if cancer has reached the bones. If prostate cancer spreads to distant sites, it often goes to the bones first.
Biopsy is a tissue sample taken from your prostate or other organs to look for cancer cells. Men may start with a prostate biopsy.
Grading: If a biopsy results in cancer, the pathologist gives it a grade. The most common grading system is called the Gleason grading system. The Gleason score is a measure of how quickly the cancer cells can grow and affect other tissue. The Gleason score will help your doctor understand if the cancer is a low-, intermediate- or high-risk disease.
Staging: Tumor, Nodes and Metastasis (TNM) staging system is the system used for tumor staging. The T, N, M Score is a measure of how far the prostate cancer has spread in the body. The T (tumor) score rates the size and extent of the original tumor in the prostate. The N (nodes) score rates whether the cancer has spread into nearby lymph nodes. The M (metastasis) score rates whether the cancer has spread to distant sites.
Early-stage Prostate Cancer
Early-stage prostate cancer is a cancer that has grown in the prostate, but not grown beyond the prostate capsule to other parts of the body, like lymph nodes or bones. Men with early-stage prostate cancer have a very good chance of survival. Here are some types of treatments that you and your doctor may discuss if you’re diagnosed with early-stage, localized prostate cancer.
Surgery (Radical Prostatectomy)
Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer. Advanced prostate cancer is not “curable,” but there are many ways to treat it. Treatment can help slow advanced prostate cancer progression.
There are many treatment choices for advanced prostate cancer. Which treatment to use, and when, will depend on discussions with your doctor. Here are the treatments you may want to discuss with your doctor if you are diagnosed with advanced prostate cancer.
Talk to your doctor to see if a clinical trial might be right for you.
Your Care Team Should Know What Matters to You
The prostate cancer journey is unique to each person and their family. It is of great importance to learn as much as you can and find the right tools and to let your care team know what is important to you. Talking with your doctor and health care team is a great place to start. Here are some questions you may want to think about asking your doctor as you navigate along the way:
What does “advanced cancer” mean for me?
Are there other tests I should have to understand how advanced my cancer is?
What are the treatment options for this grade/stage of cancer?
Which treatment do you recommend for me and why?
How long should I try a treatment type before we know whether it works?
Would a clinical trial be an option for me?
What can I do to manage my symptoms?
What can I do to help manage treatment side effects?
What can I do to help protect my bones?
What is the average lifespan for people with my grade/stage of cancer?
What kind of care will I receive to keep me comfortable if I decide not to have active treatment?
Can you refer me to another expert for a second (or third) opinion?
Read the latest issue of UrologyHealth extra®, the Urology Care Foundation's patient-focused magazine.
Your Browser is Not Supported
This web site has been optimized for user experience and security, therefore Internet Explorer(IE) is not a recommended browser.Please use the latest version of Microsoft Edge, Chrome, Firefox or Safari(MacOS). Thank you.