Sahlhealth
Sahlhealth

The role of women in Prostate Cancer Awareness

Most Kenyan women serve as the key decision-makers when it comes to the health of their families— whether through selecting a physician, deciding on treatment options, or taking steps to prevent the onset of illness. This role carries with it the responsibility to make effective, informed decisions that give your loved ones the best chance of a good outcome and good health. This is particularly true when confronting the issue of cancer. Cancer that is most likely to strike men as they age, is prostate cancer.

What Is the Prostate?

The prostate is a walnut-size gland located between the bladder and the penis. It surrounds the urethra, the tube that carries urine from the bladder to the penis. When it enlarges, a common condition with age, the urethra is squeezed and urinary problems can result. The prostate plays an important role in reproduction, being responsible for much of the seminal fluid produced by a man.

What Is Prostate Cancer?

Cancer is often the result of when cellular growth goes awry in any organ. When this happens in the prostate, it is referred to as prostate cancer. Doctors refer to the most common type of prostate cancer as adenocarcinoma of the prostate, based on the particular type of cancer cells that have developed.

How Common Is Prostate Cancer?

With the exception of skin cancer, prostate is the most common cancer occurring in men. The good news is, most forms of prostate cancer are relatively indolent, or slow-growing. As a result, the five-year survival rate following a diagnosis of prostate cancer is 98.9 percent.

Symptoms Associated with Prostate Cancer?

Prostate problems are relatively common in men over the age of 55, and these issues may be mistaken for cancer in some cases. An enlarged prostate, known as benign prostate hyperplasia (BPH), can cause problems with urination, sexual function, and other symptoms. And while problematic, BPH is far more of a nuisance than a serious threat to a man’s health.

Though prostate cancer can mimic the symptoms of BPH, it can also be present without the appearance of symptoms, particularly in its early stages. When prostate cancer becomes advanced, other symptoms may be present, including bone pain (frequently occurring in the lower back) and unexplained weight loss.

How Is Prostate Cancer Diagnosed?

Preliminary diagnosis generally relies on screening, which consists of a blood test, known as a PSA (prostate-specific antigen), accompanied by a digital rectal exam. Because the prostate is located directly in front of the rectum, a physician is able to palpate the gland with his or her finger to see if there are any obvious abnormalities. Neither test is definitive, which means that suspected cases of cancer must be biopsied.

When a man’s PSA reaches a certain threshold or there is a perceived abnormality upon physical examination, the physician may recommend a biopsy. It should be noted that some physicians also recommend biopsies based on the rate of change in PSA levels, referred to as PSA velocity. Recent research suggests, however, that PSA velocity, by itself, is not a reliable measure on which to recommend biopsies.2

When performing a biopsy, a surgeon—most frequently a urologist—relies on ultrasound-guided imaging to insert needles into various sites on the prostate. The hollow needles extract tissue cores that can then be examined to determine the extent of the disease. Twelve samples are most commonly collected.

The cores are then examined by a pathologist, who rates them based on what is known as the Gleason score,3 which ranges from 2 to 10; higher numbers signify a more serious expression of the disease.

If the disease is suspected to be more advanced, additional imaging studies may be performed to determine if the cancer has metastasized, or spread to bones or other organs. Based on the sum of the evidence collected through these various tests, patients are assigned a stage that indicates the extent of the disease. The earliest-stage cancers are described at Stage I; cancer that has spread to other portions of the body are Stage IV.

Recommended Treatment

The stage of the tumor and one’s age at diagnosis may significantly guide treatment options. Because many forms of prostate cancer are slow-growing, very early-stage tumors may warrant careful observation, known as active surveillance, rather than aggressive treatment.

When treatment is required, the urologist may recommend either radiation therapy or the surgical removal of the prostate, known as a radical prostatectomyRadiation therapy can take several forms, with the most common being an external beam of radiation to target the prostate and kill cancer cells. The most common form of external radiation is image modulated radiation therapy (IMRT). IMRT generally involves five treatments per week for eight weeks.

A small number of cancer centers offer another form of external radiation known as proton therapy. Proton therapy is controversial4 because its cost greatly exceeds that of IMRT, and numerous experts have argued that there is insufficient data to prove that it is more effective or less toxic.

For patients who do not want to undergo repeated treatments, referred to as fractions, brachytherapy provides a highly effective option. Brachytherapy involves a single, surgical insertion of radioactive seeds into the cancerous portions of the prostate.

Before deciding on a treatment option, it is vitally important that you and your loved one understand the nature of each, as well as its potential short- and long-term side effects. It is advisable to get more than one opinion. Consider scheduling a consultation with both a urologist and a radiation oncologist. You may also find it helpful to do some research into the disease and your treatment options. The National Comprehensive Cancer Network at nccn.org provides excellent treatment guides based on disease and stage.

What You Can Do to Help Your Partner When He Is Diagnosed with Prostate Cancer?

First, encourage your loved one to slow down, despite the anxiety generated by a potential diagnosis of cancer, and gather the information needed to make truly informed decisions before proceeding with a biopsy or treatment. A great deal has been written about the overdiagnosis and over-treatment of prostate cancer in recent years—with much of the controversy centering on the appropriateness of PSA testing among relatively young patients. Before undergoing a biopsy, talk to your doctor(s) about their confidence in the PSA scores and whether it may be wise to repeat the test in three to six months before proceeding to a biopsy.

No alt text provided for this image

This is your first step as you seek to become an expert on the disease, its presentation, and treatment. Once you have availed yourself of the best available information and medical opinions, you are ready to serve as an advocate who ensures that your loved one receives the most appropriate treatment based on the particular stage of the disease. Remember, that may mean active surveillance rather than active treatment. You want him neither overtreated nor under-treated, both of which are real possibilities with prostate cancer.

Finally, be sure you tune in to the potential impact of the disease and its treatment on your loved one’s quality of life, as well as his self-esteem. Issues of sexual function affect both of you, and being able to engage in open and effective dialogue is important to the health of the relationship. You may wish to seek help from a counselor trained to address such issues.

Though prostate cancer is often cured, it may nonetheless take a toll on the family. The more empowered you and your loved one are with information, the greater your probability of limiting this toll and ensuring the best possible outcome from treatment.

Ladies: Check Your Prostates

Okay…you may not have one physically, but if you are married to a man or care about other males in your life, you might as well resign yourself to becoming an advocate for this small and mysterious part of the male anatomy. Men are often their own worst enemy when it comes to their healthcare, making a strong dose of feminine persistence just what the doctor ordered. Here’s an introduction to the number one men’s health issue that might be affecting someone you love.

Prostate cancer affects one of every six American men. For those who are African American or have a family history of the disease, the odds are one in three. As the second most prevalent form of cancer for men after skin cancer, prostate cancer is projected to claim more than 27,000 lives in the United States this year, with an additional 192,000 new cases diagnosed.

In light of these figures

Battling Prostate Cancers

Prostate cancer is not one disease. It’s a problem that fuels misconceptions about this cancer and creates understandable confusion when it comes to screening, diagnosis, and treatment. One treatment option doesn’t serve all patients.

A Woman’s Guide to Prostate Cancer

  • Understand and make prostate cancer something to talk about; share what you know with your partner, family, and friends.
  • Know your partner’s family history and share it with your sons and relatives.
  • Recommend diets low in fat, carbohydrates, and processed sugars in combination with regular exercise.
  • Be sure your partner talks to his doctor about a baseline screening (PSA and DRE) at age 40 and develops a schedule of subsequent screening based on his medical history.

Common Treatment Options for Prostate Cancer

  • Active surveillance- For those men diagnosed with slow-growing cancers, immediate treatment might not be recommended because of the possible side effects of other treatments. Recent studies have shown that men over 65 with low-grade cancers can do well with this approach.
  • Surgery Because prostate cancer grows through a number of small tumors scattered throughout the prostate, the entire prostate plus some surrounding tissue must be removed. Depending on how much tissue outside the prostate must be removed, side effects can include incontinence and erectile dysfunction. Fortunately, improvements made in nerve-sparing technologies are lessening the impact of these side effects.
  • Radiation therapy- Oncologists can kill prostate cancer cells by delivering high doses of X-rays to the prostate via external beam radiation or intensity-modulated radiation therapy. Or, in a treatment called brachytherapy, small radioactive pellets can be injected into the prostate. Over the course of a year, the radioactive matter degrades, leaving harness pellets inside the prostate.
  • HIFU- High-Intensity Focused Ultrasound or HIFU is an FDA-approved, minimally invasive procedure for the treatment of prostate cancer that usually avoids permanent bladder control problems and erectile dysfunction – the two most common, life-altering side effects seen with surgery or radiation.
  • Proton Therapy For many patients proton therapy offers a new treatment option without the side effects of radiation. This treatment is relatively new and costly, however, limiting patient access.
  • Hormonal therapy- In advanced, metastatic cases of prostate cancer, testosterone can actually fuel the growth of cancer cells. With hormonal therapy patients are treated with drugs to block the effects of testosterone.
  • Precision Cancer Medicines- The first precision cancer medicines have been identified for the treatment of prostate cancer and researchers have begun to identify additional genetic biomarkers that can be targeted with precision cancer medicines and immunotherapy. Over 50% of prostate cancer patients have genomic alterations with biomarkers that could be targeted with precision cancer medicines.
  • Chemotherapy Also utilized in advanced, metastatic cases of prostate cancer, chemotherapy floods a patient’s system with cytotoxic drugs that kill fixed and circulating tumor cells.

References:

  1. SEER Cancer Statistics Fact Sheets: Prostate Cancer. National Cancer Institute website. Available at: html/ prost.html. Accessed July 25, 2016.
  2. PSA Velocity Does Not Improve Prostate Cancer Detection. National Cancer Institute website. Available at: http://www.cancer.gov/types/prostate/research/psa-velocity-detection. Accessed July 25, 2016.
  3. Understanding Your Pathology Report: Prostate Cancer. American Cancer Society website. Available at: understandingyourdiagnosis/understandingyourpathologyreport/prostatepathology/prostate-cancer-pathology. Accessed July 25, 2016.
  4. Wisenbaugh ES, Andrews PE, Ferrigni RG et al. Proton beam therapy for localized prostate cancer 101: Basics, controversies, and facts. Reviews in Urology. 2014;16(2):67-75. doi: PMC4080851.
  5. Pardo Y, Guedea F, Aguiló F et al. Quality-of-life impact of primary treatments for localized prostate cancer in patients without hormonal treatment. Journal of Clinical Oncology. 2010;28(31):4687-96. doi: 10.1200/ JCO.2009.25.3245.

Similar Posts

  • Birth defects-here is what you need to know.

    While we are still marking the pregnancy and infant loss month, I thought why not delve deeper into the menace that is birth defects? This condition is also known as congenital malformation. Globally, statistics show that birth defects are on an upward spiral. This is according to a trend monitored by the WHO over the […]

  • Stillbirth and how to cope with child loss

    Joan’s son Michael was sadly stillborn in 2019 two years after the uncomplicated birth of her firstborn son Victor. She took the time to share her experiences with us. Her story is one of a mother who has learned to cope with life after stillbirth. Joan wants to break the silence around baby loss and […]

  • Parents Dictate What their Children Eat

    “Our parents can show us a lot of things: they can show us how we are to be and what things we ought to strive for, or they can show us how not to be and what things we ought to stray from, then you may have the kind of parents that show you all […]

  • Types of contraception you can use to prevent pregnancy

    Getting frisky doesn’t have to be risky business – not when there are many contraception methods out there to suit different needs. Contraception can be used to prevent pregnancy and some types will also protect you from STI’s On Sunday the 26th of September we celebrated #worldcontraceptionday which carried the theme “Contraception: it’s your life, it’s […]

  • Urinary Tract Infections in Women

    A urinary tract infection will have you rushing to the doctor as fast as a jackrabbit in front of a prairie fire. This highly uncomfortable condition can recur for some women, but let’s look at what it is and how it can be properly managed. If you experience pain or pass blood as you pee, […]