What To Do If Prostate Cancer Strikes

Unlike breast cancer, which has recently become a celebrated cause, prostate cancer is a silent scourge. Many resources are available for men with prostate cancer, but the topic is difficult for them to discuss. Many men do not get the best treatment for their cancer because they do not act early enough.

By taking a few simple steps, men diagnosed with prostate cancer can take charge of their lives and overcome much of the fear and anxiety that accompany a cancer diagnosis. So even if you have recently been diagnosed with prostate cancer, take heart. You will have many decisions to make, but you will have plenty of company. Ultimately, there is a good chance your cancer will be cured or controlled. Most men die with, not of, prostate cancer.

If your doctor suspects from the PSA test or a suspicious digital rectal exam that you may have prostate cancer, he or she will order a biopsy. The biopsy yields multiple tissue samples which are checked for cancer. If the biopsy reveals that cancer is present, it is given a Gleason score, which is a measure of the aggressiveness of the cancer. The physician "stages" it to determine its spread, using imaging tests such as ultrasound, bone scans, computer tomography (CT) scans, and magnetic resonance imaging (MRI) scans.

Keep in mind that staging tests often underestimate the extent of prostate cancer, so unless you've already had surgery no doctor can tell you with certainty whether or not your cancer is limited to the prostate. For cancers of each stage, there are numerous treatment options (see chart below). It is important to consider all the specifics of your case in choosing a treatment.

Choosing a treatment for prostate cancer is not easy. The primary choices are surgery, radiation, and hormone therapy, which are used alone or in combination. Urologists usually specialize in surgery; radiation oncologists in radiation, both internal and external. Each group may advocate the treatment in which they have received training. What's more, there are published studies that seem to favor each type of treatment, including no immediate treatment other than careful observation for some older men.

The treatments can have side effects. Both surgery and radiation can result in impotence and incontinence. Hormonal therapy, which reduces the amount of testosterone in the bloodstream and thereby deprives a prostate tumor of a necessary stimulus, has been shown in clinical trials to extend life and delay time to disease progression. Side effects are usually loss of sex drive and weight gain.

But hormonal therapy nearly always stops working after a time because tumor cells develop that are not dependent on the hormones. The potential consequences of treatment have to be weighed care fully in each case to determine the optimal approach. Frightening as it is to remain in doubt, and difficult as it may be under the restrictions of managed care, it is best to hear more than one opinion before deciding on a course of treatment.

While it is advisable to receive treatment without great delay, there is almost always time to examine the options, including investigational therapies.

Here are some guiding principles to help you:

• insist on a second opinion;
• get as much information as possible from books, support groups, and the Internet (but be aware that this information may not always be accurate, unbiased, or applicable to your situation, so be sure to check with your doctor before following medical advice you read about);
• take along a detailed list of questions and record the answers;
• ask about your doctor's experience in treating prostate cancer;
• take along your wife or a friend who can act as your advocate;
• make sure you and your doctors treat the whole patient, not just the prostate.

There are several new and promising investigational treatments for prostate cancer that may offer improved outcomes. Hundreds of clinical trials are now testing them. You may be eligible for such a treatment depending on your cancer.

Promising investigational treatments include:

• Neoadjuvant hormonal therapy, which shrinks the prostate tumor to increase success rates of surgery or radiation;
• Cryosurgery, which destroys a tumor by freezing;
• Immunotherapy, which boosts the body's own defenses against cancer; and
• Chemotherapy, using new drugs that might help men with advanced prostate cancer.

About the Prostate Cancer Initiative
The Prostate Cancer Initiative is a partnership between the Cancer Research Institute (CRI) and the American Cancer Society (ACS) targeting efforts to both improve and increase research into prostate cancer and to educate and support prostate cancer patients.

About the Cancer Research Institute
The Cancer Research Institute supports leading-edge investigations aimed at developing new methods diagnosing, treating, and preventing cancer. Founded in 1953, the Institute has helped to establish the rapidly expanding field of cancer immunology, which seeks to utilize and strengthen the immune system's innate ability to combat cancer.

The Institute is closely guided by a Scientific Advisory Council which includes five Nobel Prize winners and 17 members of the National Academy of Sciences.

Cancer Research Institute, Inc.
681 Fifth Avenue, New York, NY
10022-4209
1-800-33-CANCER
www.cancerresearch.org

About the American Cancer Society
The American Cancer Society is a nationwide, community based, voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer, through research, education, advocacy, and service.

The American Cancer Society has a presence in virtually every American community and is supported by more than 2 million volunteers. It is the nation's most accessible and comprehensive source for cancer information.

American Cancer Society, Inc.
1599 Clifton Road NE, Atlanta, GA 30329
1-800-ACS-2345
www.cancer.org

 

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