Thursday, 10 November 2016

Prostate cancer diagnosis and treatment

Prostate cancer diagnosis and treatment
Prostate screening tests include:
·         Digital rectal exam (DRE). During a DRE, the doctor inserts a gloved, lubricated finger into therectum to examine the prostate, which is adjacent to the rectum. If the doctor finds any abnormalities in the texture, shape or size of the gland, the patient may need more tests.
·         Prostate-specific antigen (PSA) test. A blood sample is drawn from a vein in the arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.
PSA testing combined with DRE helps identify prostate cancers at their earliest stages, but studies have disagreed whether these tests reduce the risk of dying of prostate cancer. For that reason, there is debate surrounding prostate cancer screening.
Diagnosing prostate cancer
If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer, such as:
·         Ultrasound. If other tests raise concerns, the doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into the  rectum. The probe uses sound waves to make a picture of the prostate gland.
·         Collecting a sample of prostate tissue. If initial test results suggest prostate cancer, the doctor may recommend a procedure to collect a sample of cells from the prostate (prostate biopsy).
Treatment
No treatment needed in some cases
For men diagnosed with very early-stage prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance.

Radiation therapy
Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways:
·         Radiation that comes from outside of the body.
·         Radiation placed inside your body (brachytherapy).Brachytherapy involves placing many rice-sized radioactive seeds in your prostate tissue. The radioactive seeds deliver a low dose of radiation over a long period of time.
Hormone therapy
Hormone therapy is treatment to stop the body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.
Surgery to remove the prostate
Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. Ways the radical prostatectomy procedure can be performed include:
Freezing prostate tissue
Cryosurgery or cryoablation involves freezing tissue to kill cancer cells.
During cryosurgery for prostate cancer, small needles are inserted in the prostate using ultrasound images as guidance. A very cold gas is placed in the needles, which causes the surrounding tissue to freeze. A second gas is then placed in the needles to reheat the tissue. The cycles of freezing and thawing kill the cancer cells and some surrounding healthy tissue.
Chemotherapy
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both. Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don't respond to hormone therapy.

Biological therapy
Biological therapy (immunotherapy) uses the body's immune system to fight cancer cells. One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer.

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