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Palliative treatments Active surveillance The risk of some small, non aggressive, localised prostate cancers ever spreading is very low. In these cases, the risks of treatment may outweigh the benefits. In watchful waiting, the cancer and PSA levels are monitored, but no active treatment is carried out. This may be particularly appropriate for men prostwte have a life expectancy of less than 10 or 15 years, due to advanced age or other medical problems. Local treatment If a man chooses to have treatment for prostate cancer, the main options in Australia include surgery, radiotherapy and hormone therapy.
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Palliative treatments Active feamle The risk of some small, non aggressive, localised prostate cancers ever spreading is very low. In these cases, the risks of treatment may outweigh the benefits. In watchful waiting, the cancer and PSA levels are monitored, but no active treatment is carried out. This may be particularly appropriate for men who have a life expectancy of less than 10 or 15 years, due to advanced age or other medical problems. Local femwle If a man chooses to have treatment for prostate cancer, the main options in Australia include surgery, radiotherapy and hormone therapy.
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If a man has a life expectancy of less than 10 years, definitive treatment may not be recommended. RP generally involves a 4—8 day hospital stay. A urinary catheter tube through the penis into the bladder with a urine bag attached remains in place for at least 2 weeks after the operation. Fenale rates due to radical prostatectomy are 0.
Bilateral nerve sparing surgery may be possible in some cases.
In some cases, RP may be followed by radiotherapy. Beams of radiation like x-rays are targeted at the prostate by a machine that akstralia around the body. The rays kill the cancer cells. Small tattoos may be placed on the skin to make sure the beam is in exactly the right place, and minimise damage to healthy tissue. This procedure is performed in an out-patient setting, and men are usually able to maintain their normal milkign.
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Brachytherapy internal radiotherapy There are two main types of brachytherapy : Use of a radioactive pellet: This involves placing a small miking pellet into the prostate seeding. The pellet loses its radioactivity over time, and is not removed. This option may be used for low Gleason score, low PSA, small, localised prostate cancer. Use of wide bore needles: This type of brachytherapy involves inserting wide bore needles into the prostate, through which radioactive sources can be given.
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After several days of treatment, the needles are removed. This type of brachytherapy is used in conjunction with EBRT for larger, more aggressive tumours. The needles may cause local discomfort, usually relieved by painkillers. Other side effects are similar to those for EBRT. For further information on brachytherapy, see Femaale for Prostate Cancer.
Testosterone appears to drive the growth of prostate cancer. Androgen deprivation therapy Feamle aims to lower levels milkjng testosterone. Side effects of ADT include hot flushes, loss of libidoweight gain, erectile dysfunction, gynaecomastiafluid retention, osteoporosis and mood swings. Palliative treatment is deed to relieve symptoms, maintain quality of life and, in many cases, prolong life.
It will not cure the disease. Transuretheral resection of the prostate TURP may be carried out to relieve obstructive symptoms due to the cancer.
Hormone therapy: ADT is a mainstay of treatment for cancer that is not resectable removable by surgery. Eventually, the cancer will no longer respond to ADT. Bisphosphonates and analgesia may be used to treat cancer spread to bones. EBRT may be rpostate to treat pain related to bone metastases. Relative side effects of different treatments Radical prostatectomy and brachytherapy result in higher rates of urinary incontinence and sexual dysfunction than EBRT.
Bilateral femape sparing surgery not possible in all cases diminishes this difference. RT causes more bowel dysfunction than surgery. Brachytherapy causes austra,ia obstructive and irritative urinary symptoms. Treatment recommendations Good quality evidence of the best approach to prostate cancer is limited, but the following treatment strategies have been suggested: Low-risk disease: Radical prostatectomy, brachytherapy monotherapy, or EBRT.
Intermediate-risk disease: EBRT or surgery.
Prostate cancer: adenocarcinoma | healthengine blog
The role of brachytherapy alone is controversial. EBRT or brachytherapy alone are not generally appropriate. Prostate Biopsy Interpretation, 3rd Edition. Philadelphia: Lippincott, Williams, and Wilkins, New York: McGraw-Hill, Central zone carcinoma of the prostate gland: A distinct tumor type with poor prognostic features. J Urol. Cancer statistics, CA Cancer J Clin. The Cancer Council Australia. Prostate cancer screening position statement [online].
Epidemiology of cancer in Indigenous Australians: Implications for service delivery.
Paper presented at the 9th National Rural Health Conference: Standing up for rural health: Learning from the past, action in the future. National Cancer Institute.
Bethesda, MD. The role of increasing detection in the rising incidence of prostate cancer. Defining and updating the American Cancer Society guidelines for the cancer-related checkup: Prostate milling endometrial cancers. American Urological Association. Early detection of prostate cancer and use of transrectal ultrasound.
Recent trends in prostate cancer mortality show a continuous decrease in several countries.
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Int J Cancer. Natural history of low-stage prostatic cancer and the impact of early detection. Urol Clin North Am. Findings on the detection of early prostate cancer in men.
A systematic review and meta-analysis of familial prostate cancer risk. BJU Int. Cancer surveillance series: Interpreting trends in prostate cancer — Part 1: Evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates. J Natl Cancer Inst. The role of prevalence in the diagnosis of prostate cancer. Cancer Control. Stamey TA. Making the most out of six systematic sextant biopsies.
Thompson D, Easton DF. Cancer incidence in BRCA1 mutation carriers.
N Engl J Med. Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium.
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Two percent of men with early-onset prostate cancer harbor germline mutations in the BRCA2 gene. Am J Hum Genet.
J Clin Oncol. Endogenous sex hormones and prostate cancer: A collaborative analysis of 18 prospective studies. The impact of modifiable risk factors on mortality from prostate cancer in populations of the Asia-Pacific region. Asian Pac J Cancer Prev. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U. Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy.
Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Nutrition and prostate cancer: Evidence or suspicion?
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Role of diet in prostate cancer development and progression. Dietary fat aystralia prostate cancer: Current status. Colli JL, Colli A. International comparisons of prostate cancer mortality rates with dietary practices and sunlight levels. Urol Oncol. A prospective study of dietary fat and risk of prostate cancer. Fruit and vegetable intakes and prostate cancer risk.
Do dietary lycopene and other carotenoids protect against prostate cancer? Cancer Epidemiol Biomarkers Prev.
Does high soy milk intake reduce prostate cancer incidence? Cancer Causes Control. Yan L, Spitznagel EL.
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