Once preliminary screening and diagnostic exams reveal a "positive" result of cancer cells being present in a man's prostate gland, the next immediate step for a physician is to determine how aggressive the prostate cancer is or how quickly the tumor will grow and spread. This process is known as grading the cancer cells.
Grading Prostate Cancer Cells
The process of grading determines which cancer cells most resemble normal prostate gland tissue versus those that do not. The lower the grade, the more like normal prostate tissue the cancerous cells appear to be and are considered non-aggressive. They are considered aggressively abnormal from original prostate tissue when the score is very high.
Gleason Rating System for Scoring Prostate Cancer
A scoring system often used to characterize differentiations between prostate cancer cells is known as the Gleason grading system. Scores typically range from 2 (representing non-aggressive cancer cells) to 5 (representing aggressive/abnormal cancer cells). A rank of one represents normal or the most common pattern of a man's prostate cells.
Stages of Prostate Cancer
Staging is the next step that leads to prostate cancer treatment. This process involves taking various tests to determine how far the cancer has spread beyond the original tumor. Prostate cancer stages range from small, with very low Gleason scores ("stage I") to cancer that has spread to other areas of the body, referred to as metastasized. This final level is designated as "stage IV" and is typically associated with very high Gleason scores. Overall, staging prostate cancer ranges from I to IV.
Tests Used to Stage Prostate Cancer
A physician determines which additional tests will be used to stage prostate cancer in a patient, since not everyone needs all tests. Based on a patient's condition, a physician will select appropriate tests from the following options:
- magnetic resonance imaging (MRI) to allow magnetic radio waves to create internal photographs of the prostate gland for more detailed analysis
- computerized tomography (CT) scan to have X-rayed photographs taken of a man's lymph nodes and surrounding body parts outside of the immediate prostate area for possible cancer spread
- bone scan to determine if prostate cancer has spread to a man's bones; radiation injections into the bloodstream are used in this method
Prostate Cancer Treatment
How far the prostate cancer has spread, a man's Gleason score, age, symptoms, overall general health, and other important risk factors determine how it will be treated. It is imperative for a man and his physician to thoroughly discuss the benefits, potential risks, and side effects associated with any suggested treatments.
Following are several available prostate cancer treatment options that a physician may recommend:
- active surveillance
- prostate gland surgery
- chemotherapy therapy
- hormonal therapy
- radiation therapy
Active Surveillance
A doctor may recommend that a man diagnosed with a very early stage of prostate cancer not begin any type of immediate treatment if no symptoms are manifesting and/or the cancer appears to be growing very slowly. Regular exams, blood tests, and additional biopsies may all take place during this time in order to continue monitoring a patient's progress.
Prostate Gland Surgery
Several types pf prostate gland surgeries are available as treatment options. They include:
- open surgery; the entire prostate, surrounding tissue, and/or lymph nodes are removed if necessary
- laparoscopic prostatectomy; a surgeon uses a laparoscope to remove the entire prostate
- robotic laparoscopic; a laparoscope and surgical robot, controlled by the surgeon, are used to remove the entire prostate
- cryosurgery; a surgeon inserts a special tool to release gases of varied temperatures to freeze prostate tissue and kill cancer cells
- transurethral resection of the prostate (TURP); a surgical scope is used to remove some of a man's prostate tissue if he has advanced prostate cancer
Chemotherapy Treatment
Chemotherapy is a prostate cancer treatment in which a combination of medicines, via an intravenous (IV) tube and/or pills, is used to directly destroy or shrink cancer cells.
Hormonal Therapy
Hormonal therapy blocks cancer cells from receiving testosterone and other male hormones (referred to as, androgens) needed to thrive and grow. This method of treatment affects the type of prostate cancer that is sensitive to and feeds on hormones.
Radiation Treatment
External: High-powered rays specifically target the area of the body where prostate cancer cells have been located to kill them. The potency and energy of the beams used in radiation treatments are very similar to those of x-rays.
Internal: Rather than high-powered rays being applied outside of the body, radioactive seeds are implanted directly into a man's prostate. They release radiation over a period of time and never need to be removed once the dosage is exhausted.
Fighting a Diagnosis of Prostate Cancer
A diagnosis of prostate cancer does not mean that a man will automatically lose the battle for life to the disease. Informative consultations with physicians, medical personnel, family, friends, and support groups help to lessen the load of fear and devastation. Self-education also tremendously frees thoughts of doubt and the unknown.
Unlike times past, numbers of prostate cancer survivors increase daily due to new methods of treatment and ongoing research. They survive because of their will to live, tenacity to seek medical intervention, and determination to beat the disease.
References:
U.S. National Institutes of Health. "What You Need to Know About Prostate Cancer." National Cancer Institute. August 17, 2010
Scardino, M.D., Peter T., and Kelman, Judith. Dr. Peter Scardino's Prostate Book. New York: The Penguin Group, 2005.
Londa Bowers - Laughing! Attending theatrical plays and Arts Festivals. Traveling, shopping, reading, writing. Playing Scrabble. Walking along boardwalks ...
