Delta Medix Patient General Information

Prostate Cancer

Prostate cancer forms in the tissues of the prostate gland. The prostate is part of the man’s reproductive system. It is an organ located in front of the rectum and under the bladder. The prostate surrounds the urethra, the tube through which the urine flows. A healthy prostate is about the size of a walnut. If the prostate grows too large, it squeezes the urethra. This may slow or stop the flow of urine from the bladder to the penis. Male hormones (androgens) make the prostate grow. The testicles are the main source of male hormones, including testosterone. The adrenal glands, which are located on the kidneys, also make testosterone, but in small amounts.

Prostate cancer cells can spread by breaking away from the original tumor. They can spread through the blood vessels or lymph vessels, which branch into all tissues of the body. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. The spread of cancer is called metastasis.

A man with prostate cancer may not have any symptoms. For men who do have symptoms, the common symptoms include

  • Not being able to pass urine
  • Having a hard time starting or stopping the urine flow
  • Needing to urinate often, especially at night
  • Weak flow of urine
  • Urine flow that starts and stops
  • Pain or burning during urination
  • Difficulty having an erection
  • Blood in the urine or semen
  • Frequent pain in the lower back, hips, or upper thighs

These symptoms may not be due to cancer, another health problem may cause them. If you have any of these symptoms, you should tell your doctor so that problems can be diagnosed and treated.

Treatment Options for Prostate Cancer

  • Active Surveillance - Your doctor may suggest active surveillance if you are diagnosed with early stage prostate cancer that seems to be slowly growing. Your doctor may also offer this option if you are older and have other serious health problems. Patients may also choose active surveillance if the risks and possible side effects of treatment outweigh the possible benefits. If you and your doctor agree that active surveillance is a good idea, your doctor will continue to check you regularly.
  • Surgery is an option for men with certain stages of prostate cancer. There are several types of surgery for prostate cancer. Each type has benefits and risks. You and your doctor can talk about the types of surgery and which may be right for you.
  • Radiation Therapy is an option for men with any stage of prostate cancer. Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the treated area. Men with early stage prostate cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. In later stages of prostate cancer, radiation treatment may be used to help relieve pain. Doctors use two types of radiation therapy to treat prostate cancer. Some men receive both types:
    • External Radiation: The radiation comes from a large machine outside the body. Treatments are usually five days a week for several weeks. Many men receive 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy. These types of treatments use computers to more closely target the cancer to lessen to healthy tissue near the prostate.
    • Internal Radiation: The radiation comes from radioactive material usually contained in very small implants called seeds. Dozens of seeds are placed inside needles, and the needles are inserted into the prostate. The needles are removed, leaving the seeds behind. The seeds give off radiation for months. They do not need to be removed once the radiation is gone.
  • Hormone Therapy - A man with prostate cancer may have hormone therapy before, during, or after radiation therapy. Hormone therapy is also used alone for prostate cancer that has returned after treatment. Male hormones can cause prostate cancer to grow. Hormone therapy keeps prostate cancer cells from getting the male hormones they need to grow. The testicles are the body’s main source of the male hormone testosterone. The adrenal glands make other male hormones and a small amount of testosterone.

    Hormone therapy uses drugs or surgery. Your doctor may suggest a drug that can block natural hormones. Luteinizing hormone-releasing hormone agonists are drugs that prevent the testicles from making testosterone. Examples are leuprolide, goserelin, and triptorelin. The testosterone level falls slowly. Without testosterone, the tumor shrinks, or its growth slows. These drugs are also called gonadotropin-releasing hormone agonists. Antiandrogens are drugs that can block the action of male hormones. Examples are flutamide and bicalutimide. Some drugs, such as ketoconazole, can prevent the adrenal gland from making testosterone. Surgery to remove the testicles is called orchiectomy.

    After orchiectomy or treatment with an LH-RH agonist, your body no longer gets testosterone from the testicles. Because the adrenal glands small amounts of male hormone, you may receive an antiandrogen to block the action of the male hormones that remain. This combination of treatments is known as total androgen blockade.
  • Chemotherapy may be used for prostate cancer that has spread and no longer responds to hormone therapy. Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and can affect cancer cells all over the body. Anticancer drugs may be given through a vein (intravenously), but some may be given by mouth.