About prostate cancer – general, and up to the biopsy stage

GENERAL INFO

STAGING THE CANCER

A source: https://en.wikibooks.org/wiki/Radiation_Oncology/Prostate/Localized_Prostate_Cancer#Active_Surveillance_vs_Radical_Intervention

Prostate cancer has a 95 per cent survival rate, but it was still the second biggest cancer killer among Australian men. “You only have a small window for cure. When it’s closed, it’s closed for good,” Professor Loeb said. [Source]

MRI can reduce the number of men over-diagnosed with prostate cancer and improve the precision of biopsy to detect aggressive cancers, recent research suggests. [Source]

Get Vitamin D: There are well over 800 scientific studies confirming the link between vitamin D deficiency and multiple types of cancers, including prostate cancer. For example, according to a 2005 study, men with higher levels of vitamin D in their blood were half as likely to develop aggressive forms of prostate cancer as those with lower amounts. Another study published two years ago found that men with higher levels of vitamin D in their blood were seven times less likely to die from prostate cancer than those with lower amounts. [source]

Know that there is over-treatment: Watch this video. [55 per cent of prostate cancers should not be treated]

Ben Stiller reveals his battle with ‘aggressive’ prostate cancer

Fact sheet (US govt)

Very slow growing cancer, generally: Prostate cancer may follow an aggressive course, similar to that of other cancers. However, many prostate cancers are indolent, and will have no impact on health, even without treatment. The natural history of prostate cancer diagnosed in the 1970s and 1980s has been welldescribed. For example, Albertsen et al. (2005), reporting the long-term outcome of watchful
waiting, found that the 15-year prostate cancer mortality for men with a Gleason score of 6 was
18–30%, while their 15-year risk of death from other causes was 25–59%. [Prostate cancer: diagnosis and treatment – by National Collaborating Centre for Cancer]

Evidence comes from a randomised trial comparing radical prostatectomy and watchful waiting
(Bill-Axelson et al. 2005; Steineck et al. 2002), in men with localised, well to moderately well
differentiated prostate cancer (i.e. Gleason 6 or 7). Overall mortality, within 10 years of follow-up, was lower in men treated with prostatectomy than in those managed with watchful waiting: 27.0% versus
32.0% respectively (Bill-Axelson et al. 2005). Similarly, the rate of death from prostate cancer
within 10 years of follow-up was lower in the prostatectomy group than in the watchful waiting
group (9.6% vs. 14.9% respectively). Erectile dysfunction and urinary incontinence, however,
were significantly more likely in the prostatectomy group (Steineck et al. 2002). [Prostate cancer: diagnosis and treatment – by National Collaborating Centre for Cancer]

Over-detection: In comparison with those with clinically detected disease, men with PSA-detected cancers will have longer to endure any adverse effects of curative treatment, and longer to wait for any
beneficial effect on survival to emerge. [Prostate cancer: diagnosis and treatment – by National Collaborating Centre for Cancer]

“My advice to my patients is to be as aggressive in treatment as possible to cure a potentially curable cancer.” [After Prostate Cancer A WHAT-COMES-NEXT GUIDE TO A SAFE AND INFORMED RECOVERY –  Arnold Melman, M.D. and Rosemary E. Newnham]

TREATMENT RECOMMENDATION FOR LOCALISED CANCER

Healthcare professionals should offer radical prostatectomy or radical radiotherapy (conformal) to men with intermediate-risk localised prostate cancer. here is no strong evidence for the benefit of one treatment
over another.[Prostate cancer: diagnosis and treatment – by National Collaborating Centre for Cancer]

prostate cancer starts with tiny alterations in the shape and size of the prostate gland cells – Prostatic intraepithelial neoplasia (PIN). Any patient who was found to have high-grade PIN after a prostate biopsy is at a significantly greater risk of having cancer cells in his prostate

he diagnosis of high-grade PIN, which is based on a pathologist’s reading of a given tissue sample, is subjective. Partly for that reason, it is unclear how many men can expect to be diagnosed with high-grade PIN in any given year. Studies of men who have undergone prostate biopsies have found that anywhere from less than 1% to more than 20% had high-grade PIN. A respectable ballpark estimate is that 4% to 8% of men who undergo prostate biopsies will be diagnosed with high-grade PIN.

HOW AGGRESSIVE IS YOUR CANCER?

Caution: “Gleason grade from biopsy is frequently upgraded at prostatectomy, resulting in a reluctance to assign a low GS at diagnosis” [Source] – i.e. there is a small probability that my cancer is worse than the score. However, since locations to be assessed were guided by the MRI, there is a good chance that this is a genuine score.

“For prostatectomy specimens, 4 + 3 cancers were associated with a three-fold increase in lethal PCa compared with 3 + 4 cancers” [Source]

Gleason score 7 is made up of two grades (3+4=7 and 4+3=7), with the latter having a much worse prognosis. Cancers with a Gleason score of 7 can either be Gleason score 3+4=7 or Gleason score 4+3=7:

  • Gleason score 3+4=7 tumors still have a good prognosis (outlook), although not as good as a Gleason score 6 tumor.
  • A Gleason score 4+3=7 tumor is more likely to grow and spread than a 3+4=7 tumor, yet not as likely as a Gleason score 8 tumor.

Epstein criteria for insignificant prostate cancer (no more than one third of all cores positive, no more than half of any one core involved, and a PSA density <0.15).

  • In my case 3+1+4+2+1+2 (12) out of 4+4+4+3+3+3 (21) were positive (excluding one section that may have had 2-3 cores but no figures cited. This means at best 12/23 which is GREATER THAN ONE THIRD.
  • Further two sections had coverage of 50 and 55 per cent/
  • CONCLUSION: IT IS NOT INSIGNIFICANT

TREATMENT FOR SPREADING CANCERS

Prostate cancer tumours ‘shocked’ to death by flood of testosterone: researchers

Laetrile (amygdalin/ Vitamin B17) treatment for prostate cancer

Laetrile: How Much Proof Do They Need?

The cyanide released by amygdalin is one of the best killers of malignant cells as well. Amygdalin has a double punch. It lowers cancers resistance to treatment and it releases cyanide to kill cancer cells directly. [Source]

Laetrile contains an enzyme known as Emulsin that breaks down into cyanide when ingested. It is this chemical reaction that is responsible for Laetrile’s cancer-fighting properties. The most common form of laetrile, or vitamin B17, is derived from apricot seeds as these contain a large amount of the active ingredient that kills cancer…. Unlike conventional cancer treatments, Laetrile has the ability to destroy cancer cells without harming the body’s healthy cells.

 

There have been a number of studies performed in the US on the effectiveness of Laetrile against cancer, all of which claim that it has no effect on cancer cells. However, a study performed in China at the Bethune College of Medicine in 2013 found that the viability of human cervical cancer cells was significantly inhibited by amygdalin.  A 2006 study conducted at the College of Medicine in South Korea found that amygdalin was effective at killing human prostate cancer cells. [sOURCE]

  • Laetrile has shown little anticancer activity in animal studies and no anticancer activity in human clinical trials.
  • The side effects associated with laetrile toxicity mirror the symptoms of cyanide poisoning, including liver damage, difficulty walking (caused by damaged nerves), fever, coma, and death.
  • Laetrile is not approved for use in the United States.

BIOPSY ISSUES

Transperineal Prostate Biopsy – Normally, between 24 and 38 biopsies are taken. 

Australian Urology Association

NHS information sheet:  the results take around three weeks to come back. It can also diagnose other conditions such as benign prostatic hyperplasia (enlargement of the prostate), prostatitis (inflammation of the prostate, usually caused by a bacterial infection) or prostatic intraepithelial neoplasia (PIN), which is a change in the cell type but not cancer.

We give you antibiotics after your biopsy to reduce the risk of infection. You will need to take these for a minimum of three days.

Infections can be very serious after a biopsy so it is important that you seek medical attention if you have symptoms of infection even if it is in the middle of the night! [Source]

Blood when you pass urine: This is not uncommon and can range from peachy
coloured urine to rose or even claret coloured. It is rarely a sign of a serious problem.
Increasing your fluid intake will usually help ‘flush the system’ and clear any bleeding.
However, if there is persistent or heavy bleeding every time you pass urine you should
go to your nearest A&E department.

Difficulty passing urine: It is possible that the biopsy may cause an internal bruise that
causes you difficulty passing urine. This can happen in two in every 100 cases and is
more likely to happen in men who had difficulty passing urine before having the biopsy.
Should you have difficulty passing urine, you may require a catheter and you will need to
go to your nearest A&E department for assessment. A catheter is a hollow, flexible tube
that drains urine from your bladder.

Information sheet.  A general anaesthetic takes 24 to 48 hours to wear off, so please rest for this period of time

In the few days after your procedure: you may have mild discomfort in the biopsy area, with bruising around the skin of your testicles and an ‘aching’ sensation; you should rest and not do any heavy lifting; you may notice some blood in your urine and your semen may be discoloured (pink or brown) for up to six weeks, and occasionally longer — this is nothing to worry about. You should drink plenty of non-alcoholic fluids while you have blood in your urine.

If you display any of the following symptoms: • increased pain • a fever higher than 38 °C • eight hours without passing urine • passing large clots of blood • persistent bleeding.

 

 

sabhlok

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