Prostate Cancer Staging and Treatment – Aggressive Prostrate Cancer

After prostate cancer is diagnosed ? after the DRE, and the PSA, and the prostate biopsy, the physician often has to stage the disease in order to determine the aggressiveness of the prostate cancer, and thus the level of aggressiveness they have to accord to treating the disorder. In that respect, the oncologist, urologist, or whatever medical specialist is in charge of the patient’s case may decide that more tests are necessary in order to determine if the cancer has spread beyond the prostate gland. Early-stage cancers either have not spread or have spread only to nearby tissues; they are curable, and the prognoses are often very good. Not so, the case with later-stage cancers that have spread farther out of the prostate region; considered to be more aggressive, they are usually believed to require more aggressive treatment.

Staging is done using various tests. Lymph glands from the pelvis can be surgically removed and examined for cancer cells; fluid samples fluid from the seminal vesicles which secrete semen may also be examined for cancer cells; MRI ? magnetic resonance imaging ? of the inside of the body may be required as well; and computed tomography or CT scans may be needed to reveal the presence of cancerous tumors.

And in the case of prostate cancer spreading to the bones, as the disease sometimes does, a radionuclide bone scan tests for such bone metastasis. This is often the form that is considered as the most aggressive form of prostate cancer. In order to carry out the bone scan, a tiny amount of radioactive substance is injected into a vein, which collects in the bones, especially in areas of unusual activity known as “hot spots.” The hot spots show up in the image as denser parts of the bone, signaling unusual bone activity, while “cold spots” also show up, indicating that brittleness in such regions. Neither instance is favorable because it is a precursor to intense bone pain and possibly even fracture.

Aggressive prostate cancer is also often determined by the Gleason score obtained from the prostate biopsy, which indicates the potential for the metastasis of prostate cancer to the lymph nodes or bones; much in the same way as a rapid rise in PSA. Once the cancer has been defined as aggressive, then they know to offer aggressive treatment, while less aggressive cases may generally require watchful waiting or active surveillance, or other less aggressive prostate cancer treatments.

They rarely ever offer monotherapy or single treatments to patients with prostate cancer aggressive kind because the disease will not respond. So usually, the professionals have to offer any of the known standard remedies for prostate cancer ? prostatectomy, hormonal treatments, radiation therapy, chemotherapy, and immunotherapy ? usually in combinations or one after the other in order to provide symptomatic relief for the patient. If it is considered curable, they will do what they can too to cure it, but they are rarely ever excited about the prognosis.

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