Prostate Cancer Stages, Prognosis, Treatment Planning

Prostate cancer (prostate cancer)

Stages, prognosis, treatment planning

Question: My doctor said I have localized prostate cancer, in a report is "Stage II".What is the difference?
Answer: Prostate cancer has been so long known that there is a corresponding number of staging systems. They are primarily of interest to researchers, but without specifying which method was used, worthless. In practice, it is important to know whether the tumor is localized or locally advanced or already metastases has formed. Since these terms are sometimes used misleading, they rely more on the detection of tumor spread to the TNM system (in your case probably T2b or T2c N0 M0). This is more accurate and today default, because it serves for example as a basis for further action.

Question: I had surgery for an enlarged prostate. This cancer was found. I How many years yet, if I do not treat me further?
Answer: This can not be answered so. Your prognosis depends on many things, such as your age, any other diseases, the spread of the tumor and the pathological ("histological") assessment of the tissue. It is best to talk to your doctor. He knows you and your findings, and perhaps further tests are needed. Then he can provide detailed advice and decide with you on how to proceed.

Question: Is there the prostate itself also things that are particularly good or bad?
Answer: Yes. In addition to the age and health of the person concerned, the spread of the tumor and the PSA level , the finding of plays prostate biopsy (sampling) for forecasting a significant role. This gives the pathologist the type and malignancy (malignancy) of the tumor (Read more, see classification of prostate cancer ). Is favorable With proper treatment, for example, a small, one-sided, far distant from the prostate capsule tumor that arose from glandular cells (adenocarcinoma) and differs as little as possible of healthy prostate tissue. The latter is the Gleason score recognizable (to 6).

Question: What are nomograms well? Can it be trusted?
Answer: nomogram may be used to make predictions, as is likely to enter a particular event, for example, has as far prostate cancer actually spread or whether it will progress after treatment.For prostate cancer, there are numerous nomograms (Partin Tables eg, Kattan nomograms).Each serves a specific prediction and it uses individual findings of the person concerned (mostly PSA level , Gleason score and TNM stage ). Nomograms are usually developed on the basis of studies. Their reliability is prospective (forward looking) tested, which means you do with it numerous predictions and counts how many times these arrive. Only after such validation are generally used. The same is also true of special computer programs that can handle more results.

Question: What determines how prostate cancer is treated?
Answer: First of all, of course, of the type of malignancy and the spread of the tumor as well as the PSA level . At least as important is the patient: his age, his health and his personal preferences and desires. So the doctor would with a well-hazardous early prostate cancer probably recommend, for example, his aged, heart patients no serious operation. Maybe wants this but anyway, that the tumor will be removed safely. Important for the success of treatment, therefore, is always that the person concerned can be fully informed on the advantages and disadvantages of each method in question and his decision will meet with the doctor and possibly his partner.

Question: My cancer is still confined to the prostate and has not spread. What treatment options are there?
Answer: Basically six: surgery ( radical prostatectomy , with or without lymph node removal), radiation from the outside (percutaneous radiation therapy ), radiation from the inside (brachytherapy ), pushing the three methods mentioned to progression of the tumor ( active monitoring ), hormone therapy , and only treatment of complaints to tumor progression (expectant observation ). The first three methods are geared to healing ( curative ), the last two only on relief ( palliative ). Each has its own advantages and disadvantages. The individual therapy is based on the findings and will be selected jointly by the doctor and patient.

Question: I have prostate cancer that has already affected the lymph nodes. How can I be treated?
Answer: If only the lymph nodes are affected in the area, can question come: Radical prostatectomy with lymph node dissection (surgery) or radiotherapy , each combined with ahormone therapy , immediate or delayed hormonal therapy and expectant monitoring (English watchful waiting, treatment of symptoms in progression the tumor infestation). Are distant metastases present (infection of distant lymph nodes or other organs), the selection is usually limited to the hormone therapy and the wait-and observation.