Transcript Document

Presents
PLWC Slide Deck Series:
Understanding Prostate Cancer
2006
What is Cancer?
A group of 100 different diseases
The uncontrolled, abnormal growth of cells
Cancer may spread to other parts of the body
What is Prostate Cancer?
The most common type of cancer in men and second
most frequent cause of cancer-related death in men
A malignant (cancerous) tumor that begins in the
prostate gland
Some prostate cancers grow very slowly and may not
cause problems for years
Prostate cancer is somewhat unusual in that many men
with advanced cancer respond to treatment
What is the Function of the Prostate?
The prostate is a walnut-sized
gland located behind the base
of the penis, in front of the
rectum and below the bladder
It surrounds the urethra, the
tube-like channel that carries
urine and semen through the
penis
The primary function of the
prostate is to produce seminal
fluid, the liquid in semen that
protects, supports, and helps
transport sperm
What Are the Risk Factors
for Prostate Cancer?
Age
Race/ethnicity
Family history
Diet
Hormones
Prostate Cancer and Early Detection
Prostate-specific antigen (PSA) test
Digital rectal examination (DRE)
Discuss screening with your doctor
What Are the Symptoms of Prostate Cancer?
Frequent urination, or weak or interrupted urine flow
Pain or burning during urination or blood in the urine
The urge to urinate frequently during the night
Different symptoms if the cancer has spread: pain in the back,
weight loss, fatigue
Sometimes, people with prostate cancer do not show any of
these symptoms, or these symptoms may be similar to
symptoms of other medical conditions
How is Prostate Cancer Evaluated?
PSA test
DRE
Diagnosis is confirmed with a biopsy
Transrectal ultrasound (TRUS)
Imaging tests can determine if the cancer has spread
Prostate Cancer Staging
Staging is a way of describing a cancer, such as the depth
of the tumor and where it has spread
Staging is the most important tool doctors have to
determine a patient’s prognosis
Staging is described by the TNM system: the size of the
Tumor, whether cancer has spread to nearby lymph
Nodes, and whether the cancer has Metastasized (spread
to organs such as the liver or lungs)
Another staging system assigns letters (A,B,C,D) to
describe the cancer
The type of treatment a person receives depends on the
stage of the cancer
Prostate Cancer Grading
Grade describes how much cancer cells look like normal
cells (for example, do the cells look almost normal or
very abnormal?)
The grade of the cancer can help the doctor predict how
quickly the cancer will spread
The Gleason System is the most common grading system
and describes the cell patterns seen under the
microscope
Stage I or Stage A Prostate Cancer
Stage I cancer is found
only in the prostate and
usually grows slowly
Stage II or Stage B Prostate Cancer
Stage II cancer has not
spread beyond the
prostate gland, but
involves more than one
part of the prostate, and
may tend to grow more
quickly
Stage III or Stage C Prostate Cancer
Stage III cancer has spread
beyond the outer layer of the
prostate into nearby tissues
or to the seminal vesicles,
the glands that help produce
semen
Stage IV or Stage D Prostate Cancer
Stage IV cancer has spread to other areas of
the body such as the bladder, rectum, bone,
liver, lungs, or lymph nodes
How is Prostate Cancer Treated?
Treatment depends on stage of cancer
More than one treatment may be used
Surveillance (watchful waiting) for some early stage cancers
Surgery
Radiation therapy
Hormone therapy
Chemotherapy
Cancer Treatment: Watchful Waiting
A way to monitor early stage, slow-growing, prostate
cancer
Appropriate when treating cancer would cause more
discomfort than the disease itself
Mostly used in older men or men who are unwell from
other illnesses
Treatment begins when the tumor shows signs of
growing or spreading
Cancer Treatment: Surgery
Used to try to cure cancer before it spreads outside the
prostate
Usually the prostate and nearby lymph nodes are
removed
Urinary incontinence and sexual side effects may result
from surgery. These side effects are treatable
Cryosurgery (destroying cancer cells by freezing) is still
experimental
Cancer Treatment: Radiation Therapy
The use of high-energy x-rays or other particles to destroy cancer
cells
Used to try to cure disease or control symptoms
External-beam: outside the body
Brachytherapy: the insertion of radioactive pellets into the prostate
Intensity-modulated radiation therapy (IMRT): small beams of
radiation are aimed at a tumor from many angles
Side effects may include rash and dry, reddened, or discolored skin
Cancer Treatment: Hormone Therapy
Reduces level of male sex hormones to slow growth of cancer
Used to treat prostate cancer that has grown after surgery and
radiation therapy or to shrink large tumors before surgery and
radiation therapy
Can be done surgically or through medication
Hormone therapy may cause a variety of side effects
More information can be found in the ASCO Patient Guide:
Hormone Therapy for Advanced Prostate Cancer
Cancer Treatment: Chemotherapy
Drugs used to kill cancer cells
No standard chemotherapy for prostate cancer
Mitoxantrone (Novantrone) and docetaxel (Taxotere) are
both used in men with prostate cancer that is resistant to
hormone therapy
Paclitaxel (Taxol), estramustine (Estracyte), doxorubicin
(Adriamycin), and cyclophosphamide (Cytoxan, Neosar)
have shown promise in treating advanced prostate cancer
The Role of Clinical Trials for the
Treatment of Prostate Cancer
Clinical trials are research studies involving people
They test new treatment and prevention methods to
determine whether they are safe, effective, and better
than the best known treatment
The purpose of a clinical trial is to answer a specific
medical question in a highly structured, controlled
process
Clinical trials can evaluate methods of cancer prevention,
screening, diagnosis, treatment, and/or quality of life
Clinical Trials: Patient Safety
Informed consent: Participants should understand why
they are being offered entry into a clinical trial and the
potential benefits and risks
Informed consent is an ongoing process; participants are
constantly updated as new information becomes
available
Participation is always voluntary, and patients can leave
the trial at any time
Clinical Trials: Phases
Phase I trials determine safety and dose of a new
treatment in a small group of people
Phase II trials provide more detail about the safety of the
new treatment and determine how well it works for
treating a given form of cancer
Phase III trials take a new treatment that has shown
promising results when used to treat a small number of
patients with cancer and compare it with the current,
standard treatment for that disease; phase III trials
involve a large number of patients
Clinical Trials Resources
Coalition of Cancer Cooperative Groups
(www.CancerTrialsHelp.org)
CenterWatch (www.centerwatch.com)
National Cancer Institute
(www.cancer.gov/clinical_trials)
Coping With the Side Effects of Cancer
and its Treatment
Side effects are treatable; talk with the doctor or nurse
Fatigue is a common, treatable side effect
Pain is treatable; non-narcotic pain relievers are
available
Medication can treat many sexual side effects
For more information, visit www.plwc.org/sideeffects
Where to Find More Information:
PLWC Guide to Prostate Cancer
(www.plwc.org/prostate)
Overview
Medical Illustrations
Risk Factors and
Prevention
Symptoms
Diagnosis
Staging With
Illustrations
Treatment
Side Effects of Cancer
and Cancer Treatment
After Treatment
Questions to Ask the
Doctor
Current Research
Patient Information
Resources
Clinical Trials Resources
People Living With Cancer (www.plwc.org)
PLWC is the cornerstone of ASCO’s patient resources program
Visitors to PLWC will find:
 PLWC Guides to more than 90 types of cancer
 Coping resources
 Ask the ASCO Expert Series, including chats, Q&A forums,
and event transcripts
 Cancer information in Spanish
 The latest cancer news
For patient information resources, please call 888-651-3038