Many men diagnosed with prostate cancer whose disease has not spread outside the prostate live normal lives for several years after treatment. You can help reduce your risk of prostate cancer by getting regular screenings and by staying at a healthy weight, exercising regularly and eating a balanced diet.
Some men may choose to not have treatment, which is called watchful waiting. Your doctor can help you think about the pros and cons of this option.
In early stages, prostate cancer often does not cause any symptoms. However, it may get larger over time and cause your urethra (the tube that carries urine from the bladder out of the body) to become blocked or inflamed. This can lead to urinary problems like a weak flow of urine, pain during urination or difficulty urinating. It can also cause back pain or a painful erection.
Men who have a family member with prostate cancer have a higher risk of developing it themselves, especially if the affected relative was diagnosed at a younger age. Other factors that increase your risk include a family history of other cancers, a diet high in dairy and obesity, and living in areas with a lot of pollution or poor water quality.
Symptoms of prostate cancer usually develop in the later stages of the disease, when the cancer has spread from the prostate gland to other parts of the body. The most common symptoms are pain in the lower back or pelvis, loss of bowel control or trouble having an erection (erectile dysfunction).
If cancer has spread to your bones, you may also feel bone or back pain. This can happen if the cancer cells break away from the prostate and enter the bloodstream, where they travel to distant parts of your body. Cancer cells can also damage other healthy tissues, such as the bladder and urethra.
If prostate cancer has spread to other areas of your body, it may be harder to diagnose because the signs and symptoms vary depending on where the cancer has gone. You may also experience other health conditions that can cause similar symptoms to prostate cancer, such as an enlarged prostate (benign prostatic hyperplasia or BPH) or a bacterial infection of the urethra (prostatitis). If the cancer has recurred in the same area after treatment, it is called local recurrence, while if it has spread elsewhere in your body, it is called metastatic disease. In rare cases, prostate cancer can spread to the liver or lungs. This is called advanced prostate cancer.
Prostate cancer is often diagnosed after a man has a PSA test that shows an abnormally high level. Most of the time, this means the cancer is in the early stages and hasn’t spread to other tissues, which doctors call non-metastatic. Nevertheless, prostate cancer can also be aggressive and spread quickly, which doctors call metastatic.
PSA levels increase when the cells in your prostate gland develop changes that aren’t normal. These growths are called tumors. The type of tumor you have determines whether it’s prostate cancer or another condition, such as benign prostatic hyperplasia (BPH).
BPH isn’t a cancer, but it can grow and cause symptoms like urinating more frequently or having trouble emptying your bladder completely. Some people with prostate cancer have no symptoms at all. That’s why screening is important. The PSA blood test checks your PSA levels over time and helps identify possible problems.
When your doctor suspects a problem, they may order an MRI or a CT scan of your prostate. These imaging tests provide a clearer view of the prostate and help doctors decide whether you need a biopsy. They also can improve the accuracy of a biopsy by allowing doctors to see tissue samples with more detail.
If a biopsy sample contains cancer, the pathologist analyzing it will assign a Gleason score. This score tells how abnormal the cancer cells look under a microscope. The higher the score, the more likely it is that the cancer will advance and spread.
Other rare types of prostate cancer include transitional cell carcinoma, which starts in the cells that line the urethra or bladder, and carcinoid tumors, which start in nerve cells that release hormones. Together, these account for less than 1% of prostate cancer cases.
The stage of prostate cancer describes how far the cancer has spread and can influence treatment options. Staging is typically reported in three terms: T, N, and M. The T stage describes the size of the tumor, the N stage identifies whether or not it has reached the lymph nodes, and the M stage indicates if it has spread to other parts of the body.
Prostate cancer develops when abnormal cells grow and replace normal prostate gland tissue. The growths are called tumors. Not all tumors are cancerous (malignant). Some are benign, such as an enlarged prostate (benign prostatic hyperplasia). When cancer does spread to other parts of the body, it is called metastatic disease. Some types of prostate cancer are more likely to be metastatic than others.
Treatment for prostate cancer depends on the type and stage of the disease, whether it has spread beyond the prostate gland, and how well you respond to hormone therapy. Hormone therapy reduces the levels of testosterone in your blood, which helps prevent cancer cells from growing and spreading. Your doctor may recommend surgery, radiation or other treatments to manage the symptoms of prostate cancer and keep it from getting worse.
Some people with early-stage prostate cancer may choose watchful waiting instead of treatment. This involves tracking your PSA levels over time to see if the cancer is growing. Doctors also use a test called the Gleason score to rate how abnormal the cancer cells are and estimate how quickly they might spread.
If your Gleason score is high or your PSA level rises, you will likely need treatment to kill any remaining cancer cells and relieve your symptoms. If the cancer has not spread outside of the prostate, local treatments such as surgery and radiation can destroy it. Other types of treatment include drugs that kill cancer cells or stop them from growing and spreading.
Some doctors use focal therapies to destroy cancerous tissue without affecting surrounding healthy tissue. This is especially useful for men who want to avoid or minimize side effects, such as erectile problems or bowel changes. Focal therapies include high-intensity focused ultrasound, which uses sound waves to kill cancerous prostate cells; cryosurgery, which freezes the tumor with liquid nitrogen; and photodynamic therapy, which combines medications that make cancer cells sensitive to certain light wavelengths.
Immunotherapy drugs help your own immune system recognize and attack cancer cells. These drugs can be used to treat advanced prostate cancer that no longer responds to hormone therapy, or as a first treatment for people with recurrent cancer.
While it’s not possible to prevent all cases of prostate cancer, taking steps to improve your overall health can help reduce your risk. The most important prevention steps include: Eat a healthy diet that includes plenty of fruits and vegetables, avoid high-fat foods, limit alcohol consumption, get regular exercise, stay at a healthy weight, quit smoking, and reduce stress.
If you have a family history of prostate cancer or other health conditions, talk to your doctor about getting screened regularly. Your doctor will recommend a screening schedule based on your age, race, and other factors.
A man’s chance of developing prostate cancer increases with age. In fact, most prostate cancers are found in men over the age of 65. Your risk also increases if you have a close relative, such as a father or brother, who has had prostate cancer or other types of cancer.
Certain genes, called oncogenes, can cause cells to grow out of control. They may also trigger changes (mutations) in other genes that regulate cell growth or that help cells repair mistakes. Mutations in these genes can increase a man’s chances of getting prostate cancer.
A person’s risk of prostate cancer also rises with certain lifestyle choices. These include:
Drinking coffee may help lower the risk of prostate cancer. Researchers aren’t sure why, but they think it may be because coffee has antioxidants that reduce inflammation and protect cells from damage.
Eating more fish, such as salmon, trout, and sardines, may also help lower the risk of prostate cancer. It is thought that these fish are rich in omega-3 fatty acids, which can help protect against prostate cancer. It is also recommended to avoid charbroiled meats and fried foods. Adding more whole grains and fruits to your diet can also help lower the risk of prostate cancer. Some people also benefit from eating more foods that are high in vitamin D. This is because vitamin D helps keep the prostate gland healthy. It’s important to talk to your doctor before making any dietary changes. They can help you create a dietary plan that is right for you.
Many prostate cancers grow slowly and don’t cause symptoms. In these cases, doctors can choose to monitor the cancer instead of starting treatment right away. This is called active surveillance.
All treatments can cause side effects, including urinary, bowel and sexual problems. Some may also cause bone pain. Talk to your doctor about these side effects and how they might affect you.
Erectile Dysfunction, or ED, can be a side effect of prostate cancer treatment. It happens when the blood flow to the penis is reduced, or the nerves that control erections are damaged. This problem can also be caused by other conditions that affect the prostate, colon and rectum. It is more common for men with a history of cancer to develop problems with erectile function than in those without such a history. ED can be difficult to diagnose and may not improve for a long time after prostate cancer treatments end.
Some men who have prostate cancer don’t have any symptoms at all. This is because the prostate cancer is usually found when it is very early and has not spread beyond the prostate. Men with prostate cancer that has not spread may choose to wait to have treatment, which is called active surveillance. This means they will have regular PSA tests and their doctor will look for any signs that the cancer is growing.
If prostate cancer does cause symptoms, they will most often be urination problems or problems with having an erection. These problems can happen when the prostate cancer grows large enough to block the tube that carries urine from the bladder to the penis. But they can also be a sign of another condition that does not cause cancer, such as an enlarged prostate gland, or BPH (benign prostatic hyperplasia).
Other symptoms may include weak urine flow and pain in the back, hips or pelvis. But they can also be a sign that the cancer has spread and is in other parts of the body.
Men with prostate cancer and their partners can have trouble in their sexual relationships because of the side effects of their treatment. This can lead to a lack of interest in sex and changes in the way that a couple have sexual relations.
It is important to talk about the changes in a man’s sexuality with his partner. This can help them deal with the issues and work out solutions. It can also be helpful for a partner to go with the man to his medical appointments, so they can learn more about prostate cancer treatment and how it might affect their own sexual health.
A prostate cancer tumor grows over time and if it gets too big it can start to affect the prostate gland surrounding it. This is where symptoms often begin, with problems with urinary function. This can cause a variety of issues from feeling the need to pee all the time to leaking urine or having trouble starting a flow.
The prostate gland sits directly below the bladder and surrounds a tube that empties the bladder (the urethra). This is why most people have issues with their plumbing if they get prostate cancer as the tumour can grow to the point where it presses on the urethra causing problems with urinating.
Having a frequent urge to pee, especially at night. Urge incontinence is the most common type of urinary incontinence and it is when you are leaking urine before getting to a toilet. Having to be close to a toilet all the time and having to stop what you’re doing when you feel the need to pee can really impact on your quality of life.
If you have this symptom, it’s worth taking a PSA test because it could be a sign of cancer. However, this is not always the case and it can also be caused by a condition called benign prostatic hyperplasia or BPH.
BPH is a condition where the prostate grows and can cause similar issues with urination. However, this condition is not a sign of prostate cancer and you should see your doctor if you have concerns.
You should keep a diary of how often you have to go and if you leak urine between trips to the bathroom. You can then bring this journal to your doctor and they may be able to diagnose the issue. They will want to see if you have pain or not when passing urine and they may want to carry out an internal examination of your urethra, the area where the prostate was removed during surgery and your bladder using a scope called a cystoscopy.
Some people with severe stress incontinence have had a procedure called a male urinary sling and others have undergone a surgery to replace their natural urinary sphincter with an artificial one. Both of these procedures can help with a range of urinary incontinence issues so it’s worth speaking to your doctor about what might be causing your problem and if they can recommend anything to help you.
Prostate cancer occurs when cells in the prostate gland grow out of control. This can happen when genes that keep cell growth under control or repair mistakes in DNA are damaged, or when a man’s testosterone levels increase due to an enlarged prostate (benign prostatic hyperplasia). Cancer cells also break apart easily and can spread to other parts of the body. When this happens, it is called metastasis.
Most prostate cancer grows slowly and causes few symptoms in its early stages. In some cases, it may cause pain in the back or hips, and a weak or interrupted flow of urine.
Men with these symptoms should talk to their doctor right away. The doctor can do a blood test to measure PSA levels, and a rectal exam can help determine the size of the prostate. The doctor can then decide whether or not to perform a biopsy. If a biopsy shows that cancer is present, the doctor can give the patient a Gleason score. The higher the score, the more likely the prostate is to spread to other areas of the body.
Swelling in the lower extremities can be a sign of prostate cancer, but it is not always a bad sign. It can be a side effect of chemotherapy or radiation therapy that is used to treat cancer, or it can occur when cancer has spread from the prostate to the bones or other tissues in the body. If a man is experiencing this symptom, the doctor will recommend elevating the leg as much as possible and treating it with special compression garments or using decongestive massage.
If the cancer has not spread beyond the prostate, doctors can use a method called watchful waiting, also known as active surveillance. This means the doctor will monitor the cancer closely and treat it if it starts to grow or cause problems. Some treatment options include surgery, which removes the prostate and some surrounding tissue; radiation, which uses high energy to kill cancer cells and shrink tumors; or hormone therapy, which blocks cancer cells from getting the hormones they need to grow.
Bone pain can be a sign of prostate cancer that has spread to the bones. The pain usually happens in the lower back or the hips. It may come and go or get worse with movement. It can also be a symptom of cancer that has spread to the bones from other parts of the body (metastasis).
Most prostate cancers don’t cause symptoms in the early stages. This is because the tumors grow slowly and are not big enough to press on a nerve or the tube that carries urine from the bladder to the penis. Often, the first signs of prostate cancer are found during screening, when a PSA test shows a rise in levels of the hormone.
The PSA test is done with a blood sample taken from the arm. It is the only way to tell if cancer cells are present in the body. Doctors can use the results of a PSA test to help decide whether treatment is needed and what type of treatment will be best.
Some types of bone cancer, including osteosarcoma, can also cause pain in the bones. Cancer that has spread to the bones can weaken them, making them more likely to break or bend. Bone pain can also be a symptom of cancer in the bones that has spread to other parts of the body, such as the spine or pelvis.
Getting diagnosed with prostate cancer can be a shock, but it’s important to know what the next steps are. The most common treatments for prostate cancer are surgery and radiation therapy. Most men can be cured by these treatments. Some men need to be monitored after treatment, a process called active surveillance. This involves regular screenings and tests, so doctors can watch for any changes in the prostate and other parts of the body that might indicate the cancer is growing.
Many different things can cause prostate cancer, but having a family history of the disease is one of the biggest risk factors. Certain lifestyle habits can also increase the likelihood of prostate cancer, such as eating a lot of dairy and smoking.
Many prostate cancers grow very slowly and may never cause any symptoms or health problems. They can be treated with watchful waiting or low-dose radiation.
Radiation therapy that comes from outside the body (external beam radiation). This treatment has a lower chance of damaging healthy tissue around the prostate.
The doctor may recommend radiation therapy for prostate cancer that is found early and is not very aggressive. It also can be used after surgery to kill any cancer cells that are left behind. Radiation therapy is usually done five days a week for 6 to 8 weeks. It is often painless. Before you have treatment, you should tell your doctor what medicines you are taking. You may need to stop taking some that make it hard for your blood to clot, such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix) and warfarin (Coumadin). You should also avoid strenuous activities for several days after treatment.
The type of radiation therapy used depends on your diagnosis and whether or not your cancer has spread. It can be delivered from outside your body with a machine called a linear accelerator, or it can be injected into the prostate through a tube called a catheter. This method is called stereotactic body radiotherapy or SBRT. It focuses on a smaller area, so it is less likely to cause side effects in other areas of the body.
Your doctor can also give you brachytherapy. This is when the radiation comes from small, radioactive metal’seeds’ that are surgically placed inside the prostate. The seeds stay in the prostate and slowly release radiation over a set time. Before you have this treatment, the doctor takes a picture of your prostate with a CT scan or an MRI scan and then passes thin tubes through the skin between your scrotum and back passage to put the seeds in your prostate. You will have a general or spinal anaesthetic so you won’t feel any pain. The doctor will also put a tube into your bladder to drain urine (a catheter) until the swelling of the prostate goes down and you can pass urine normally again.
You can also have low-dose brachytherapy. This uses the same technique as HDR brachytherapy but with lower radiation doses. It is also less likely to cause side effects such as a blocked back passage or incontinence. Another option is cryosurgery, which involves placing a probe inside or near the cancer to freeze it. It is not well tested against standard treatments for prostate cancer, so doctors don’t know if it works as well.
If your cancer hasn’t spread outside the prostate, surgery may be an option. You and your doctor will discuss the benefits and risks of different procedures. The choice depends on many factors, including the size of the tumor, your age, and your overall health.
A surgeon can remove the part of your prostate gland with the cancer or just some surrounding tissues. This is called a radical prostatectomy. It’s the most common operation to treat prostate cancer in men who are healthy. It can also be used to treat a recurrent (recurring) prostate cancer, or one that has stopped responding to hormone therapy.
Before surgery, your healthcare provider will need to do a biopsy of your prostate. This is the only sure way to diagnose prostate cancer and find out how aggressive it is. The sample is sent to a lab to get information about the type of cancer cells and their arrangement, which is called your Gleason score. The results can help determine how aggressive the cancer is and what kind of treatment you need.
A transrectal magnetic resonance imaging (MRI) scan or a rectal exam can help your healthcare provider find out more about the condition of your prostate and nearby tissue. Your healthcare provider might also use these tests to help decide whether you need a biopsy.
During a biopsy, your healthcare provider inserts a needle into your urethra and removes small samples of tissue for testing in a lab. The biopsy can also be done while you’re under general anaesthetic or a spinal anaesthetic. Your healthcare provider may also use a needle to extract fluid from your prostate or the seminal vesicles for further testing in a lab.
You might have a newer procedure, such as brachytherapy or high-intensity focused ultrasound (HIFU), instead of surgery for your prostate cancer. These treatments are being studied and have fewer side effects than surgery.
Radiation can cause side effects, such as a frequent need to urinate and erectile problems. These side effects can be permanent, so it is important to follow up with your doctor regularly.
Many people with slow-growing, localized prostate cancer that hasn’t spread beyond the prostate live normal lives for several years after their diagnosis and treatment. But for a small number of people, the disease can be more aggressive and spread quickly to other parts of the body. If your tumor is thought to be more aggressive, your provider may recommend that you have further testing and a biopsy.
A biopsy is the only sure way to diagnose prostate cancer and find out how much it has spread. During the procedure, a healthcare professional removes a tissue sample from your prostate and tests it in a lab for cancer cells. A biopsy also allows your provider to know how quickly the cancer is likely to grow and whether it will be resistant to certain treatments.
Your provider can use a transrectal magnetic resonance imaging (MRI) scan or a transrectal ultrasound to see images of the prostate and surrounding tissues. The MRI or ultrasound can help identify areas that may be suspicious and need a biopsy. These procedures can also be used to check for a cancer that has spread to nearby tissue or organs, such as the lymph nodes.
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. It can be given through a vein in your arm, through the bladder or into the peritoneal cavity (the space that surrounds your abdominal organs). It is also a possible treatment for advanced prostate cancer that has not responded to hormone therapy. It can be given alone or with radiation.
Immunotherapy treats cancer by helping your body’s disease-fighting immune cells to identify and attack the cancer. The immunotherapy drug sipuleucel-T (Provenge) takes some of your own immune system cells and genetically engineers them in a lab to fight prostate cancer. It is an option for men with locally advanced cancer that hasn’t yet spread to other parts of the body and who can receive both radiation therapy and ADT.
Talk with your doctor about the goals of each treatment, its likelihood of working and how it might affect your urinary, bowel, sexual and hormone function. Your doctor can also explain any short-term or long-term side effects of the treatments and how they might affect your quality of life. This type of talk is called shared decision-making.
Prostate cancer is most often adenocarcinoma, which starts in the prostate gland (the small walnut-shaped gland below the bladder and in front of the rectum in men and people assigned male at birth). It secretes fluid that mixes with semen, keeping sperm healthy for conception and pregnancy. Most prostate cancers grow slowly and do not spread beyond the prostate gland. For these patients, a healthcare provider may monitor the condition instead of giving treatment, called active surveillance. A patient on active surveillance gets regular scans and biopsies to check for any signs of cancer growth, but doesn’t receive treatment until the tumor is causing symptoms or growing fast.
Treatment for prostate cancer that has already spread outside the prostate is usually less effective, but still may extend life for many years. Your treatment plan will include palliative care to manage symptoms, such as pain and difficulty urinating.
For advanced prostate cancer, treatment options may include surgery, radiation therapy or hormone therapy. Hormonal therapy lowers levels of male sex hormones, including testosterone, which promote the growth of prostate cancer cells. A form of this treatment, called androgen-deprivation therapy or ADT, can be done by surgically removing the testicles (surgical castration) or by taking drugs that prevent testosterone from being made in your body, such as nilutamide or gonadotropin releasing hormones (GnRH).
Radiation treatment for a localized prostate cancer can be delivered through a large machine that directs strong X-ray beams directly to the tumor site, or through brachytherapy, which places radioactive seeds inside the prostate to kill cancer cells. Your doctor will decide which option is best for you.
Immunotherapy uses your body’s disease-fighting immune cells to help fight the prostate cancer. Sipuleucel-T, or Provenge, is a type of immunotherapy that takes your own immune cells and genetically engineers them to target prostate cancer cells. It is an option for people with metastatic prostate cancer that has stopped responding to ADT and taxane chemotherapy, such as docetaxel. Another immunotherapy option is lutuxetan, or 177Lu-PSMA-617, which targets a protein that is highly expressed on prostate cancer cells and delivers radiation to them.
Many men diagnosed at an early stage go on to live a long, cancer-free life. However, prostate cancer can be very aggressive in some people.
When a doctor in a lab examines a sample of your prostate cancer cells, they rate how quickly the cancer will grow and spread (the grade). This rating is called your Gleason score.
Cancer is a disease that occurs when cells grow out of control and take over the body’s normal tissue. Some of these abnormal growths, called tumors, are cancerous, and some are not (benign). Cancer can occur in glandular cells that line organs such as the colon, breasts, esophagus, pancreas, and lungs. These cancers are referred to as adenocarcinomas.
Glands make fluids that keep the body’s tissues moist and help organs function properly. When these cells grow out of control and overtake healthy tissue inside an organ, they become adenocarcinomas. Adenocarcinomas can also spread to other parts of the body, such as to the lungs or liver.
Adenocarcinomas are usually a type of epithelial cancer, which means they develop from tissues that line the skin, glands, and cavities of organs. They are most often found in glandular tissue, such as the lining of the colon, the lungs, and the pancreas. Cancers in the lining of the stomach are also classified as adenocarcinomas. Adenocarcinomas are usually followed by a name that describes the organ or tissue where they begin, such as infiltrating ductal carcinoma of the stomach or hepatocellular adenocarcinoma of the pancreas.
Some types of adenocarcinoma can be found early and are not very large, so they may not cause any symptoms at all. Other types are more aggressive and may cause symptoms such as a lump or pain in the area where the tumor is located.
Doctors use several tests to diagnose adenocarcinoma, such as blood tests and imaging tests. They may also take a sample of tissue, called a biopsy, to see if it is cancerous. The doctor can then test the tissue to find out if it came from that one organ, or whether it has spread to another part of the body, which is called metastasis.
Treatment for adenocarcinoma depends on the type and location of the tumor, how large it is, and whether it has spread. Doctors may suggest surgery, radiation, or chemotherapy.
If the adenocarcinoma has spread, doctors will use a numbering system to describe how far the cancer has progressed. This system is called TNM, and it measures the size of the primary tumor, how many lymph nodes are affected, and whether any of the cancer has spread to other areas of the body. The doctor will then use this information to plan your treatment. The TNM stage of your adenocarcinoma will be numbered from 0 to 4. 0 is the least advanced, and 4 is the most advanced.
Squamous cell carcinoma, or squamous cell cancer, develops from flat cells in the outer layer of skin (epidermis). This type of skin cancer is the second most common in the United States, affecting about 700,000 people per year. It usually develops on areas of the body frequently exposed to the sun. These include the face, neck, and head. In addition, it often forms on the genitals (the cervix and penis). Squamous cell cancer may also occur in the mouth or nose. The most serious risk factor for developing squamous cell carcinoma is long-term exposure to the sun’s UV radiation, which contributes to skin damage and increases the speed at which cancerous cells grow.
SCC typically causes scaly patches, red patches, open sores, or warty growths on the skin. These abnormal growths can be painful, itch, or bleed. They tend to be more noticeable on areas that receive the most sun exposure, such as the face, ears, scalp, arms, and legs. However, squamous cell carcinoma can form on other parts of the body as well, including the lungs and mouth.
Symptoms of squamous cell cancer vary depending on the location of the tumor and its stage. The earliest stages of squamous cell carcinoma are often painless. As the cancer grows, it becomes a more noticeable lump or bump and may bleed easily. If the cancer is left untreated, it can spread to the deeper layers of the skin and other organs.
To diagnose squamous cell cancer, your doctor will examine you and inspect any abnormal areas of the skin. If they suspect squamous cell cancer, they will take a tissue sample from the area and test it for the presence of cancerous cells.
If the squamous cell cancer is in the early stages, your doctor can remove it surgically via excision. They will also use imaging tests to check for the size of the tumor and to see if it has spread.
In later stages, radiation therapy can be used in combination with surgery to reduce the chance of recurrence. Radiation therapy uses high-energy beams of X-rays or protons to destroy cancerous cells and limit the side effects of surgery. This type of treatment can be delivered externally or internally, using a technique called Mohs surgery to maximize skin preservation.
Chemotherapy can be an option when the squamous cell cancer has already spread. Medications that destroy cancerous cells can be given orally or intravenously, and may be combined with other treatments such as radiation or immunotherapy.
Immunotherapy works by boosting your immune system’s ability to fight cancerous cells. It uses drugs such as Libtayo(r) and Keytruda(r), which block the protein PD-1 on cancer cells to help your immune system recognize them and attack them. This is a newer form of cancer treatment and it can be combined with other therapies.
A layer of cells called the urothelium lines the interior surface of your urinary tract. Cancer that starts in this layer is called transitional cell carcinoma (TCC). TCC most often occurs in the bladder, but it can also occur in the kidney, ureters and urethra.
Symptoms of TCC in the bladder include painful micturition (urination) or a feeling that your urine is not draining well. This may be caused by a tumor that presses on the nerves that control your bladder muscles, or it could be a result of the cancer spreading from other parts of your body to your bladder. You may also notice blood in your urine, or you may feel like you are passing a lot of fluid when you urinate.
The doctor will perform a physical exam and order a urinalysis to check for signs of cancer in your urinary tract. Your doctor will also use a device called a ureteroscope to see inside your ureters and renal pelvis. During this procedure, your doctor can take tissue samples to test for the presence of cancer.
Your doctor will recommend treatment based on the type of cancer you have, its grade and whether or not it has spread. If your cancer has not spread, you might need only chemotherapy. If your cancer has already spread, you may need surgery plus systemic chemotherapy.
A phase II trial showed that gemcitabine is effective in treating TCC. This is a chemotherapy drug that can be given orally (by mouth) or intravenously (injected into a vein). It works by stopping cancer cells from growing and multiplying.
Surgery is the most common treatment for transitional cell cancer. If the cancer is in the upper part of your ureter, your doctor might be able to do a procedure called segmental resection through a ureteroscope. This means removing the section of your ureter where the cancer is located, along with some healthy tissue around it. Your doctor might also use a tool to destroy the cancer cells by sending electricity through them, a process called fulguration.
If your urothelial cancer has spread to other parts of the body, you will need systemic therapy. The standard combination is cisplatin, vinblastine, and doxorubicin (MVAC). Some patients might benefit from other drugs that block the growth of cancer cells, such as adriamycin or methotrexate. Newer immunotherapy agents are also showing promise in treating metastatic urothelial cancer. These drugs target the cancer cells’ proteins, blocking their ability to grow or multiply. These drugs are usually administered through a vein (IV). Talk to your oncologist about the best option for you.