By Donald Saunders
Prostate cancer normally develops within the peripheral area of the prostate gland and this initially small area of cancerous tissue cannot be felt on a digital rectal examination (DRE) but is often picked up through a PSA test or an ultrasound examination. At this point prostate cancer is described as being in Stage I or is described as a T1 cancer.
As the cancerous region grows within the prostate it will create abnormalities which can now be felt during a DRE and, at this point, the disease is said to have progressed to Stage II or become a T2 cancer.
In both Stage I and Stage II cancer is confined to the prostate gland and is normally treated surgically, with radiation therapy, with cryosurgery or using ultrasound.
As the cancer continues to grow it will spread into surrounding tissues within the pelvic area and will move into Stage III or be classed as a T3 cancer. Finally, prostate cancer cells will be carried to regions of the body outside of the pelvic area and prostate cancer reaches Stage IV or becomes a T4 cancer. It is these two stages of the disease that are classed as being “advanced prostate cancer”.
The treatment of advanced prostate cancer is aimed principally at slowing the spread of the disease, providing the best possible quality of life for the patient and extending the patient’s life as far as is possible. Although it is possible to cure prostate cancer, particularly in Stage III, the advanced nature of the disease makes this a difficult task and the reality of the situation is that treatment at this point generally represents management of the disease rather than a cure for it.
As prostate cancer cells require male hormones (such as testosterone) to grow, the main form of treatment for advanced prostate cancer is hormone treatment to reduce the production of testosterone.
Hormone therapy may include the use of drugs to reduce testosterone levels in the body or to block the action of testosterone and other male hormones. Treatment options will also include the removal of the testicles (orchiectomy) which produce 95% of the testosterone found in the body.
In some cases of Stage IV cancer hormone therapy may not be effective, or may have only limited results, and patients may require systematic radiation therapy or chemotherapy.
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