...PROSTATE CANCER TREATMENT


We won’t go into detail describing the hun- dreds of methods of treatment for prostate cancer here, mainly because (a) we are not medically trained; and (b) we believe most of our readers aren’t doctors either! However, anyone out there who has gone through, or is going through, some of these treatments will be all too familiar with them.


Obviously the direction of treatment for any patient is totally dependent on their own physical state and symptoms (or lack of them in some cases). The factors in deciding on individual treatments may be talked about in terms of TNM, or Tumour, Nodes and Metastases: this is a detailed way of staging that tells the doctor the size of the tumour, whether there is cancer in nearby lymph nodes, and whether it has spread to anywhere else in the body.


This system of categorisation places prostate cancers into three groups: localised, which is contained within the prostate gland; locally advanced, where it has broken through the outer covering of the prostate; and metastat- ic, which has spread to other parts of the body.


A number of factors will be considered in deciding treatment for prostate cancer. These include the stage it is at present; the grade and pattern of cells in the prostate tis- sue (your Gleason score), the PSA test results, and your age and general health.


Depending upon the status of the cancer, treatments can range from active surveil- lance (more about this below), surgery to remove the prostate,


chemotherapy, hormone treatments, freez- ing therapy (cryotherapy), or high intensity ultrasound. Cancer Research UK provides a detailed list of questions to ask your doctor about individual treatments, how they may affect your system, and whether any side effects are temporary or permanent.


Monitoring is a crucial part of the proceed- ings: your treatment team keeps a close eye on you with regular tests, to see whether the cancer is growing. There are two categories of monitoring: the first is active surveillance, which may be used if you are diagnosed with localised prostate cancer – contained com- pletely within the gland - that may never need treatment. You attend the hospital for regular appointments (every few months) for blood tests and examinations. If the cancer is shown to be starting to grow after a year of this testing, the specialist will recommend treatment at that time.


The other type of monitoring is watchful waiting, for locally advanced or metastatic


MARCH 2019


– and remain upbeat and positive about the future.” This is exactly what he is doing, despite undergoing over nine rounds of chemotherapy with more to come.


Actor Stephen Fry also received the gut- wrenching diagnosis, and it took him a while to be able to talk about it publicly. It was dis- covered during one of his “general check-ups” after his doctor called him after- wards and said, “I’m a little worried about your PSA levels.” “Of course I didn’t know what a PSA level was… but I certainly do now.


prostate cancer that has grown too far to cure (ie. outside the prostate or to other parts of the body) but is not causing symp- toms. This type of monitoring, which surprisingly involves fewer tests than active surveillance, may also be used for those with prostate cancer that was contained within the gland and with no symptoms, but who may have other medical problems which pre- clude surgery or radiotherapy.


PROGNOSIS


It is extremely difficult to work out a progno- sis (outlook/chances of getting better) due to the myriad of different factors that affect how the cancer could grow. So it is very important to discuss with your cancer spe- cialist those factors: namely the stage, the Gleason score and the PSA level.


radiotherapy,


No statistics can tell any cancer patient what will happen to them; their cancer is unique, and the same type of cancer can grow at dif- ferent rates in different people. Similarly, the statistics cannot talk about the different treatments people may have had, or how that treatment may have affected their prog- nosis.


If you look at some of the many celebrities and prominent people who are survivors of prostate cancer, they’ll tell you how they’ve done it: such as Robert De Niro, golfer Arnold Palmer, Colin Powell, Jeffrey Archer, former New York City mayor Rudy Giuliani, singer Harry Belafonte, and broadcaster Sir Michael Parkinson – to name just a few.


Jeffrey Archer was particularly vocal about his own case; we ran excerpts from his narra- tive in the Daily Mail last time, as it raised such a huge level of awareness nationally.


Broadcaster Bill Turnbull recently appeared on his old show, BBC Breakfast, to talk about his gruelling treatment after being diag- nosed with the incurable disease in 2017. His message is clear and simple: “We don’t want to waste the doctor’s time; we don’t want to waste our time. We don’t like going to the surgery. But it’s crucial that you get checked


“Cancer is a word that rings in your head. ‘I’ve got cancer’, I kept saying to myself. Good Heavens, you’re not supposed to get cancer. You don’t think it’s going to happen to you.” He has undergone a different procedure; namely they removed his prostate. So far so good, but obviously it’s a day-at-a-time job.


But for Bill Turnbull and Stephen Fry, they both took the decision that it was better to discuss the problem openly, and there are many who are very grateful. The ‘Turnbull and Fry effect’, as it’s been dubbed, has helped countless men get over the embarrassment of going to their GP with their concerns.


Statistics will show an overall increase in the incidence of prostate cancer over the last 20 years, but that is largely due to the increased publicity the disease has undergone, and the fact that we are all living longer.


The main fact to bear in mind is that over the same 20-year period, due to greater vigi- lance and earlier detection, the numbers of prostate cancer sufferers who have been given the chance of a full life is well on the increase. On the basis that this column is produced always with the idea of looking after your bod, we wanted not to scare read- ers but to raise awareness.


Think about it... and act on it if you have any doubts or fears.


With Prostate Cancer Awareness Month in mind, Prostate Cancer UK advises that with the money invested in research over the past 20 years there have been some major break- throughs, but there is so much more work to be done. They predict that £120m would see through their strategy to halve deaths from prostate cancer by 2026 – and with your help they can reach that target. There is a range of fundraising events you can take part in, so whether you want to run, walk, cycle or sky- dive – or something else – there are plenty of ways to join the team fighting against prostate cancer.


VISIT: www.prostatecancerresearch.org/events and sign up to help men facing prostate cancer.


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