Sometimes the disease is hereditary but for the most part the cause is unclear. There are various treatments. Sometimes you can wait with treatment. The risk of the disease increases with age.
The prostate is a gland that, among other things, forms transport fluid for the sperm at the time of ejaculation.
What is prostate cancer?
Cancer of the prostate means that a cancerous tumor has formed. First, it only grows inside the prostate gland, often in the parts that are furthest from the urethra. Then you do not notice the disease. It may take 10 to 15 years for the cancer tumor to spread or cause symptoms. Sometimes the disease can develop faster.
The cancer can spread in the body and form daughter tumors, also called metastases. Prostate cancer can spread to the lymph nodes and the skeleton, for example in the lower spine and pelvic bone.
In late stages of the disease, metastases may also be formed in other organs, for example in the liver and lungs.
You may have several of these symptoms:
- You need to pee often.
- When you want to urinate, it takes time before the urine arrives.
- You have weak urine.
- There is blood in the urine.
Prostate cancer that has spread can also cause other symptoms. You can hurt the skeleton anywhere in the body without injuring yourself. Some feel tired or lose their appetite so that they lose weight.
The symptoms may have causes other than prostate cancer. The trouble with peeing, for example, may be due to a benign enlargement of the prostate gland , which is common in people over 60 years of age.
When and where should I seek care?
If you think you have prostate cancer, contact a health care provider. It is often not in a hurry. If it is a weekend, you can wait until it is everyday. You can contact most receptions by logging in .
If you have blood in your urine, contact a health care provider as soon as possible. You do not need to seek care elsewhere if it is closed. Wait until the health center opens.
Investigation and investigations
Here you will find out more about some studies that are common in suspected prostate cancer.
PSA is measured by blood test
PSA can be measured with a blood sample . PSA is a protein that is formed in the prostate gland. Elevated values of PSA may be a sign that there is a cancerous tumor in the prostate. But it can also have other causes, such as a benign prostate enlargement or an infection in the prostate.
The doctor feels the prostate
The doctor can feel the prostate gland by inserting a finger through the rectum. You can lie or stand. The survey does not hurt and goes fast.
Usually the prostate is smooth, firm and a little elastic. It can be a sign of cancer if the prostate is bigger, harder or more knotty than it usually is.
Magnetic camera examination
The prostate is examined with a magnetic camera if the PSA value is increased. Then you can see if there is any change.
Tissue test – prostate biopsy
Changes are examined with ultrasound and tissue samples from the prostate . Often, the doctor takes several tissue samples at the same time. The tissue tests allow the physician to tell for sure whether it is cancer, and whether the cancer is growing rapidly or slowly. Tissue tests are also called biopsy.
The cancer tumor gets a Gleason sum that can have a value between 6 and 10. A Gleason sum of 6 means that the cancer tumor grows slowly.
You who have prostate cancer may need to be examined to see if the disease has spread to the skeleton.
You will then receive a small dose of a radioactive substance injected into the bloodstream. The subject seeks out areas in the skeleton where some type of injury may exist, for example due to cancer. It is visible when you are examined with a special camera called gamma camera. The radioactive tracer disappears quickly from the body.
The investigation is conducted according to a standardized course of care
You will be investigated according to a standardized course of care if your doctor suspects you have prostate cancer.
Standardized care processes are a way of organizing the investigation so that it goes as quickly as possible. Among other things, there are times set for the investigations that may be needed.
The doctor writes a referral and tells you why you should be investigated, what it means and when you can be told if you have cancer or not.
It is often quick to get calls for examinations in a standardized course of care. It is good if you are clear about how the staff most safely reach you, so that you do not miss any time.
About the treatments
Prostate cancer can be treated with surgery, radiation, hormones and cytostatic drugs. Sometimes different treatments are combined. What treatment you can receive depends, among other things, on the size of the cancer tumor, if it has spread, and how you feel otherwise.
All treatments have side effects that can affect, among other things, sexuality.
You may have to wait for treatment if you are suffering from the disease and it is developing slowly.
Stop smoking before treatment
There are many benefits to quitting smoking if you are to be treated for prostate cancer.
After an operation, the wounds heal faster and the blood circulation and fitness improves to recover faster. The best thing is to quit smoking completely, but if it fails, it is good if you can refrain from smoking before the surgery and even the first weeks afterwards.
Even in radiation therapy, it is good if you refrain from smoking. Treatment becomes more effective.
Talk to your doctor if you need help and support to quit smoking.
Treatment can wait – active monitoring
You can choose to wait for treatment if the cancer is only present in the prostate and is growing slowly. Instead, you may come up with regular checks. It is called active monitoring.
It is common to have checks about every six months. You will then be required to submit PSA exams . The doctor feels the prostate through the rectum. You may also need to be examined with a magnetic camera and submit tissue samples .
You will receive treatment if the controls show that the cancer tumor is starting to develop.
Treatments that can remove the disease
Prostate cancer can be removed with surgery or radiotherapy if the disease has not spread.
Treatment with surgery
You can be operated on if you feel good and the disease has not spread. The prostate and bladder are removed. The treatment is called radical prostatectomy and is done while you are anesthetized . Sometimes, some lymph nodes are also removed to see if the cancer has spread.
The surgery can cause you to impair your ability to stand. You can also leak urine but it usually subsides. There is help to get.
You may experience swelling in, for example, one or both legs if lymph nodes have been removed. It’s called lymphedema . There are various help and treatments for lymphedema.
Radiation therapy gives the same chance as surgery to get rid of the disease. There are external and internal radiation treatments.
External radiation therapy
External radiation therapy can be an alternative to surgery if you have other illnesses. The treatment takes a few minutes and is not felt. It is common to receive the radiation once a day, five days a week. The whole treatment lasts for six to eight weeks.
Internal radiation therapy – brachytherapy
Internal radiation therapy is usually used if the cancer tumor is larger and grows rapidly. The treatment is given inside the prostate. Then it is possible to get higher doses of radiation than with external radiation treatment without affecting the healthy body tissue.
Internal radiation therapy is also called brachytherapy.
You can you treatment in two ways:
- Disposable treatment: Small grains with radioactive iodine are inserted with needles through the skin behind the scrotum and into the prostate gland. The grains radiate for a few months. You get back anesthesia or are anesthetized before the grains are inserted. You stay in the hospital overnight. The treatment is also called seed therapy. The grains need not be removed when the treatment is complete.
- Repeated treatment: The prostate gland is irradiated with a radioactive substance for a few minutes through needles inserted through the skin behind the scrotum. You get anesthesia or are anesthetized. You come to the hospital the night before the treatment and stay for a day. After two weeks you will receive another treatment. Often, the treatment is combined with external radiation treatment every weekday for a total of four to five weeks.
It is common for radiation therapy to be combined with hormone therapy that makes cancer cells more sensitive to radiation. Hormone therapy begins a few months before radiotherapy and sometimes continues for one to two years after radiation therapy is completed.
Before starting treatment, the doctor may need to find out if the cancer has spread to the lymph nodes. For example, you may be examined with a PET camera or computer tomography .
It is common for gold markers to be inserted into the prostate to increase the radiation’s accuracy before treatment can begin.
The gold markers are a few millimeters of grain. You get local anesthesia . Then the gold markers are inserted with a needle. This happens much like when the doctor takes a tissue sample from the prostate . Then images are taken with a computer tomography or magnetic camera to direct the radiation.
The gold markers need only be inserted at one time. They do not need to be removed when you are finished.
Side effects of radiation therapy
All radiotherapy can impair the ability to stop. You may also feel pissed off often or leak urine or have bowel problems so that you get diarrhea, for example. The problems can be alleviated over time but they can also increase or come after only a few years. There is help to get.
You may come up with post-checks for up to ten years when you are finished. In the first few years you may come two to three times a year. Then you come once a year. Post-examination usually means that you have to have blood tests that can show if there are any signs that the cancer has returned.
If the disease recurs – relapse
It is called relapse if the cancer disease returns. In cases of recurrence of prostate cancer, it is common to receive hormone therapy.
Treatments that can curb the disease
Prostate cancer cannot be removed if the disease has spread.
Radiation to the prostate can slow down the disease if it has only spread a little.
The disease can also be curbed with hormone therapy. There are various hormone treatments. They do in different ways so that it is more difficult for the hormone testosterone to be formed or to work. Prostate cancer needs testosterone to grow.
Hormone therapy to curb the disease you usually need the rest of your life.
Drugs that make testosterone less effective
There are various drugs that make testosterone less effective without reducing the body’s production of testosterone. The drugs are called antiandrogens. The side effects are less than with other hormone treatments where the testosterone is completely removed. Treatment is usually not enough if the disease has spread.
You take the medicine as tablets.
Treatment with antiandrogens can cause the mammary glands to start to grow, but radiation can be prevented against the breasts.
Drugs that reduce testosterone production
You may need to remove the testosterone from the body if the prostate cancer has spread. Then you can get a drug in the form of a GnRH analog. It causes the body to stop producing testosterone. The drug starts to work after about two weeks. During the first month, you may be able to combine a GnRH analog with another drug that reduces the ability of cancer cells to take up testosterone.
You may also be able to combine the drug with cytostatic drugs or the drug Zytiga.
You are given the medicine as a syringe to be taken regularly, either under the skin or in a muscle.
The side effects of the drug are the same as when the testes are removed but sometimes treatment can be delayed. Then the side effects are usually reduced. It is important that you consult your doctor if you want to take a break.
Sometimes it is important to quickly remove the testosterone from the body. Then you may need to have the testicles removed. Most of the testosterone is formed in the testes. The operation is done with local anesthesia . You can leave the hospital the same day.
It is common for the desire for sex and ability to cease to disappear if the testosterone has been removed. You can get reduced energy and hot flashes with heat sensation and sweating. There is help that relieves.
Hormone therapy does not work
It is common for the cancer to start growing again after one to two years with a hormone therapy. Then you can switch to one of the other hormone treatments.
Sometimes the hormone therapy is combined with other treatment. Here are examples of such treatment.
Cytostatic drugs are also called cell-inhibitory drugs. Drugs with cytostatics that belong to the taxane group can be used in prostate cancer.
Cytostatic drugs are often combined with drugs in the form of GnRH analogues.
Medicines with extra hormonal inhibitors
The drug Zytiga prevents testosterone formation in the cancer cells. Another drug is Xtandi which prevents the cancer cells from contacting the testosterone. Both drugs are taken as tablets every day. Zytiga can cause you to collect fluid. There are drugs that counteract it. Xtandi can make you feel very tired. It can feel better if you move.
Zytiga is often combined with drugs in the form of GnRH analogs.
Medicines with radiation
The drug Xofigo contains a radioactive substance that can reduce the growth of skeletal metastases.
The radiation has a short range. This means that the radiation does not affect the body as much as anything else. You get the drug as a syringe in your blood once a month.
Treatment that relieves
You receive treatment that relieves the hassles you may have if the disease can no longer be cured. It is called palliative care .
You have the right to be involved in your care as far as possible. The healthcare staff should tell you which treatment options are possible for you. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment.
That way you can help decide which treatment is right for you.
Take time to make decisions
It may seem best to get treatment so that you get rid of the disease immediately, if you have the opportunity to choose it. But such treatment has the risk of side effects that can be more or less permanent. For example, you may have reduced sex drive, decreased ability to get a hold, and have the trouble of leaking urine.
Sometimes you can wait with treatment, read more in the chapter Treatment can wait – active monitoring.
It is common for there to be plenty of time to decide. Prostate cancer often develops slowly. Talk to your doctor several times about your thoughts and feelings.
Talk to your partner or other important relative, if you have it. They can be your support, and your decision can affect their lives as well.
You decide on the care plan
You can make a care plan together with the contact nurse, the doctor and other staff. The care plan should answer questions that are important to you. Here you can read more about the contact nurse and the care plan .
New medical assessment
You can get a new medical assessment if you are unsure if you are receiving the care and treatment that is best for you. You will then see another doctor, usually at another specialist clinic. Ask your doctor if you want to know more about how to get a new medical assessment.
To participate in studies
You may be asked if you would like to participate in research projects to increase knowledge about prostate cancer. Participation is voluntary. Your health care will not be affected if you say no.
How can life be affected by prostate cancer?
You can live as usual if you have prostate cancer that does not need treatment. Some are sometimes emotionally affected by knowing that the disease exists in the body.
It is common for life to be different if you have received treatment, even if the treatment has gone well and you do not have such major problems.
You always have the experience of what you have been with. It may feel painful periodically but usually it gets better. Sometimes it takes time.
Some feel vulnerable and worried long after treatment is over.
Treatment can affect sex life
The ability to get a stall is affected by surgery, radiation therapy and hormone therapy. Sometimes it is difficult to avoid damage to the nerves that control the condition because the nerves are on the prostate.
After an operation, the ability to stand is impaired immediately. It can gradually get better over many years, although it will not be as before treatment.
After radiotherapy, the ability can gradually deteriorate for a few years so that you eventually need aids to be able to stand.
Try to get a stand often
It is good if you can try to get a stand frequently and as soon as possible after an operation. It reduces the risk of blood flow deteriorating. When you get a stand, the swelling bodies in the penis are filled with blood.
You can start with medicines that help the condition as soon as the urinary catheter is removed after one to two weeks.
Avoid intercourse for the first three weeks after surgery, for wound healing.
You can still have an orgasm, although it may feel different if you no longer have semen. The semen fluid disappears for everyone who is operated on and for some who have received radiation therapy.
There may be some urine when you get ejaculation in the first few months after surgery. It is harmless for both you and a potential partner.
The penis becomes shorter in the slaughtered state after an operation.
Sex desire decreases with hormone therapy. The desire often comes back by itself after six months to a year after the treatment is completed, if you only need the treatment for a limited time.
There are various drugs and aids to improve the ability to get a hold. Read more in the text Difficult to obtain .
It may take some time before you find a treatment that works for you. Make sure you meet with your doctor or contact nurse a month after starting a new treatment. Call the contact nurse if you need advice or want to ask about anything in the meantime.
It is often good if you as a partner allow them to be as involved in the treatment as possible.
Help to reduce sexual desire
Treatment with testosterone can cause the appetite to return. You can get such treatment if the cancer is gone and the risk is small that it will return. The testosterone is a gel you apply to your skin, or a syringe in a muscle that you need to get about four times a year.
Important with conversation and proximity
Sexuality is different in different people but it is important for most people to feel good about others and with themselves. Sex is part of sexuality.
Talking about their thoughts and feelings can enhance sexuality, whether you have a partner or not.
Body contact and closeness without sex can strengthen the relationship with a partner, and make the desire come back.
Read more about what you can do for yourself and what help there is in the text Cancer and sexuality.
Other causes of reduced desire
Sex appetite can be affected if the cancer treatment makes you feel anxious or depressed. Medicines for depression can also reduce the desire for sex and the ability to have sex.
Try to disperse your thoughts. Do something you like and move on .
Avoid resting for a long time during the day if you are tired. Rather rest several short moments.
Other side effects
Surgery and radiotherapy can cause you to become pissed off often and have difficulty keeping tight. Radiation treatment also affects the rectum. Most people do not have that much trouble over time.
Side effects that you can get from hormone therapy usually disappear when the treatment is completed but the treatment needs to last a long time.
Often there is help that relieves the side effects. Talk to your doctor. You can switch to another treatment that suits you better.
It can also make it easier to talk to someone who has received the same treatment.
Touch yourself as much as you can. It relieves many hassles and allows you to cope more. A physiotherapist or physiotherapist can help you design the workout according to your circumstances.
Who gets prostate cancer?.
It is common for prostate cancer to be discovered at age 70, or earlier if it is hereditary. It is unusual to get prostate cancer before you turn 50, for whatever reason.
It is unknown what can cause prostate cancer, other than heredity.
Prostate cancer can be hereditary
Heredity is the cause in approximately every twenty people who get prostate cancer. Heredity is found in some hereditary genes, which are also called genes. But anyone who inherits such genes does not get prostate cancer.
The risk can be investigated
It is unknown exactly which hereditary causes cause prostate cancer. Therefore, there is no test that can show if you have an increased risk of becoming ill.
But the risk of having prostate cancer can still be investigated. You can get help with it at a cancer genetic clinic if you have two or more genetic relatives with prostate cancer.
Getting a cancer message
There are many ways to respond to a cancer message. You may need plenty of time to talk to your doctor and other healthcare professionals about what the message means.
If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.
You have the right to understand
You can ask to have the information written down so you can read it peacefully. Ask questions if you don’t understand. You have the right to receive information in your own language. You have the right to receive interpreting assistance if you have a hearing impairment .
In many hospitals there are special nurses called contact nurses who can provide support and also help with various practical things.
You can get help in several places
The contact nurse or the hospital’s curator can help you if you need to talk more or have questions.
You can contact for example Cancer Counseling or Cancer Foundation. Patient associations can provide support in various ways.
Here you will find contact information for Cancer Counseling, Cancer Foundation, patient associations and others who also provide advice and support in cancer.
For many, it usually feels easier once treatment has begun and they know what is going to happen.
Children need to know
A child under the age of 18 is entitled to receive information and support based on his or her own needs if a close adult becomes ill. It is the responsibility of care. You can get help with what to say, if you want to tell yourself.
Often it is good to make children as involved as possible, regardless of age. That doesn’t mean you have to tell everything.
Sometimes it can be difficult to be close to someone who is seriously ill. Maybe you want to give support while you have a strong concern and feel bad. It is very common to do so.
On the Cancer Related page you will find tips on how to handle the situation and what help you can get.