Prostate Cancer Defined

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong — cells become abnormal and form more cells in an uncontrolled way.

These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Prostate cancer occurs when a malignant tumor forms in the tissue of the prostate, a gland in the male reproductive system. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive.

The prostate is about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate’s main function is to make fluid for semen, a white substance that carries sperm.

Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 65 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age.

Sometimes, cancer cells break away from a malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body.

When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer — not bone cancer. Doctors sometimes call this “distant” disease.

Today, more men are surviving prostate cancer than ever before. Treatment can be effective, especially when the cancer has not spread beyond the region of the prostate.

Causes and Risk Factors

Scientists don’t know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease.

Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 65 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 70.

Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men.

A man’s risk for developing prostate cancer is higher if his father or brother has had the disease.

Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

Scientists have wondered whether an enlarged prostate, a condition also known as benign prostatic hyperplasia or BPH, might increase the risk for prostate cancer. They have also studied obesity, lack of exercise, smoking, radiation exposure, and a sexually transmitted virus to see if they might increase risk. But at this time, there is little evidence that any of these factors contribute to an increased risk.

Symptoms and Diagnosis

Most cancers in their early, most treatable stages don’t cause any symptoms. Early prostate cancer usually does not cause symptoms.

However, if prostate cancer develops and is not treated, it can cause these symptoms:

• a need to urinate frequently, especially at night
• difficulty starting urination or holding back urine

Possible symptoms of prostate cancer:

• inability to urinate
• weak or interrupted flow of urine
• painful or burning urination

Possible symptoms of prostate cancer:

• difficulty in having an erection
• painful ejaculation
• blood in urine or semen
• pain or stiffness in the lower back, hips, or upper thighs.

Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If you have any of these symptoms, see your doctor or a urologist right away to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system.

The doctor will ask questions about your medical history and perform a digital rectal exam to try to find the cause of the prostate problems. In this exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean cancer is present.

The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present.

Neither of these screening tests for prostate cancer is perfect. Screening tests check for disease in a person who shows no symptoms. Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers.

The doctor may order other exams, including ultrasound and x-rays, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope.

If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope.

One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors.

Treatments and Research - Planning Treatment

If tests show that you have cancer, you should talk with your doctor in order to make treatment decisions.

A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient’s progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others.

Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it.

Some prostate cancer patients take part in studies of new treatments. These studies — called clinical trials — are designed to find out whether a new treatment is safe and effective.

Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor.

Treatments and Research - Staging Prostate Cancer

If cancer is found in the prostate, the doctor needs to know the stage of the disease and the grade of the tumor. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The grade tells how closely the tumor resembles normal tissue in appearance under the microscope.

Doctors use various blood and imaging tests to learn the stage of the disease. Imaging tests, such as ultrasound and magnetic resonance imaging, or MRI, produce pictures of images inside the body.

There are four stages used to describe prostate cancer. Doctors may refer to the stages using the Roman numerals I-IV or the capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.

Stage I or Stage A — The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA.

Stage II or Stage B — The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.

Stage III or Stage C — The cancer has spread outside the prostate to nearby tissues. The person may be experiencing symptoms, such as problems with urination.

Stage IV or Stage D — The cancer has spread to lymph nodes or to other parts of the body. The bones are a common site of spread of prostate cancer. There may be problems with urination, fatigue, and weight loss.

Treatments and Research - Standard Treatments

There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man’s needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man’s age, general health, and his feelings about the treatments and their possible side effects.

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is the goal for men whose prostate cancer is diagnosed early.

You and your doctor will want to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life.

Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment.

The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems.

For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment.

Surgery is used to remove the cancer. It is a common treatment for early stage prostate cancer. The surgeon may remove the entire prostate with a type of surgery called radical prostatectomy or, in a few cases, remove only part of it.

Sometimes the surgeon will also remove nearby lymph nodes. Side effects of the operation may include lack of sexual function or impotence, or problems holding urine or incontinence.

Improvements in surgery now make it possible for some men to keep their sexual function. In some cases, doctors can use a new technique known as nerve-sparing surgery. This may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.

Some men with trouble holding urine may regain control within several weeks of surgery. Others continue to have problems that require them to wear a pad.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area.

In advanced stages, the doctor may recommend radiation to relieve pain or other symptoms. It may also be used in combination with hormonal therapy. Radiation can cause problems with impotence and bowel function.

The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy.

For external radiation therapy, patients go to the hospital or clinic — usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time.

Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body.

Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. Some hormone therapies increase the risk of blood clots.

Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include

• a PSA blood test — usually every 3 months to 1 year.
• bone scan and/or CT scan to see if the cancer has spread.

Monitoring may include

• a complete blood count to monitor for signs and symptoms of anemia.
• looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function.

Treatments and Research - Latest Research

Scientists continue to look at new ways to prevent, treat, and diagnose prostate cancer. Research has already led to a number of advances in these areas.

Several studies are under way to explore the causes of prostate cancer. Some researchers think that diet may affect a man’s chances of developing prostate cancer. For example, some studies show that prostate cancer is more common in populations that consume a high-fat diet, particularly animal fat, and in populations with diets that lack certain nutrients.

Some research suggests that high levels of testosterone may increase a man’s risk of prostate cancer. The difference in prostate cancer risk among racial groups could be related to high testosterone levels, but it also could result from diet or other lifestyle factors.

Researchers are studying changes in genes that may increase the risk for developing prostate cancer. Some studies are looking at the genes of men who were diagnosed with prostate cancer at a relatively young age, such as less than 55 years old, and the genes of families who have several members with the disease. Other studies are trying to identify which genes, or arrangements of genes, are most likely to lead to prostate cancer. Much more work is needed, however, before scientists can say exactly how genetic changes relate to prostate cancer.

Several studies are under way to explore ways to prevent prostate cancer. These include the use of dietary supplements such as vitamin E and selenium. In addition, recent studies suggest that a diet that regularly includes tomato-based foods may help protect men from prostate cancer.

According to results of a recent study, men who took finasteride, a drug that affects male hormone levels, reduced their chances of getting prostate cancer by nearly 25 percent compared to men who took a placebo.

Scientists are also looking at ways to stop prostate cancer from returning in men who have already been treated for the disease. These approaches use drugs such as finasteride, flutamide, nilutamide, and LH-RH agonists that manipulate hormone levels. One recent study found that the combination of nilutamide and an experimental cancer vaccine was effective in reducing recurrence of prostate cancer. The experimental vaccine was designed to strengthen the body’s natural defenses against prostate cancer.

Researchers also are looking at diets that are low in fat and high in soy, fruits, vegetables, and other food products to see if they might prevent a recurrence.

At this time, doctors are not sure whether screening for prostate cancer actually saves lives, even if the disease is found at an earlier stage. The National Cancer Institute is sponsoring the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial to find out whether certain detection tests can reduce the number of deaths from these cancers.

This trial is looking at the usefulness of prostate cancer screening by performing a digital rectal exam and checking the PSA level in the blood in men ages 55 to 74. The results of this trial may change the way men are screened for prostate cancer.

Some researchers are working to develop new blood tests to detect the antibodies that the immune system produces to fight prostate cancer. When used along with PSA testing, the antibody tests may provide more accurate results about whether or not a man has prostate cancer.

Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery — destroying cancer by freezing it — is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it.

Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues.

Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond, or stops responding, to hormonal therapy. They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach.

For men with early stage prostate cancer, researchers are also comparing treatment with watchful waiting. The results of this work will help doctors know whether to treat early stage prostate cancer immediately or only later on, if symptoms occur or worsen.

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong — cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous.

The prostate is a male sex gland, about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate’s main function is to make fluid for semen, a white substance that carries sperm.

Prostate cancer occurs when a malignant tumor forms in the tissue of the prostate. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive.

Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 65 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age.

Sometimes, cancer cells break away from the malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body.

When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer, not bone cancer. Doctors sometimes call this “distant” disease.

Yes. Today, more men are surviving prostate cancer than ever before. In fact, the number of deaths from prostate cancer has been declining since the early 1990s. If found early, the disease can very likely be cured.

Scientists don’t know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease.

Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 65 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 70.

Yes. Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men. A man’s risk for developing prostate cancer is higher if his father or brother has had the disease.

Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

Scientists have wondered whether an enlarged prostate, a condition also known as benign prostatic hyperplasia or BPH, might increase the risk for prostate cancer.

They have also studied obesity, lack of exercise, smoking, radiation exposure, and a sexually transmitted virus to see if they might increase risk. But at this time, there is little evidence that any of these factors contribute to an increased risk.

• a need to urinate frequently, especially at night
• difficulty starting urination or holding back urine
• inability to urinate
• weak or interrupted flow of urine

If prostate cancer develops and is not treated, it can cause these symptoms:

• painful or burning urination
• difficulty in having an erection
• painful ejaculation
• blood in urine or semen
• pain or stiffness in the lower back, hips, or upper thighs

Yes. Any of the symptoms caused by prostate cancer may also be due to enlargement of the prostate, which is not cancer. If you have any of the symptoms mentioned in question #9, see your doctor or a urologist right away to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system.

Doctors use the following tests to detect prostate abnormalities, but these tests cannot show whether abnormalities are cancer or another, less serious condition. The results from these tests will help the doctor decide whether to check the patient further for signs of cancer.

• Digital Rectal Exam — the doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer.

• Blood test for prostate specific antigen or PSA — a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, an enlarged prostate, or infection in the prostate.

The doctor may order other exams, including ultrasound and x-rays, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope.

If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope.

If cancer is found in the prostate, the doctor needs to stage the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The doctor also needs to find out the grade of the cancer. The grade tells how closely the tumor resembles normal tissue.

There are four stages used to describe prostate cancer. Doctors may refer to the stages using Roman numerals I-IV or capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.

Stage I or Stage A — The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA.

Stage II or Stage B — The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.

Stage III or Stage C — The cancer has spread outside the prostate to nearby tissues. The person may be experiencing symptoms, such as problems with urination.

Stage IV or Stage D — The cancer has spread to lymph nodes or to other parts of the body. There may be problems with urination, fatigue, and weight loss.

There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man’s needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man’s age, general health, and his feelings about the treatments and their possible side effects.

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early.

Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment.

With watchful waiting, a man’s condition is closely monitored, but treatment does not begin until symptoms appear or change. The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly.

Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment.

Surgery is a common treatment for early stage prostate cancer. It is used to remove the cancer. The surgeon may remove the entire prostate — a type of surgery called radical prostatectomy — or, in a few cases, remove only part of it.

Sometimes the surgeon will also remove nearby lymph nodes. Side effects may include lack of sexual function, which is called impotence, or problems holding urine, which is called incontinence.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area. In advanced stages, the doctor may recommend it to relieve pain or other symptoms. Radiation can cause problems with impotence and bowel function.

The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy.

For external radiation therapy, patients go to the hospital or clinic — usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time.

Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body. Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones.

Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working.

Monitoring may include

• a PSA blood test, usually every 3 months to 1 year.
• bone scan and/or CT scan to see if the cancer has spread.

• a complete blood count to monitor for signs and symptoms of anemia.
• looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function.

Through research, doctors are trying to find new, more effective ways to treat prostate cancer. Cryosurgery — destroying cancer by freezing it — is under study as an alternative to surgery and radiation therapy. To avoid damaging healthy tissue, the doctor places an instrument known as a cryoprobe in direct contact with the tumor to freeze it.

Doctors are studying new ways of using radiation therapy and hormonal therapy, too. Studies have shown that hormonal therapy given after radiation therapy can help certain men whose cancer has spread to nearby tissues.

Scientists are also testing the effectiveness of chemotherapy and biological therapy for men whose cancer does not respond or stops responding to hormonal therapy.

They are also exploring new ways to schedule and combine various treatments. For example, they are studying hormonal therapy to find out if using it to shrink the tumor before a man has surgery or radiation might be a useful approach. They are also testing combinations of hormone therapy and vaccines to prevent recurrence of prostate cancer.

Researchers are studying changes in genes that may increase the risk for developing prostate cancer. Some studies are looking at the genes of men who were diagnosed with prostate cancer at a relatively young age, less than 55 years old, and the genes of families who have several members with the disease. Other studies are trying to identify which genes, or arrangements of genes, are most likely to lead to prostate cancer.

Much more work is needed, however, before scientists can say exactly how genetic changes relate to prostate cancer. At the moment, no genetic risk has been firmly established.

Some prostate cancer patients take part in studies of new treatments. These studies — called clinical trials — are designed to find out whether a new treatment is safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. People with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor.

Diet may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk.

Researchers are also looking at diets that are low in fat and high in soy, fruits, vegetables, and other food products to see if they might prevent a recurrence of prostate cancer. In addition, recent studies suggest that a diet that regularly includes tomato-based foods may help protect men from prostate cancer.

Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

These studies include the use of dietary supplements such as vitamin E and selenium. At the moment, no dietary factor has been proven to change your risk of developing prostate cancer or to alter the course of the disease after diagnosis.

Living with a serious disease such as cancer is not easy. Some people find they need help coping with the emotional as well as the practical aspects of their disease. Patients often get together in support groups where they can share what they have learned about coping with their disease and the effects of treatment. Patients may want to talk with a member of their health care team about finding a support group.

People living with cancer may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, dietitians, and other members of the health care team can answer questions about treatment, working, or other activities.

Meeting with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for help with rehabilitation, emotional support, financial aid, transportation, or home care.

It is natural for a man and his partner to be concerned about the effects of prostate cancer and its treatment on their sexual relationship. They may want to talk with the doctor about possible side effects and whether these are likely to be temporary or permanent. Whatever the outlook, it is usually helpful for patients and their partners to talk about their concerns and help one another find ways to be intimate during and after treatment.

Originator: NCI Source: www.cancer.gov