Prostate Treatment Tips - Help a Father Foundation

Prostate Treatment Tips

Treating Prostate Cancer

Prostate Treatment Tips

PSA Tests

What is a Prostate-Specific Antigen (PSA)?

Prostate-specific antigen, or PSA, is a protein produced by normal, malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.

Why would I need this test?

PSA test is used to screen for prostate cancer. Screening is a test that looks for a disease, such as cancer, in its early stages, when it’s most treatable. Therefore you may get a PSA test if you have certain risk factors for prostate cancer. These include:

Men with a family history of prostate cancer
Your age: Prostate cancer is more common in men over the age of 50.
Being African: Prostate cancer is more common in African men. The reason for this is unknown.

You may also get a PSA test if:

You have symptoms such as painful or frequent urination, and pelvic and/or back pain.
You’ve already been diagnosed with prostate cancer. The PSA test can help monitor the effects of your treatment.

How do I prepare for a PSA test?

If our doctors requests that you should have a PSA test, make sure that they are aware of any prescription or medicines, vitamins, or supplements you take. Certain drugs may cause the test results to be falsely low.

If our doctors thinks your medication might interfere with the results, they may decide to request a different test or they may ask you to avoid taking your medicine for several days so your results will be more accurate.

How is a PSA performed?

You are required to sit upright in a chair and rest your arm face up on an elevated arm rest. The will tie a strap (tourniquet) around the top of your arm to temporarily restrict the blood flow from your arm back to your heart. This will make the vein inside your elbow “pop out”, and therefore easier to find. The area where the needle will be inserted is wiped with a sterile alcohol wipe to reduce any risk of infection. A needle is inserted into the vein and a small amount of blood is drawn into the vial attached to the needle.
If seeing blood makes you uneasy, it is best to look away. Usually the phlebotomist will ask you questions as they take the blood to distract you from the procedure. It is done in no time! If there is any pain at all, it is minimal. More often than not, you will only feel a slight discomfort.
After the procedure, the phlebotomist will press a small wad of cotton on the entry point to stop the flow of blood. The cotton wad is strapped on with a band aid. This only needs to remain on for a couple of hours. Sometimes a little bruise is left in this spot, but this is nothing to worry about.

What do the results of my PSA test mean?

In general, a PSA level that is above 4.0 ng/mL is considered suspicious. However, there are many other factors to consider before taking further action. The following are some general PSA level guidelines:

0 to 2.5 ng/mL is considered safe
6 to 4 ng/mL is safe in most men but talk with our doctors about other risk factors
0 to 10.0 ng/mL is suspicious and might suggest the possibility of prostate cancer. It is associated with a 25% chance of having prostate cancer.
0 ng/mL and above is dangerous and should be discussed with our doctors immediately. It is associated with a 50% chance of having prostate cancer.

If Your PSA is High

Talking to our doctors can explore several options if your PSA is high. One option is to have a second PSA screening; recent research has shown that a second screening can improve the accuracy of an abnormal result. A digital rectal exam (DRE) and a biopsy can also confirm the presence or absence of prostate cancer. However, there are several other reasons why a PSA result might be high:

Advanced age
Recent biopsy
Catheter
Injury to pelvic region or prostate
Prostatitis
Riding a bicycle
Sex (within the past 24 hours)
Supplements that effect testosterone
Urinary tract infection

If Your PSA is Rising Quickly

The rate in yearly increase in the PSA level is known as the PSA velocity. This is one measure of prostate cancer risk, since PSA levels can rise rapidly in men who have prostate cancer. This can be especially useful to find prostate cancer in early stages before the cancer has left the capsule of the prostate.

PSA result between 4.0 and 10.0 ng/ml is an early indicator of prostate cancer if a man.

>What are the risks of a PSA test?

Drawing blood is considered safe. However, because veins and arteries vary in size and depth, getting a blood sample is not always simple.

The healthcare professional who draws your blood may have to try several veins in multiple locations on your body before they find one that allows them to get enough blood.

Drawing blood also has several other risks. These include risk of:

Fainting
Excessive bleeding
Feeling lightheaded or dizzy
An infection at the puncture site
A hematoma, or blood collected under the skin, at the puncture site.

References:

Diamed Diagnostical Centre

Dealing with prostate

Common warning signs of Warning signs of prostate cancer

Sexual functioning after prostate cancer treatment

All you need to know about prostate cancer

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Prostate Treatment Tips

Common problems arising after prostate cancer surgery

Magnetic resonance imaging (MRI) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.

The MRI scanner causes no pain. If a person is awake during the test, the person may feel some discomfort or pressure when the needle is inserted. An MRI scan may not be possible if you have a pacemaker or other metal inside your body.

Pros and Cons of MRI Scan Before Biopsy

Advantages

It can give your doctor information about how likely it is that you have cancer in your prostate.
It’s less likely than a biopsy to pick up a slow-growing cancer. This means you are less likely to have a biopsy and treatments that could have life-changing side effects if your cancer is unlikely to cause you any problems in your lifetime. Some side effects include severe infections and long lasting urinary or sexual problems.
It can help your doctor decide if you need a biopsy – if there’s nothing unusual on the scans, this means you’re unlikely to have prostate cancer that needs to be treated. You may be able to avoid having a biopsy, and its possible side effects.
If you do need a biopsy, your doctor can use the scan images to decide which parts of the prostate to take samples from.
If your biopsy finds cancer, you probably won’t need another scan to check if it has spread, as the doctor can get this information from your first MRI scan. This means you can start talking about suitable treatments as soon as you get your biopsy results.

Disadvantages

Being in the MRI machine can be unpleasant if you don’t like closed or small spaces (claustrophobia).
Some men are given an injection of dye during the scan – this can sometimes cause mild side effects.

What does an MRI scan involve?

Before the scan the doctor or nurse will ask questions about your health. As the scan uses magnets, they will ask whether you have any metal in your body such as implants or fragments that could be attracted to the magnet. They will decide if you can't have an MRI or if there are any changes needed to make sure the MRI is as safe as possible for you. For example, if you have a pacemaker for your heart you may not be able to have an MRI scan. You’ll also need to take off any jewellery or metal items. If you use patches on your skin such as pain medication, you should ask the doctor if this should be removed for the MRI scan.

You will lie very still on a table, which will move slowly into the scanner which is shaped like a doughnut or a long tunnel. If you don’t like closed or small spaces (claustrophobia), tell your radiographer (the person who takes the images) and they may be able to suggest some ways that could help you feel more comfortable in the scanner.

The radiographer might give you an injection of a dye during the scan. The dye helps them see the prostate and other organs more clearly on the scan. It is usually safe, but can sometimes cause problems if you:

have kidney problems
have asthma
are allergic to the dye or have any other allergies.

Let the radiographer know if you have either of these.

The scan takes 30 to 40 minutes. The machine won’t touch you but it is very noisy and you might feel warm. The radiographer will leave the room but you’ll be able to speak to them through an intercom, and will wear earplugs or ear defenders. You may also be able to listen to music through headphones.

Getting the results

Your MRI scan images will be looked at by a specialist called a radiologist, who specialises in diagnosing health problems using X-rays and scans. The radiologist will give the images of your prostate a score from 1 to 5. You may hear this called your PI-RADS (Prostate Imaging – Reporting and Data System) score or your Likert score. It tells your doctor how likely it is that you have cancer inside your prostate.

PI-RADS and Likert scores have the same values, and your score will be between 1 and 5.

PIRADS or Likert score 1 It’s very unlikely that you have prostate cancer that needs to be treated
PIRADS or Likert score 2 It’s unlikely that you have prostate cancer that needs to be treated.
PIRADS or Likert score 3 It isn’t possible to tell from the scan whether you have prostate cncer that needs to be treated – you may hear this called a borderline result.
PIRADS or Likert score 4 It’s likely that you have prostate cancer that needs to be treated.
PIRADS or Likert score 5 It’s very likely that you have prostate cancer that needs to be treated.

If your PI-RADS or Likert score is 1 or 2

This means you’re unlikely to have prostate cancer that needs to be treated. Your doctor would discuss advantages and disadvantages of having a further biopsy to help make a shared decision with you. This would include talking through your individual risk factors such as age, ethnicity or family history.

Together, you and your doctor may decide that you don’t need to have a biopsy. Your doctor may suggest you have regular PSA tests so that any changes in your PSA level are picked up early. You’ll also be offered treatment for any urinary symptoms.

Or you and your doctor can decide for you to have a prostate biopsy as it will help confirm if there is no cancer that needs to be treated.

If your PI-RADS or Likert score is 3 or more

You’ll usually be offered a prostate biopsy to find out whether you have cancer.

References:

Sweden Ghana Medical Centre

Prostate cancer UK

Dealing with prostate

Peroblems after prostate surgery

Sexual functioning after prostate cancer treatment

All you need to know about prostate cancer

What can help with leaking urine?

There are treatments and products available that can help, and there are things you can do to help yourself. Your treatment options will depend on how much urine you’re leaking, and how recently you had your prostate cancer treatment.

Treatments and products available that can help include:

absorbent pads and pants
pelvic floor muscle exercises
urinary sheaths
bed protectors and handheld urinals
penile clamps.
If you have sudden urges to urinate (urinary urgency) and sometimes leak urine before you get to the toilet (urge incontinence), you may be offered bladder retraining.

If you still leak urine six to twelve months after surgery and pelvic floor muscle exercises haven’t helped, there are treatments available that might help. These may include:

an internal male sling
an artificial urinary sphincter
adjustable balloons
medicines.
Talk to your doctor or nurse about treatments and products that may be suitable for you.

Absorbent pads and pants

These can be worn inside your underwear or instead of underwear to soak up any leaks. Some people find it helpful to wear close fitting underwear with pads. You may want to try female pads as your leaking improves, as these tend to be smaller and lighter and may fit better. Pads are usually very discreet, so people won’t know you’re wearing them. But you may feel more confident wearing dark trousers so it won’t show as much if your pad does leak.

Services vary from area to area, but your GP or the continence nurses at your hospital may provide some pads for free. Or you can buy them in supermarkets, chemists or online. Age UK also has a range of products that can be ordered online.

If you haven’t had your operation yet, you might find it helps to prepare by finding out what products are available. Talk to your doctor, nurse or continence advisor for more information, or visit the Continence Product Advisor website.

Pelvic floor muscle exercises

These can strengthen the pelvic floor muscles, which help control when you urinate.

Read about pelvic floor muscle exercises.

Urinary sheaths
You might hear these called external catheters. These look like condoms with a tube attached to the end that drains urine into a bag. The sheath fits tightly over the penis and you can strap the bag to your leg – under your clothes – and empty it as needed.

Bed protectors and handheld urinals
If you have to go to the toilet often during the night, or you leak urine when you’re in bed, bed protectors or handheld urinals might be useful to you.

Bed protectors are large pads that protect your sheets and mattress by soaking up any urine that you might leak. There are pads that you can wash and reuse, and others that you only use once before throwing them away

Handheld urinals are containers with a lid that can be used if you can’t reach the toilet in time or if there isn’t a toilet nearby. They have a large opening with a lid so that you can store the urine until you reach a toilet. These might also be useful if you drive long distances and don’t have any toilet near you.

Penile clamps

A penile clamp fits onto the penis and squeezes it, closing the urethra so that no urine can leak out. You should only use a penile clamp during the day for short periods of time, and should open it at least every two hours to let your blood flow back into your penis.

Penile clamps can be uncomfortable to wear and aren’t commonly used in the UK. They aren’t usually recommended by health professionals, as they reduce the blood flow to the penis. This means it can be unsafe if a clamp is put on too tightly or for too long. However, some men like to use them for activities such as swimming or jogging.

For more information about the different types of products to manage leaking urine, visit Continence Product Advisor.

Internal male sling

This is a small piece of material (mesh) that presses gently on your urethra and supports the urinary sphincter to keep it closed. This helps to stop urine leaking. You’ll have an operation to fit the sling. It should be tight enough to stop urine leaking out, but loose enough to let you urinate when you want to.

Treating Prostate Cancer

How to identify and select the right treatment

How to handle a prostate cancer comaback

PSA Tests

What is a Prostate-Specific Antigen (PSA)?

Why would I need this test?

How do I prepare for a PSA test?

What do the results of my PSA test mean?

If Your PSA is Rising Quickly

>What are the risks of a PSA test?

Common problems arising after prostate cancer surgery

Pros and Cons of MRI Scan Before Biopsy

Advantages

Disadvantages

What does an MRI scan involve?

Getting the results

What can help with leaking urine?

Absorbent pads and pants

Pelvic floor muscle exercises

Penile clamps

Internal male sling

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