Prostate cancer usually grows slowly and stays in the prostate. In fact, many men with prostate cancer die of other causes, sometimes without knowing that they had the disease. While some types of prostate cancer grow slowly and may need no treatment or minimal treatment, other types are considered aggressive and can spread quickly. If you have been diagnosed with prostate cancer, it is important to know the stage and Gleason Score of your cancer. Stage refers to the location of the prostate cancer and the Gleason Score, or grade, refers to the aggressiveness of the cancer.
Staging Prostate Cancer determines if and how far the prostate cancer has spread beyond the prostate.
The Gleason scoring system is used to grade prostate cancer and is a good indicator of the aggressiveness of the disease. Scores go from 2 to 10. The higher the number the more abnormal the prostate tissue is compared to normal tissue. The two numbers are then added to get a score. Higher Gleason Scores mean the cancer is more likely to spread.
A Pussycat or a Tiger?
Treatment options vary depending on prostate cancer stage and grade. Before making a treatment decision:
- Consider a second opinion
- Make sure to include a visit to an oncologist to know all of your options
- Find out if genomic testing was done to learn how aggressive your cancer is and how likely it is to recur
- Ask your doctor: Is my prostate cancer a pussycat or a tiger?
If your prostate cancer is a pussycat that means that there is a very low risk of the disease spreading beyond your prostate anytime soon. If your prostate cancer is a tiger that means there is a very high risk of the disease being aggressive and spreading beyond your prostate.
Remember, the more information you and your doctor have about your actual cancer, the better armed you are to fight the disease with the right tools.
Other Prostate Conditions
Prostate cancer is not the only disease that affects the prostate. As a man ages, his prostate continues to grow larger. This continued growth can cause benign (not cancer) prostate conditions. Conditions such as Benign Prostatic Hyperplasia (BPH) and prostatitis are also a concern for men and can be disruptive. Fortunately both conditions can be treated and managed to improve quality of life.
Benign Prostatic Hyperplasia (BPH)
BPH is a common condition caused when a man’s prostate is enlarged. Benign means not cancer and hyperplasia means abnormal cell growth. Men with this condition can have their prostates double or even triple in size. The enlarged prostate can press against the bladder and cause trouble with urination (peeing).
BPH is not cancer and men who have BPH are not at an increased risk for prostate cancer. Symptoms of BPH are similar to those of prostate cancer, so it’s important to talk with your doctor if you are experiencing these symptoms:
- Trouble starting a urine stream or making more than a dribble
- Frequent urination, especially at night
- Feeling that the bladder has not fully emptied
- Weak or slow urine stream
- Stopping and starting again several times while urinating
While BPH cannot be cured, drugs and surgery can help to relieve symptoms from the disease. Talk with your doctor or urologist about the best choice for you.
Prostatitis is the inflammation or swelling of the prostate. A diagnosis of prostatitis does not mean that a man has prostate cancer. The inflammation of the prostate can increase the PSA level in the blood.
Men with prostatitis frequently have swelling and pain in their prostate. As many as 50 percent of all men will be diagnosed with one form of this condition. There are four types of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis.
The symptoms a man will experience depend on the type of prostatitis and some men do not have any noticeable symptoms. The most common symptoms include:
- Trouble passing urine
- Burning or stinging feeling or pain upon urination
- Strong, frequent urge to urinate, even when there is very little urine
- Chills and high fever
- Low back pain
- Painful ejaculation
Talk with your doctor or urologist if you have these symptoms or have been diagnosed with prostatitis. One tool that may be used to diagnosis prostatitis is the National Institutes of Health Chronic Prostatitis Symptom Index. This brief questionnaire helps the physician understand how your prostatitis symptoms are affecting you. The questionnaire should be repeated at follow up appointments to compare your progress.
To find a urologist, visit the American Urology Association’s Doctor Finder. All active members are certified by the American Board of Urology.