What is the typical age for prostate cancer?
Rising age is a risk factor for prostate cancer, so the probability of developing the disease increases with age. The average age at which prostate cancer develops is 70 years. Most men develop prostate cancer during their lifetime, but often the disease does not become symptomatic and those affected die from other causes.
Prostate cancer is then only diagnosed afterwards. In the age group of those over 80, for example, the incidence of prostate cancer is around 60%. However, the annual preventive medical check-up is recommended from the age of 45 and is covered by the statutory health insurance companies.
What is the course?
No general statement can be made about the course of prostate cancer, as it is very individual. In addition to the initial stage, the course of the disease mainly depends on the therapy and also on the patient’s general condition. Among the cancers that lead to death in men, prostate cancer was in second place in 2014 (11.4%) after lung cancer (24.4%) and should therefore not be underestimated. However, it is a relatively slow-growing tumor and because of the preventive examinations more and more carcinomas are detected in their early stages.
How is prostate cancer treated?
There are several ways to treat prostate cancer. Three factors lead to a decision: For localized tumors without metastases, the concrete treatment measures are surgical removal of the prostate (radical prostatovesiculectomy) and/or radiation (radiotherapy). Hormone treatment can supplement radiation or be used independently for tumors that have already metastasized.
If distant metastases are present, hormone therapy or combined hormone chemotherapy can also be initiated. In addition to these methods, there is always the possibility of a wait-and-see treatment at first.Since prostate carcinoma is a relatively slow-growing tumor, it is possible to wait and see (“active surveillance”) if the findings are low-risk. This means that treatment is not required immediately, thus avoiding the side effects of the therapy options.
However, there is a risk of not initiating therapy in time. Another concept is controlled waiting (“watchful waiting”). This is mainly used in older patients in whom the carcinoma does not lead to a significant reduction in life expectancy (tumour-independent life expectancy <10 years).
In addition, it is used in palliative care when a cure is ruled out.
- Tumor Stage
- Age
- General condition
Surgical removal of the prostate (radical prostatectomy) is, in addition to radiation, the optimal procedure for non-metastatic tumors. In addition to the prostate, the adjacent seminal vesicles and pelvic lymph nodes are removed and the vas deferens are severed.
The patient must therefore be aware that he or she is infertile after this operation. Furthermore, the surgery bears risks. First and foremost is stress incontinence, i.e. an involuntary loss of urine under stress.
The cause is a damaged pelvic floor muscles. The degree of severity is determined by the intensity of the load. In the first period after the procedure, incontinence is normal and usually uncomplicated.
However, if it persists, it must be treated medically, surgically or conservatively with pelvic floor training. In 50 – 70% of cases, erectile dysfunction (= inability to get an erection) occurs. For reasons that are not yet fully understood, surgical or radiation induced changes in the anatomy of the pelvis can lead to this.
It is assumed that erectile dysfunction is a consequence of the influence of the vascular-nerve bundles that supply the prostate. Irradiation is considered equivalent to surgery as the optimal therapy. The patient is usually irradiated daily on an outpatient basis for several weeks.
The procedure only takes a few minutes and is painless. The patient can then go home. A distinction is made between percutaneous irradiation (from the outside) and so-called brachytherapy (from the inside).
Thanks to the most modern technologies, the radiation is performed selectively with the intention of destroying as little surrounding tissue as possible. However, this cannot be avoided completely. Side effects can therefore be burns, reddening and inflammation of the skin.
In the long term, incontinence, impotence and diarrhoea can result from damage to surrounding structures. Get more details about the advantages and disadvantages as well as the exact procedure of radiation therapy for prostate cancer. Chemotherapy is especially indicated in an advanced stage of the disease, when the tumor has already spread to other organs.
In this case, local surgery or radiation cannot do much more. The patient must be aware, however, that chemotherapy alone serves to prolong the life span of the patient, a cure cannot be achieved. In addition, this therapy places an enormous burden on the body and is therefore not suitable for every patient.
Chemotherapy is carried out in several cycles. The infusion takes about one hour, after which the patient can go home. The aim of chemotherapy is to destroy rapidly dividing cells, which include tumor cells.
Other fast-dividing cells include the mucous membrane cells of the digestive tract, hair root cells and haematopoietic cells in the bone marrow. As a result, vomiting, nausea, hair loss, susceptibility to infections or anaemia can occur. For this reason, the patient is closely monitored and medically adjustedThe testosterone dependence of prostate carcinoma is used in hormone therapy.
Androgens are the male sex hormones which are mainly produced in the testicles and to whose group testosterone also belongs. Among other things, they cause the growth and proliferation of prostate cancer cells. In principle, hormone therapy can be used both curatively (for healing) and palliatively (healing is no longer possible).
However, the curative approach only works in combination with other therapies, such as radiation. If used alone, hormone therapy cannot bring about a cure because the tumor becomes resistant to the drugs after a certain time and continues to grow despite low testosterone levels. There are various substances that are either injected into the muscle or under the skin as depot injections or administered in tablet form.
Despite their different mechanisms of action, all these substances have in common the elimination of the androgen effect.One speaks therefore also of chemical castration. The side effects of hormone therapy can be summarized under the androgen deprivation syndrome. These include loss of libido, muscle loss, enlargement of the mammary glands (gynecomastia), osteoporosis, erectile dysfunction or hot flushes.
Immunotherapy for prostate cancer is the subject of current studies. Up to now, the use of immunotherapy has been known mainly from the treatment of lung or skin cancer. Cancer immunotherapies help the immune system to recognize and destroy cancer cells.
The immune system is not only able to fight foreign pathogens such as bacteria or viruses, but also to eliminate the body’s own degenerated cells. However, this is extremely difficult in the case of cancer cells, as they have developed various camouflage mechanisms with which they can trick the immune system. At this point, immunotherapy is a good support. Due to the exaggerated reaction of the immune system, side effects must be expected, such as chronic or acute inflammation in the intestine with diarrhea, vomiting, weight loss or fatigue, inflammation on the skin and inflammation of the liver.
