THE AZURE STAGE OF BLUE | HIGH RISK
Featured
Many treatments have irreversible consequences, so the goal is to do it right the first time. It is well known that long-term survival is improved by receiving optimal treatment upfront. The first treatment is your best opportunity to eradicate cancer…
PSA plays a variety of roles, the most familiar being screening to detect prostate cancer. PSA also helps to define the Stages of Blue. Another role of PSA is to detect cancer relapse after surgery or radiation. Lastly, rises or declines in PSA after hormone therapy or chemotherapy help determine whether a treatment is working…
The two major components of the pathology report from a random 12-core biopsy are the Gleason score, which measures how aggressive the tumor appears, and the quantity of cancer, i.e., the extent of disease detected by the 12-core specimen.
Multiparametric MRI (MRI) provides a three-dimensional image of the prostate, giving important information about the cancer’s location, size, and how “aggressive” it appears. MRI also greatly increases the confidence that higher-grade cancers are not being overlooked in men on active surveillance. MRI is usually performed without an endorectal coil...
While multiparametric MRI is an excellent tool for monitoring disease inside the prostate, scanning the rest of the body for cancer that may have spread to the lymph nodes or bones is also critical. Body scans are necessary for every Stage of Blue except Sky. Traditionally, doctors have…
The official medical terminology used by doctors for Azure is “High-Risk.” Criteria for a man to be in Azure are:
Hormonal therapy is a mainstay for Azure, Indigo, and Royal. The testosterone inactivating pharmaceuticals (TIP) fall into three broad categories…
With Azure, the first step is to make sure no detectable metastases exist outside the pelvic lymph nodes. PSMA-PET scans are particularly useful in managing high-risk prostate cancer. These scans are highly sensitive in detecting prostate cancer cells inside or outside the prostate gland…
Chemotherapy or Zytiga for High-Azure In a large randomized trial called STAMPEDE, men with High-Azure showed a survival improvement when six cycles of Taxotere was added to TIP/radiation compared to men treated with TIP/radiation without Taxotere. Two additional studies…
Men contemplating prostate cancer treatment need to consider another defining characteristic of prostate cancer—the precarious anatomic location of the prostate deep in the lower portion…
Erectile dysfunction (ED) is a risk with every type of treatment for prostate cancer, but the exact risk is very specific to each patient. The better a man’s erections are before prostate cancer treatment, the better chance he has of preserving function…
Loss of bladder control (urinary incontinence) after surgery can be a devastating complication with a very negative impact on quality of life. Bladder control problems for the first few months following radical prostatectomy are to be expected. A biofeedback program (see below) may be helpful during this period to help restore bladder control…
Radiation for prostate cancer may cause short- or long-term side effects. Even though radiation targets the cancer cells, normal body tissues near the tumor can be affected. Specifically, we are talking about…
Blocking testosterone, a hormone that induces libido, strength, endurance, emotional stability, and potency, creates all kinds of side effects…
The post-treatment surveillance policy for men who have undergone an attempt at curative surgery or radiation is to check PSA quarterly for the first two years, biannually for the next three, and annually thereafter. For radiation patients, a yearly digital rectal examination is also recommended. After treatment with…
Ideally, food intake should be from whole food sources (unprocessed, unadulterated, natural), with only a small percentage of food products (processed, refined, boxed, bottled, canned, packaged, and powdered). Whole foods provide…
The risk of a sedentary lifestyle is about the same as a pack-a-day smoking habit. “Sitting is the new smoking.” After age 60, just through the normal aging process, men lose 1% of their muscle every year. Hormonal treatments accelerate…
When it comes to dietary supplements, less is more. Mega-doses suggest a worse outcome or prognosis in patients with cancer...
This article will discuss an alternative type of imaging, called color Doppler ultrasound (CDU). Unfortunately, CDU followed by targeted biopsy is available in only a few centers around the United States. Even so, this article will expound the many advantages of CDU for the diagnosis and staging of prostate cancer...
Once the proper Stage of Blue is assigned, the different treatments appropriate for that Stage can be considered and compared. In the prostate cancer treatment realm, decisions are usually based on comparisons among several alternatives. In the most general sense, there are four main types of treatment: observation, local treatments, systemic treatments, and combination therapy…