+ AGE, of the patient:
As a prognostic factor, the physiological age is more important than the chronological age. This is how the patient’s life expectancy is considered and the absence or presence of other health problems.
+ ALTERNATIVE TREATMENTS
Numerous treatments which have not been scientifically proven (by means of clinical testing) are offered to patients, particularly terminal patients. There are ineffective and expensive. Many of these remedies interfere with medical treatment and/or cause side effects.
Masculine sexual hormones, of which the main one is testosterone.
Prevent the stimulating growth action of the tumour at prostate level, by blocking the receptors required for them to be active. The most commonly used are flutamide, bicalutamide and nilutamide.
+ ANXIETY, from PSA
Excessive concern whilst waiting for PSA results.
There are no symptoms of the illness. This is frequent in the earliest stages of prostate cancer.
+ BENIGN PROSTATE HYPERPLASIA
The size of the prostate has grown although not related to the cancer. This can cause problems when urinating and increase PSA.
+ BIOPSY, of the lymph nodes
If a prostatectomy has been indicated, a biopsy can be performed at the same time on the nodes. If there is any suspicion, in the light of any treatment, that the nodes close to the prostate are affected, they can be biopsied using a fine needle guided by CAT.
+ BIOPSY, of the prostate
Using a fine needle, and guided by direct observation using transrectal ultrasound, cylinders of prostate tissue are extirpated. The needle is inserted via the rectum. The biopsy is done on the most suspicious zone or zones. When you wish to cover all the prostate tissue, a minimum of 6 punctures are made. The cylinders obtained are sent to the pathologist for diagnosis.
+ BLOOD CHEMISTRY
Analysis of the components of the blood solution, in order to assess how well the kidneys (urea, creatinine) and liver (transaminase, GGT, alkaline phosphatase, bilirubin) are working as well as other aspects (cholesterol, glycaemia, etc.).
Internal radiotherapy by means of implanting radioactive “seeds”, generally palladium 103, in the tumour or close to it. The “seeds” are fitted inside fine needles which are inserted in the scrotum and the anus.
Blood test to determine the level of urea. This allows the kidney functions to be assessed.
+ CATHETERISATION, of the urinary bladder
Passing a catheter into the bladder, via the urethra.
Non hormonal treatment, with medication which can destroy cancerous cells.
+ CLINICAL TESTING
Studies carried out on humans to establish scientifically if one treatment is better than another. This could look particularly at the repercussion on survival and quality of life.
+ CLINICAL TESTING, phases
After the experimental phase (study of a new medication or a new treatment on experimentation animals), it moves to Phase I, or study of the maximum doses tolerated in our species for this medication or therapeutic modality; once this phase is completed it enters Phase II, which studies its possible activity in different tumours, finally Phase III is designed to compare the new medication or treatment with the best drug available at the present time. If this phase is passed, it goes to Phase IV when it is sold and used.
+ COMPUTERISED AXIAL TOMOGRAPHY (CAT)
This combines the rotating radiographic machine with a computer. It incorporates the information received from the radiographic images into a single transverse image. It can detect nodes which are larger than normal size and metastasis.
Blood test which assesses how well the kidneys are working.
Freezing the prostate using liquid nitrogen, in an attempt to destroy the tumour.
Narrow tube with a light on the end, which allows the doctor to observe what is happening in the urethra and the urinary bladder.
Exploration of the urethra and urinary bladder, with a cystoscope.
+ DIGITAL RECTAL PROBE
This allows an experienced doctor to recognise irregularities, hardness or nodules in the prostate.
+ EARLY DIAGNOSIS
Cancer is diagnosed in its early stages. It has not propagated either to lymph nodes or through the blood.
Release semen during orgasm.
+ EXTERNAL RADIOTHERAPY
This is performed using apparatus (sources) which emits external rays, focussed on the region of the body where the cancer is located. The most frequently used apparatus includes the cobalt “bomb” and linear accelerators.
+ FREE PSA
Quantity of PSA which circulates, without being joined to other proteins in the blood. When the percentage of free PSA compared to the total PSA is low, it is more probable that this is a prostate cancer than if this percentage is high.
+ GAMMAGRAPHY OF THE BONES
By means of prior injection of radioactive material (in harmless doses and materials for the patient and people around them), the whole skeleton can be seen and metastasis can be seen in it.
Painful sensitivity and increase in the size of mammary glands.
+ GLEASON, definition
Very valuable diagnostic method which classifies the tumour according to how aggressive it is: the higher the Gleason, the greater the probability that the tumour is aggressive and will extend beyond the prostate, the opposite for a low Gleason.
+ GLEASON, in practice
The pathologist assesses two portions of the biopsy which are representative of the tumour they are examining. He classifies each area from 1 to 5 and the sum of the two gives this specific person’s Gleason.
+ HAEMOGRAM AND PLATELETS:
Analysis of a patent’s blood sample which tells us the figures for red blood cells, haemoglobin (iron content in red blood cells), leucocytes (white blood cells) and platelets (essential cells for blood clotting).
Blood in the urine.
+ HEPATIC TESTS
These are carried out during the diagnosis and in patients receiving hormone therapy, periodically, given that this therapy can affect the liver.
+ HORMONALLY INDEPENDENT, cells
Cells from some prostate cancers which are not controlled by hormonal treatment.
Chemical substance produced and released in the organism by what are called endocrine glands (testicles, ovaries, thyroids, suprarenal, etc.) From their origin they circulate through the blood and influence the body’s functions. What we are most interested in here is oestrogen (female hormone) and testosterone (male hormone).
+ HORMONE THERAPY
This is done by means of hormone medication which changes the person’s hormonal make-up, to try and stop the tumour growing.
+ HORMONE THERAPY, adjuvant
This is applied after surgery or radiotherapy, when the extent of the tumour after these treatments recommends therapeutic reinforcement.
+ HORMONE THERAPY, combined
At the same time, more than one hormonal medication is applied to try and totally block the production of androgens.
+ HORMONE THERAPY, continuous
In people with local growth which cannot be controlled by surgery and/or radiotherapy or with metastasis, some doctors prefer continual hormone treatment.
+ HORMONE THERAPY, discontinuous
This is applied to the same situations described in the “Continual hormone therapy", but applying it according to the illness's evolution and the PSA.
+ HORMONE THERAPY, neoadjuvant
This is applied before radiotherapy, when the size of the tumour located in the prostate is excessive. Reducing the tumour makes radiotherapy easier.
Excessive benign growth of the cells or the tissues in a determined region or organ.
Difficulty or impossibility for the penis to become erect to allow sexual relations.
+ IMPOTENCE, treatment
Seek help from experts on the matter. The methods which are most commonly used are prosthesis or Viagra.
+ INCONTINENCE, due to stress
This is the most frequent. The urine escapes when coughing, laughing, sneezing or exercising.
+ INCONTINENCE, overflow
If you wait a long time to urinate; weak urinary flow.
+ INCONTINENCE, urgency
Unstoppable need to urinate.
+ INTERNAL RADIOTHERAPY
A long, slim tube is inserted in the abdomen, by means of a small incision. This allows us to look at the lymph nodes close to the prostate and, if considered appropriate, extirpate them.
Produced by the hypothalamus (cerebral gland), this is the hormone which releases the luteinizing hormone.
+ LHRH, agonists
Products which are similar to LHRH, which prevent the production of testosterone by the testicles.
+ LUTEINIZING HORMONE
Hormone produced in the hypophysis (gland located in the brain) which stimulates the production of testosterone.
+ LYMPH, nodes
Small structures (which look like a bean) situated along the lymphatic ducts or vessels.
The lymph nodes close to the prostate are extirpated for diagnostic or therapeutic purposes.
+ MAGNETIC NUCLEAR RESONANCE (MNR)
This produces images which are similar to CAT (see), except that MNR uses magnetic fields whilst CAT uses radiographies. It means that the effects on the nodes and metastasis can be focussed on.
Control over the patient’s evolution following treatment.
Alteration of the quality of life and general state of health, as a consequence of the undesirable side effects of the treatments.
Need to urinate several times at night.
Both testicles are extirpated for therapeutic purposes.
+ PALLIATIVE TREATMENTS
Intended to improve the quality of life, when the quantity of life cannot be guaranteed. It aims to improve symptoms, particularly pain.
Doctor specialised in diagnosis by means of examining the biopsy samples under the microscope.
The most important factors are age, stage (TNM), Gleason and PSA level before treatment.
An exclusively male gland which produces part of the seminal liquid (protecting and nourishing the sperm). It surrounds the upper part of the urethra, tube which leads the urine from the bladder to the penis. If the person is standing, it is located behind the base of the penis, under the urine bladder and in front of the rectum (last portion of the intestine).
+ PROSTATE CANCER
This is developed in the prostate cells.
+ PROSTATE CANCER, symptoms
They depend on the extension of the illness. In early stages, there are no symptoms. Problems when urinating, when the tumour has advanced locally. Osseous pain, if there is metastasis in the bones.
+ PROSTATECTOMY without cutting nerves
When it manages not to cut through one or both complexes of nerves and blood vessels which control penis erection.
Benign inflammation of the prostate.
+ PSA (prostate specific antigen), definition
Substance specifically produced by the prostate.
+ PSA, causes of temporary increase
Ejaculation, benign hyperplasia of the prostate, infection of the prostate and some medication (Finasterid type) temporarily increase the level of PSA.
+ PSA, growth speed
By means of successive PSA measurements, the speed that its level increases can be measured. The higher it is, the higher the probability that the patient has prostate cancer.
Psychologist who is specialised in detecting and treating possible psycho-social, emotional and sexual alterations which can emerge as a consequence of diagnosing and treating prostate cancer. They also give psychological support to the patient’s family.
+ RADICAL PROSTATECTOMY
Extirpation of the whole prostate, the seminal vesicles and the anatomical tissue close to the prostate. Generally, this should cut through both complexes of nerves and blood vessels which control penis erection.
This is the reproduction of the disease in a person who has been successfully treated. It can be suspected due to the reappearance of the symptom, increase in PSA, particularly if this is progressive or due to findings in periodic check-up studies.
+ RESCUE TREATMENTS
This refers to treatments which are applied to the patient in whom, despite being apparently cured, the illness reappears or extends.
+ SIDE EFFECTS OF CHEMOTHERAPY
These vary a lot depending on the type of medication used. The most common are nausea and vomiting, anorexia (reduction or loss of appetite) and alopecia (loss of hair, which returns once the chemotherapy has finished).
+ SIDE EFFECTS OF RADIOTHERAPY
During the treatment, diarrhoea and colitis, due to irritation of the rectum; need to urinate frequently, urgently and burning sensation when urinating; tiredness can also occur (these effects disappear 2-3 months after the treatment has finished). 40 to 60% of men develop some degree of non immediate impotence, which develops over one or several years.
+ SIDE EFFECTS OF SURGERY
The most noteworthy, due to the radical prostatectomy, are urine incontinence (this usually disappears within a year of treatment) and impotence (immediately after treatment) to perform the sexual act, between 60 and 90% of people.
+ SIDE EFFECTS OF THE HORMONAL TREATMENT
Both orchiectomy and LHRH treatment include reduction or absence of libido, impotence and suffocations. Ginecomasty can occur. The anti-androgens do not produce these effects but can cause nausea, diarrhoea and tiredness.
+ SIDE EFFECTS OF THE TREATMENTS
Theses are the problems which emerge in parallel to the therapeutic methods. They can be significant in prostate cancer and can affect the person’s quality of life.
TNM classification, which assesses the extension of the tumour in the prostate, whether the nodes have been affected and whether there is metastasis present.
The most active medication in extended prostate cancer (M1).
Male glands located in the scrotum. Produce sperm and testosterone, a male hormone.
Produced essentially in the testicles. It stimulates the secondary male sexual characteristics and stimulates the growth of prostate cancer.
This describes the extent of the tumour located in the prostate (T); whether lymph nodes close to the prostate are affected (N) and the presence or absence of propagation of the illness through the blood (M), mainly to the bones.
+ TRANSRECTAL ULTRASOUND
The waves are released from a small probe fitted in the rectum. Fitting the probe can be uncomfortable, but only for a moment. The exploration lasts between 10 and 20 minutes. It is used for diagnosis and to help to guide the biopsy needle.
+ TRANSURETHRAL RESECTION OF THE PROSTATE (TUR)
This is used to remove part of the prostate which surrounds the urethra. It does not cure prostate cancer. It is used more to eliminate the urinary symptoms caused when the prostate grows excessively, but benignly.
Diagnosis from the image obtained using ultrasound, sound waves which create an image of the prostate on a screen.
Anatomic tube which leads the urine from the urinary bladder and prostate fluid from the prostate to the penis.
+ URINARY CATHETER
Fine and flexible tube, used to drain urine.
+ URINARY INCONTINENCE
Incapacity to control the emission of urine, so it escapes.
+ URINARY URGENCY
Very unpleasant sensation produced by the need to urinate immediately.
+ WAIT AND SEE
This refers to when a person is diagnosed with prostate cancer and the doctor and patient agree that it is best to defer the treatment and wait to see what happens, to decide according to the illness’s evolution.