Why is a Prostate Cancer Diagnosis So Confusing?

Navigating anything cancer related, for a lay-person, can be incredibly confusing. Especially when you feel fine and are getting blind-sided by something like elevated bloodwork. Other than skin cancer, prostate cancer is the most common cancer in American men, according to cancer.org. They also report that about one man in seven will be diagnosed with prostate cancer during his lifetime.

Prostate Cancer doesn't have to be confusing.

Even though it’s so prevalent, it’s still pretty bewildering. The acronyms and lingo, the staging, and the treatment options. No wonder everyone is confused!

As Maria von Trapp taught us in the movie “The Sound of Music,” “Let’s start at the very beginning…”

PCa? PSA? Huh?

So, what is PCa? PCa stands for prostate cancer. Another common acronym is PSA, which stands for prostate-specific antigen, which is a protein in the blood that is produced by the prostate gland. The PSA test measures the level of the protein in the blood. Generally speaking, unless a man is thought to have a specific risk factor, most men will begin having PSA levels drawn at age 50.

An elevated PSA could indicate prostate cancer, with a higher number more greatly indicating the disease. From this test, a doctor would likely recommend further diagnostic measures, such as a prostate biopsy. A Gleason score, a score given to how aggressive the cancer cells are, would also be obtained along with the biopsy to form the correct determination of the specific stage of the cancer.

What stage is my cancer?

Prostate cancer is staged by looking at several factors that make up one number score, the TNM score. T stands for tumor, N for lymph nodes, and M for metastasis, (how far the cancer has spread outside the prostate gland). This measurement is used along with the Gleason score, the PSA level, and the patient’s health is used to determine the best course of treatment.

What are my treatment options?

One of the most confusing parts of receiving a prostate cancer diagnosis is whether or not to treat. Many doctors even question the need for routine PSA tests – feeling that even detecting and treating these non-life threatening tumors is overtreatment.

There is a population of doctors that believe in the watch-and-wait approach. Meaning that once a man receives a diagnosis of prostate cancer, his doctor simply monitors his condition through diagnostic imaging and bloodwork, versus treating with traditional avenues such as radiation or removal.

Treatment through radiation comes with a host of potential side effects and complications. Radiation, while effective, doesn’t just kill off the bad cancer cells, it kills off all the surrounding healthy tissue. Side effects are common, such as urinary incontinence and sexual dysfunction. A partial or total prostatectomy is sometimes advised as well, and is not without its downsides.

With roots running deeper than its official entrance into the United States in October 2015, HIFU is a new player in prostate cancer treatment. By using focused ultrasound, heat is used to destroy the cancer cells without destroying healthy tissue. Minimal side effects are one of the most attractive qualities of this treatment option, and a man’s cancer can be treated without a single incision.

I’m still confused!

This is by no means an exhaustive list of every confusing aspect of prostate cancer, but it does begin to shed light on why a PCa diagnosis can be confusing. The key is to find the right support system, including a trusted prostate cancer doctor. When you find the right navigator, it makes the course a lot more manageable.

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