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Prostate Cancer

Topic Overview

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For information on cancer that has come back or spread to other parts of the body, see the topic Prostate Cancer, Advanced or Metastatic.

What is prostate cancer?

Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. As men age, the prostate usually grows larger.

Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. As with other cancers, treatment for prostate cancer works best when the cancer is found early. Often, prostate cancer that has spread responds to treatment. Older men who have prostate cancer usually die from other causes.

Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. What you eat, such as foods high in fats, may also play a part.

What are the symptoms?

Prostate cancer usually doesn't cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical examination.

When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.

See your doctor for a checkup if:

  • You have urinary problems, such as:
    • Not being able to urinate at all.
    • Having a hard time starting or stopping the flow of urine.
    • Having to urinate often, especially at night.
    • Having pain or burning during urination.
  • You have difficulty having an erection.
  • You have blood in your urine or semen.
  • You have deep and frequent pain in your lower back, belly, hip, or pelvis.

How is prostate cancer diagnosed?

The most common way to check for prostate cancer is to have a digital rectal examination, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer. But it could also mean that you have an enlargement or infection of the prostate.

If your PSA is high, or if your doctor finds anything during the rectal examination, he or she may do a prostate biopsy to figure out the cause. A biopsy means that your doctor takes tissue samples from your prostate gland and sends them to a lab for testing.

How is prostate cancer treated?

Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.

You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or if you have cancer that is low-risk and hasn't spread (early stage), you may be able to wait and watch with active surveillance to see what happens. During active surveillance, you will have regular checkups with your doctor to see if your cancer has changed.

Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that's best for you.

How can treatment affect your quality of life?

Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before you are treated, especially urinary, bowel, or sexual function problems, will affect how you recover.

Both surgery and radiation can cause urinary incontinence (leaking urine) or impotence (not being able to have an erection). The level of urinary incontinence and how long it lasts and the quality of the erections a man has after treatment will depend on whether the cancer has spread. These also depend on what treatment is used.

Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage these nerves. Many times a special form of surgery, called nerve-sparing surgery, can preserve the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.

These same nerves can also be damaged by the X-rays that are used in radiation therapy.

Medicines and mechanical aids may help men who are impotent because of treatment. Some men recover part or most of their ability to have an erection several months or even years after surgery.

Frequently Asked Questions

Learning about prostate cancer:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with prostate cancer:

Health Tools Health Tools help you make wise health decisions or take action to improve your health.

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Decision Points focus on key medical care decisions that are important to many health problems. Decision Points focus on key medical care decisions that are important to many health problems.
  Prostate Cancer Screening: Should I Have a PSA Test?
  Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?

Actionsets help people take an active role in managing a health condition. Actionsets are designed to help people take an active role in managing a health condition.
  Stress Management: Breathing Exercises for Relaxation

Cause

The exact cause of prostate cancer isn't known. But experts believe that your age and family history (genetics) may have something to do with your chances of getting the disease. What you eat may add to your chances of getting it.

The prostate usually gets larger as you age. Having an enlarged prostate (benign prostatic hyperplasia, or BPH) is very common among older men and doesn't increase your chances of getting prostate cancer. But an enlarged prostate is sometimes caused by prostate cancer instead of BPH.

Symptoms

Prostate cancer usually doesn't cause symptoms in its early stages. When there are symptoms, they may include:

  • Urinary problems, such as:
    • Not being able to urinate at all.
    • Having a hard time starting or stopping the flow of urine.
    • Having to urinate often, especially at night.
    • Having pain or burning during urination.
  • Difficulty having an erection.
  • Blood in your urine or semen.
  • Deep and frequent pain in your lower back, belly, hip, or pelvis.

Symptoms that may show that the cancer has spread, or metastasized, to other parts of the body include:

  • Weight loss.
  • Bone pain, especially in the lower abdomen, hip, pelvis, or lower back.
  • Swelling in the legs and feet.

For more information about prostate cancer that has come back or spread, see the topic Prostate Cancer, Advanced or Metastatic.

What Happens

Prostate cancer is a common cancer affecting older men. It usually takes years to become large enough to cause any problems. Sometimes, though, it grows quickly.

Many prostate cancers are found early, when the cancer cells are only in the prostate. When prostate cancer spreads beyond the prostate, it goes first to the lymph nodes in the pelvis, and then on to the bones, lungs, or other organs. For more information, see the topic Prostate Cancer, Advanced or Metastatic.

About 26,000 men are diagnosed with prostate cancer in Canada every year.1 In the United States, about 16 out of 100 men in the U.S. will get prostate cancer, but only about 3 will die because of it. That means about 97 out of 100 men will die of something other than prostate cancer.2

What Increases Your Risk

Some things can increase your chances of getting prostate cancer. These things are called risk factors. But many people who get prostate cancer don't have any of these risk factors. And some people who have risk factors don't get this cancer.

Age

Being older than 50 is the main risk factor for prostate cancer. About 6 out of 10 new prostate cancers are found in men who are 65 or older.3

Family history

Your chances of getting the disease are higher if other men in your family have had it.

  • Your risk is doubled if your father or brother had prostate cancer. Your risk also depends on the age at which your relative was diagnosed.
  • Men whose families carry the gene changes that cause breast cancer, BRCA1 or BRCA2, are thought to be at increased risk for prostate cancer.

Race

  • Prostate cancer is more common among men of African descent than men of other races. Men of African descent also have a greater chance of getting the kind of prostate cancer that grows and spreads.
  • In men of other races, non-Hispanic white men are more likely to get prostate cancer than Hispanic men or men of Asian descent.

Other factors

  • What you eat. Men who live in countries where people eat more red meat and fats are more likely to be diagnosed with and die from prostate cancer, according to some studies. Eating more lycopene, found in tomatoes and beets, may reduce the risk.
  • Hormones. Researchers are studying the link between high testosterone levels and prostate cancer.

When To Call a Doctor

Call your doctor right away if:

  • You cannot urinate.
  • You have symptoms of a urinary infection. For example:
    • You have blood or pus in your urine.
    • You have pain in your back just below your rib cage.
    • You have a fever, chills, or body aches.
    • It hurts to urinate.
    • You have groin or belly pain.
  • You have pain in your back or hips.
  • Your pain isn't controlled.
  • You are vomiting or nauseated.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have pain when you ejaculate.
  • You have trouble starting or controlling your urine.

Who to see

Your family doctor or general practitioner can check your urinary symptoms. For treatment of prostate cancer, you may be referred to a:

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Examinations and Tests

Tests if you have symptoms

If you are having problems urinating, your doctor may use tests to see if you have an enlarged prostate (benign prostatic hyperplasia). This condition is the most common cause of urination problems.

Tests include:

  • A digital rectal examination, in which the doctor inserts a gloved finger into your rectum to feel your prostate gland. Some prostate tumours can be found this way.
  • A PSA test to measure the levels of prostate-specific antigen (PSA) in your blood. A higher level of PSA may be a sign of an enlargement, infection, or cancer of the prostate. If it's possible that an infection is raising your PSA, you may first have 4 to 6 weeks of antibiotics. Your doctor may suggest a second PSA test before thinking about doing a biopsy.
  • A transrectal ultrasound, in which the doctor inserts a probe into your rectum to check your prostate. The probe uses sound waves (ultrasound) to create a picture of the prostate.

If tests point to prostate cancer, your doctor may recommend a prostate biopsy, in which tissue is taken from the prostate and examined under a microscope. A biopsy is the only way to confirm whether you have prostate cancer.

Tests after diagnosis

After prostate cancer has been diagnosed, tests will be done to see if the cancer has spread. Tests include:

Tests after treatment

After treatment for prostate cancer, you have regular checkups to check for any signs that the cancer has come back or spread. Tests include:

  • Blood tests. Different types of blood tests are used to see whether cancer has spread to your bones or liver.
  • A bone scan to check for bone damage caused by the cancer spreading.
  • A CT scan or MRI to look for a new tumour.

Screening tests

Screening for prostate cancer involves checking for signs of the disease when there are no symptoms. It may be done with the digital rectal examination and the PSA test. And while it's important to have regular health checkups, experts disagree on whether PSA testing should be used to routinely screen men for prostate cancer. Testing could lead you to have cancer treatments that you don't need.

So talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of PSA testing.

Click here to view a Decision Point. Prostate Cancer Screening: Should I Have a PSA Test?

Treatment Overview

Choosing treatment for prostate cancer can be confusing. Any treatment can cause serious side effects.

Your treatment decision will depend on:

  • Your age.
  • Any serious health problems, including any urinary, bowel, or sexual function problems.
  • Your PSA level.
  • What kind of cancer cells you have. This is called the grade or Gleason score of your cancer. Most prostate cancer cells grow very slowly. But some types of cells grow quickly and spread to other areas of the body.
  • How far your cancer has spread. This is called the stage of your cancer.
  • The side effects of treatment.
  • Your personal feelings and concerns.

Treatment may be more successful if prostate cancer is found and treated early. Unlike many other cancers, prostate cancer is usually slow-growing. For most men, this slow growth means they have time to learn all they can before deciding whether to have treatment or which treatment to have.

Types of treatment

The main treatments for prostate cancer include:

  • Active surveillance. This is a treatment choice for any man who has low-risk cancer that has not spread (early stage). To learn more, see Other Treatment.
  • Surgery to remove the cancer by removing the prostate gland. This operation is called a prostatectomy.
  • Radiation treatments, which include external and internal radiation. These treatments have been improved with newer technologies that reduce side effects and other problems caused by radiation. To learn more, see Other Treatment.
  • Hormone therapy, also called androgen deprivation therapy or ADT. To learn more, see Medications.

Another treatment is high-intensity focused ultrasound (HIFU), which uses an intense heat from focused sound waves to kill cancer cells. HIFU is also used for men who have cancer inside the prostate but who can't have surgery. HIFU is a treatment that is used in Canada and Europe.

A diagnosis of prostate cancer usually means that you will be seeing your doctor regularly for years to come. So it's a good idea to build a relationship that is based on full and honest information. Ask your doctor questions about your cancer so that you can make the best decision about treatment. Your doctor also may give you some advice on changes to make in your life to help your treatment succeed.

You can find more information about prostate cancer online at the:

  • Canadian Cancer Society website at www.cancer.ca.
  • U.S. National Cancer Institute website at www.cancer.gov.

Coping with cancer

A cancer diagnosis can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counsellor can really help. Ask your doctor about support groups. Or call the Canadian Cancer Society (1-888-939-3333) or visit the website at www.cancer.ca.

Follow-up care

After surgery or radiation

If you choose surgery or radiation to treat your prostate cancer, it will be important to have regular checkups. If your cancer comes back, this will help your doctor find it early.

If you choose active surveillance

If you decide on active surveillance, you will have regular checkups and tests, including prostate biopsies. It is possible that a curable cancer could spread and become incurable during a 6-month period, but this isn't common. If there is no change in your condition, you may continue active surveillance. If tests show that your cancer is growing, it may be time to start other treatment.

Treatment decisions

  • Age isn't a reason to avoid surgery. But if you are 70 or older, other medical conditions, such as heart disease, may affect your decision. Men who are older also have a higher rate of incontinence and impotence after surgery. Age is especially important to think about if you have early-stage cancer, which generally grows slowly.
  • Get a second or even a third opinion before making your treatment decisions. You may hear differing advice or opinions, which may seem confusing. But talking with other doctors can help you make your decision.
  • Studies show that fewer side effects are reported at large medical centres, where the surgeons do prostatectomies more often and so are more experienced and skilled.4

Prevention

One thing you can do that may lower the risk for prostate cancer is eat more low-fat, high-fibre foods and foods with omega-3 fatty acids, such as:

  • Soy products, like tofu and soy beans.
  • Tomatoes and foods that contain tomato sauce.
  • Vegetables like broccoli, cauliflower, and cabbage.
  • Fish, like salmon, albacore tuna, and sardines.
  • Walnuts and flaxseed, and their oils.

Being physically active and staying at a healthy body weight also can help reduce the risk of prostate cancer.5

Home Treatment

Managing symptoms and side effects

During any stage of prostate cancer, there are things you can do at home to help manage the symptoms of cancer or the side effects of treatment or both. If your doctor has given you instructions or medicines to treat symptoms or side effects, be sure to use them. Healthy habits such as eating right and getting enough sleep and exercise can help control your symptoms and side effects.

Try the following tips to manage:

  • Nausea or vomiting. Watch for and treat early signs of dehydration, such as having a dry mouth or feeling light-headed when you stand up. Eating smaller meals may help. So can a little bit of ginger candy or ginger tea.
  • Pain. Not all forms of cancer or cancer treatment cause pain. But if you do have pain, there are many home treatments that can help.
  • Diarrhea. Rest your stomach, and be alert for signs of dehydration. Check with your doctor before using any non-prescription medicines for your diarrhea. Be sure to drink enough fluids.
  • Constipation. Make sure you drink enough fluids and eat fruits, vegetables, and fibre in your diet each day. Do not use a laxative without first talking to your doctor.
  • Sleep problems. Often, simple measures such as having a regular bedtime, getting some exercise during the day, and having no caffeine late in the day can help with sleep problems.
  • Urinary problems. Home treatment for urinary incontinence includes eliminating caffeinated drinks from your diet and setting a schedule of urinating every 3 to 4 hours, regardless of whether you feel the need. Try doing pelvic floor (Kegel) exercises to strengthen your pelvic muscles.

Managing stress

  • Learning that you have prostate cancer and being treated for it can be very stressful. Find ways to reduce your stress.
  • You may want to talk with family or friends. Some people find that spending time alone is what they need. Consider meeting with a counsellor or joining a support group of others who have prostate cancer.
  • Your doctor may also be able to help you find other sources of support and information. Learning relaxation techniques, such as yoga or visualization exercises, may also help you reduce your stress. Your feelings about your body may change after treatment. Dealing with your body image may involve talking openly about your worries with your partner and discussing your feelings with a doctor.

For more information, see the topic Getting Support When You Have Cancer.

Medications

Hormones are medicines that can affect the growth of prostate cancer cells. Hormone therapy is sometimes used with radiation treatment or surgery to help make sure that all cancer cells are destroyed.

Hormone therapy can't cure prostate cancer. But it will usually shrink the tumour and slow the rate of cancer growth, sometimes for years. Taking a hormone-therapy medicine lowers your level of testosterone and other male hormones. Another way to lower male hormones is by having surgery to remove the testicles, called an orchiectomy.

Surgery

Surgery for prostate cancer may be done to:

  • Remove the prostate and its cancer (prostatectomy). Nearby lymph nodes also may be removed to check for cancer (lymphadenectomy) during a prostatectomy.
  • Fix urinary problems that are caused by a tumour pressing on the urethra (transurethral resection of the prostate, or TURP).

Radical prostatectomy

Radical prostatectomy is an operation to remove the entire prostate and any nearby tissue that may contain cancer. It can be done as open surgery through an incision (cut) in the belly, or as laparoscopic surgery through several very small incisions in the belly. Laparoscopic surgery to remove the prostate is done with a tiny camera and special tools. Sometimes lymph nodes in the area also are removed so that they can be checked for signs of cancer. This is called a lymph node biopsy.

  • Nerve-sparing surgery helps preserve the nerves that are along the side of the prostate and that are needed for an erection. This is only done when there is little chance of leaving cancer cells behind. If you already have sexual function issues, nerve-sparing surgery may not be the best choice for you.
  • Robotic-assisted laparoscopic radical prostatectomy is surgery done through small incisions in the belly with robotic arms that translate the surgeon's hand motions into finer and more precise movements. This surgery requires specially trained doctors.

Surgery may completely remove your prostate cancer. But it isn't possible to know for sure before surgery whether the cancer has spread beyond the prostate. When cancer has spread, it can't always be cured with surgery alone.

Click here to view a Decision Point. Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?

Other Treatment

Active surveillance or watchful waiting

Active surveillance means that you will be watched closely by your doctor. If you are a younger or active man who is at low risk, this will mean regular checkups. If the cancer starts to grow more quickly, you will need to have other treatment, such as surgery. Your regular checkups may include digital rectal examinations, PSA tests, and biopsies.

Active surveillance is a good treatment choice for younger or active men who have low-risk cancer that hasn't spread.6

  • The main reason to choose active surveillance is to avoid or delay the side effects of treatments.
  • The main reason to choose other treatment (and not active surveillance) is to not miss the chance to cure the cancer. If the cancer grows and spreads, it may be harder to treat.

Watchful waiting also means that you will be closely watched by your doctor. But the goal of watchful waiting is to treat symptoms that cause problems rather than to cure the cancer. For some older men or those who aren't expected to live more than 10 years, the main reason to choose watchful waiting is to have the best possible quality of life.

Radiation therapy

Radiation therapy may be used alone or combined with hormone treatment or surgery to treat prostate cancer. Like surgery, it is most effective in treating cancer that hasn't spread outside the prostate. When combined with surgery, radiation is used to destroy any cancer cells that might be left behind and to relieve pain when the cancer has spread.

Radiation treatment for prostate cancer includes:

  • External radiation. Also called external beam radiotherapy, or EBRT, radiation therapy uses high-energy rays, such as X-rays, to destroy the cancer. It is usually given in multiple doses over several weeks. Radiation destroys tissue, so it may damage the nerves along the side of the prostate that affect your ability to have an erection. If you already have bowel problems, external radiation may make your symptoms worse. The most common forms of external radiation are:
    • Conformal radiotherapy (3D-CRT). It uses a three-dimensional planning system to target a strong dose of radiation to the prostate cancer. This helps to protect healthy tissue from radiation.
    • Intensity-modulated radiation therapy (IMRT). It uses newer 3D-CRT technology to target the cancer.
  • Internal radiation (brachytherapy). Brachytherapy is a one-time radiation treatment that uses tiny radioactive seeds. After you are given anesthesia, the doctor uses a needle to inject the seeds into your prostate, where they slowly release radiation directly into the cancer. Sometimes external radiation or hormone therapy is added to brachytherapy. If you already have urinary problems, brachytherapy may make your symptoms worse.
    • High-dose-rate (HDR) brachytherapy. For this form of brachytherapy, radioactive material is placed into the prostate for a very brief period of time (seconds to minutes) and then removed. The radiation is delivered this way several times.
Click here to view a Decision Point. Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?

Cryosurgery

Cryosurgery, also called cryoablation, freezes the prostate gland to kill the cancer. This is often done when surgery isn't an option and when the cancer is advanced but still inside the prostate gland. And the results, including side effects such as incontinence or an injury to the rectum, depend very much on the doctor's skill and experience. With cryosurgery, the prostate gland isn't removed.

Other treatment

Another treatment is high-intensity focused ultrasound (HIFU), which uses an intense heat from focused sound waves to kill cancer cells. HIFU is also used for men who have cancer inside the prostate but who can't have surgery. HIFU is a treatment that is used in Canada and Europe.

Clinical trials

Your doctor may talk to you about joining a research study called a clinical trial if one is available in your area. Clinical trials are research studies to look for ways to improve treatments for prostate cancer.

Complementary therapy

People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:

Mind-body treatments like those mentioned above may help you feel better and cope better with treatment. These treatments also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.

Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. Complementary therapies aren't meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.

Other Places To Get Help

Organizations

AUA Foundation: The Official Foundation of the American Urological Association
1000 Corporate Boulevard
Linthicum, MD  21090
Phone: 1-800-828-7866
Phone: (410) 689-3700
Fax: (410) 689-3998
Email: auafoundation@auafoundation.org
Web Address: www.urologyhealth.org
 

UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.

The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology A–Z page to find materials about urologic problems.


Canadian Cancer Society
55 St. Clair Avenue West
Suite 300
Toronto, ON  M4V 2Y7
Phone: (416) 961-7223
Fax: (416) 961-4189
Email: ccs@cancer.ca
Web Address: www.cancer.ca
 

The Canadian Cancer Society (CCS) is a national, community-based organization that provides information about cancer prevention, care, and treatment. The CCS also provides funding for cancer research.


Canadian Urological Association
185 Dorval Avenue
Suite 401
Dorval, QC H9S 5J9
Phone: (514) 395-0376
Fax: (514) 395-1664
Email: corporate.office@cua.org
Web Address: www.cua.org
 

The Canadian Urological Association provides information about a variety of urological conditions in the patient information section on this website. Some of the pediatric topics are bedwetting, circumcision, and undescended testicle. Adult topics range from prostate, kidney, and bladder health to erectile dysfunction and vasectomy.


Man to Man
Phone: 1-800-227-2345
Web Address: www.cancer.org/Treatment/SupportProgramsServices/MantoMan/index
 

The American Cancer Society's Man to Man program provides community-based education and support for men with prostate cancer. Self-help and support groups focus on prostate cancer, treatment, side effects, and coping with the disease and with treatment.

Program services and activities depend on the location. Some locations offer groups for men along with their wives or partners. And other locations may offer a group setting called Side by Side for the wives or partners to meet separately.

To locate a program in your area, call the American Cancer Society toll-free at the number shown above.


Prostate Cancer Canada
2 Lombard Street, 3rd Floor
Toronto, ON  M5C 1M1
Phone: 1-888-255-0333
(416) 441-2131
Fax: (416) 441-2325
Email: info@prostatecancer.ca
Web Address: www.prostatecancer.ca
 

Prostate Cancer Canada funds research related to the causes, cure, and prevention of prostate cancer. The organization offers a variety of educational information about the disease as well as up-to-date news on prostate cancer issues.


References

Citations

  1. Canadian Cancer Society's Steering Committee on Cancer Statistics (2012). Canadian Cancer Statistics 2012. Toronto, ON: Canadian Cancer Society. Available online: http://www.cancer.ca/Canada-wide/About%20cancer/Cancer%20statistics.aspx?sc_lang=en.
  2. Zelefsky MJ, et al. (2008). Cancer of the prostate. In VT DeVita Jr et al., eds., Devita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 8th ed., vol. 1, pp. 1392–1452. Philadelphia: Lippincott Williams and Wilkins.
  3. American Cancer Society (2012). Cancer Facts and Figures 2012. Atlanta: American Cancer Society. Available online: http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012.
  4. Rosenberg JE, Kantoff PW (2011). Prostate cancer. In EG Nabel, ed., ACP Medicine, section 12, chap. 9. Hamilton, ON: BC Decker.
  5. Kushi LH, et al. (2012). American Cancer Society guidelines on nutrition and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians, 62: 30–67.
  6. National Comprehensive Cancer Network (2012). Prostate cancer. NCCN Clinical Practice Guidelines in Oncology, version 2.2012. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.

Other Works Consulted

  • Han M, Partin AW (2012). Retropubic and suprapubic open prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2695–2703. Philadelphia: Saunders.
  • Izawa JI (2011). Prostate cancer screening: Canadian guidelines 2011. Canadian Urological Association. Available online: http://www.cua.org/guidelines_e.asp.
  • Keating NL, et al. (2010). Diabetes and cardiovascular disease during androgen deprivation therapy: Observational study of veterans with prostate cancer. Journal of the National Cancer Institute, 102(1): 39–46.
  • Leung M (2011). Management of side effects of chemotherapy and radiation therapy. In C Repchinsky, ed., Therapeutic Choices, 6th ed., pp. 1663–1686. Ottawa: Canadian Pharmacists Association.
  • Malcolm JB, et al. (2010). Quality of life after open or robotic prostatectomy, cryoablation or brachytherapy for localized prostate cancer. Journal of Urology, 183(5): 1822–1828.
  • Nakashima L (2011). Chemotherapy-induced nausea and vomiting. In C Repchinsky, ed., Therapeutic Choices, 6th ed., pp. 1652–1662. Ottawa: Canadian Pharmacists Association.
  • National Cancer Institute (2011). Prostate Cancer Treatment (PDQ)—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/patient.
  • National Comprehensive Cancer Network (2012). Prostate cancer. NCCN Clinical Practice Guidelines in Oncology, version 2.2012. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
  • Schaeffer EM, et al. (2012). Radical retropubic and perineal prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2801–2829. Philadelphia: Saunders.
  • Su L, Smith JA (2012). Laparoscopic and robotic-assisted laparoscopic radical prostatectomy and pelvic lymphadenectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2830–2849. Philadelphia: Saunders.
  • Zelefsky MJ, et al. (2011). Cancer of the prostate. In VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 9th ed., pp. 1220–1271. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
Last Revised November 13, 2012

Last Revised: November 13, 2012

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Brian D. O'Brien, MD - Internal Medicine & Christopher G. Wood, MD, FACS - Urology, Oncology

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