What Do Your Prostate Cancer Grade and Gleason Score Mean?

What Is Cancer “Grading”?

After a biopsy is taken and prostate cancer is diagnosed, the “grade” of your cancer will be determined. This is done by examining cells from the cancer under a microscope to decide how abnormal the cancer cells are.

The more abnormal the cancer cells are, the more likely the cancer is to be aggressive or to spread quickly outside of the prostate. The grade of your cancer is an important piece of information for your physicians to have when deciding upon the proper treatment.

The most common scale for prostate cancer grading is the Gleason score.

What Is the Gleason Score?

When cells from the prostate are examined under a microscope, the pathologist will identify many types of cells that range from very normal, non-aggressive cells to very abnormal, aggressive cells. The pathologist determines which type of cell is the most common and which type is the second most common.

Each of these two cell types is then given a score from 1 to 5. Higher numbers in this system mean more abnormal, aggressive cancer cells.

Because the two most common types of cancer cells are identified in the prostate, the Gleason score is a combination of these two cells types.

For example, if the most common cell type is a 3 (on the 1 to 5 scale) and the second most common type is a 4, then the Gleason score is reported as a 7 or sometimes as a “3+4”.

Similarly, if the most common cell type found is a 3 and the second most common type is a 2, then your Gleason score is a 5 or “3+2”.

For the most part, the lower your overall Gleason score is, the less aggressive the cancer and the better your prognosis.

Sources:

Allsbrook Jr WC, Mangold KA, Yang X, et al. The Gleason grading system: an overview. J Urologic Path 10:141-157, 1999.
Gleason DF. Histology grading of prostate cancer: a perspective. Hum Path 23:273-279, 1992.

Are There Warning Signs That Could Herald Prostate Cancer?

Prostate cancer can be a completely silent disease, especially in its early stages. It can grow slowly for years without causing any noticeable signs or symptoms. Sometimes, however, there are important warning signs that something is wrong with the prostate.

What Are the Most Common Warning Signs of Prostate Cancer?

Because of the prostate's location in the body (located just below the bladder in the lower pelvis), urinary symptoms are common warning signs that something is wrong with the prostate.
As urine empties out of the bladder it travels through a thin tube called the urethra. At the very beginning of the urethra, just as it exits the bladder, it passes directly through the prostate. As the prostate enlarges due to cancer or another problem, the urethra is pinched tighter and tighter within the prostate. As the tube narrows, urine has a much harder time making its way through the urethra and out of the body.

Urinary warning signs that something could be wrong with the prostate include:

• Frequency - urinating much more often than normal.
• Urgency - having a sensation that you need to urinate immediately.
• Nocturia - getting up to urinate multiple times during the night.
• Hesitancy - difficulty starting the urine stream.

Prostate cancer is not the only disease that can cause the prostate to swell, however. In fact, BPH (benign prostatic hyperplasia) is a much more common cause of an enlarged prostate and, thus, of urinary symptoms. BPH is not cancer, but is still an important condition that should be treated by a physician.

What Are Other Less Common Warning Signs of Prostate Cancer?

The urinary problems discussed above are among the most common experienced by men with prostate cancer. However, they are not the only ones. Other less common warning signs include:

• Blood in the urine.
• Blood in the semen.
• New-onset erectile dysfunction (impotence).
• Bone pain (especially in the lower back, hips, or ribs).
• Loss of bladder control.

When Should I Go to See My Doctor?

The answer to this question is simple. Visit your physician and explain your situation whenever you first begin to experience any of these symptoms. It is especially important for African-American men and those with a family history of prostate cancer to see their physicians as these two groups have much higher rates of prostate cancer.

The warning signs listed above are almost always abnormal and all need to be evaluated by a physician. This is especially true if these warning signs appear suddenly. Very simple examinations and laboratory tests can be put to use by your doctor to determine whether or not your symptoms are due to prostate cancer, another serious disease, or a less dangerous condition.

International Agency Gives Nod to Prostate Cancer Pill Before Chemo

he European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has recommended extending the use of the prostate cancer pill abiraterone acetate ( Zytiga, Janssen) to include men with advanced prostate cancer who fail on androgen-deprivation therapy.

The drug is currently approved in Europe and the United States for these same men, but only as second-line treatment, after docetaxel chemotherapy. If approved, abiraterone could be used by European clinicians as a first-line treatment for men who progress on androgen-deprivation therapy.
Specifically, CHMP recommended that abiraterone be administered in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) who are asymptomatic or mildly symptomatic after the failure of androgen-deprivation therapy.
A supplemental New Drug Application for this use was submitted to the US Food and Drug Administration (FDA) in June.

In both cases, the proposed expanded use of abiraterone is based on efficacy and safety results from an international phase 3 trial, which were presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in June. The trial compared abiraterone plus prednisone with placebo plus prednisone in 1088 asymptomatic or mildly symptomatic men with mCRPC who had not received chemotherapy. It has been criticized for being stopped too early and for the unproven nature of one of its primary end points.

However, European reviewers apparently agree with a study investigator who, at the ASCO meeting, said that the abiraterone data "merit consideration" as a "new standard approach" for the first-line treatment of mCRPC.

Abiraterone in combination with prednisone was approved by the FDA in April 2011 for the treatment of patients with mCRPC who have received previous chemotherapy containing docetaxel.
The drug reportedly costs $5000 per month in the United States.

Diet for an Enlarged Prostate

Prostate enlargement is gradually becoming one of the most serious problems concerning men's health. Thousands of new cases of prostate enlargement are diagnosed each year. There's a lot you can do to maintain a healthy prostate by proactively changing your lifestyle. Dietary modifications and working out regularly are the most important steps you should follow to keep your prostate gland in top shape.

It's no secret that what you eat directly influences your well-being. It has scientifically proven that certain foods boost your immune system and lower the risks of acquiring any disease, and the same goes for prostate health too. Let's take a look at what you should be eating and the foods you should ideally avoid to help manage prostate enlargement.

Diet Tips for an Enlarged Prostate

• Go in for five servings of fresh fruits and vegetables every day. Include cauliflower, Brussels sprouts, kale, broccoli, turnips, garlic, onions, and mushrooms. Fruits like tomatoes, grapefruit, watermelon, guava, and papaya contain antioxidants that combat the free radicals in our body and prevent the proliferation of malignant cells.
• Zinc is very important for prostate health because it decreases the level of dihydrotestosterone in the body which in turn means better prostate health. Foods high in zinc include oysters, pumpkin seeds, sesame seeds, sunflower seeds, cashews, and pine nuts.
• Selenium is another prostate-friendly element. Wheat germ, tuna, herring, Brazil nuts, and eggs are rich sources of selenium.
• Soy products like tofu, soy flour, and soy milk help to maintain a healthy prostate.
• Say no to saturated fats, which mainly come from meat products. Limit your consumption of red meat (hot dogs, bologna, pork, and beef), packages foods, and fast food. Instead choose leaner cuts of meat. Bake and grill the meat instead of deep-frying it.
• Omega-3 fatty acids are linked to better overall health. Salmon, mackerel, olive oil, walnuts, and almonds are rich sources of these healthy fats which not only maintain prostate health but are also good for cardiovascular health.
• Choose whole-grain bread, pasta, and cereals over white bread.
• Choose low-fat dairy products over whole-fat milk, yogurt, and cheese. Foods that contain excess fats are not just bad for the prostate, but they may encourage obesity which is a precursor to heart disease.
• Multivitamins provide your system with the necessary dose of vitamins and minerals which you might not be receiving from your daily diet, especially if you're a fussy eater. You can also take nutritional supplements like Super Beta Prostate which keep the prostate gland functioning efficiently.
• Cut back on the baddies, namely alcohol, sugar, and too much caffeine. Excess consumption can have an adverse effect on your prostate health.

Smoking Harms Men and Women

Most people acknowledge what are the effects of smoking but not all people understand that smoking harms women more than men. It is an accepted fact that tobacco has never done anything good to the body, but it seems unfair that women receive more damage for having a daily puff of Dunhill than men.

Here are some of the results of a research made by Lancet about the effects of smoking among women:

· Women are more prone than men to have heart disease caused by smoking
· Women receive more carcinogens and toxins from tobacco than men
· Yet, men are more likely to quit than men
· The effects of smoking is more prominent in women than in men

The research started from 1966 to 2010 and studied individuals that came from diverse range of populations worldwide. The study received no funding, and the results were consistent. Smoking is more harmful for women because they are more heavily influenced by hormones compared to men. In men, the genes play much more significant role in their bodies.

Women are mostly estrogen-powered; it keeps sexual characteristics and makes them feminine in many ways. It is the estrogen that is responsible for distribution of fats in favorable places like the breasts, hips and buttocks. It is also responsible for menstrual cycles and maintenance of the
reproductive tract. Estrogen makes the heart and blood vessels healthy. It stimulates bone formation and prevents its resorption to avoid osteoporosis. In addition, high levels of estrogen are responsible for excellent mood (cranky mood is usually caused by insufficient levels of estrogen, which happens in cases like menopause and during menses).

One of the reasons why smoking harms more women than men is because nicotine (along with harmful chemicals found in cigarette smoke) reduces the ability of the body to produce estrogen. Reduced estrogen in the bloodstream is akin to a 'mini' menopause. The 'favored' fat distribution will be in disarray, piling up fat in places where no woman wants to have such as under the chin, arms and above the hips (lovehandles). Tobacco abuse can disrupt daily menstrual cycles, cause infertility, vaginal dryness and increased susceptibility to vaginal infections as the protective secretions dries up. Long-term tobacco use weakens the bones by inhibiting calcium absorption, causing early onset of osteoporosis.

As said, estrogen plays an important role to keep heart and blood vessels healthy. Estrogen helps increase good cholesterol (high-density lipoprotein) while keeping bad cholesterol levels down. And it can be a reason why women are more prone to heart disease the longer they smoke, because nicotine reduces production of heart-friendly estrogen. Therefore smoking increases risk of diseases in heart and blood vessels, especially in women.

Women's bodies also have more fluid content than men. This is evident by having soft, suppler and clearer skin. It also makes them more sensitive to even slight changes in water levels. Cigarette smoke has a drying effect on the skin, and it constricts tiny blood vessels that nourish the skin with nutrients and water. It prematurely ages the skin, making it less elastic and decreasing its natural protection from the elements. Because of decreased blood circulation cell replacement slows down, causing emergence of dark spots. Nicotine also stains skin cells, which is hard to remove because of slow skin turnover. Women have proportionally more circulating blood than men of the same height and weight therefore this feature explains why women absorb more toxins and carcinogens in each puff of cigarette smoke.

But the big reason why the effects of smoking are more harmful in women than in men is due to their anatomy. It is a fact that women have more complicated bodies; they have mammary glands, uterus and cervix which have no equivalent parts in men. They undergo pregnancy, monthly menstrual periods during reproductive years and menopause when supply of egg cell runs out. These complicated operations require precise actions of different body systems to accomplish. Men do not to undergo such events. Therefore, components in cigarette smoke like toxins and carcinogens can do a lot more damage in women's bodies.

Sadly, most cigarette cessation programs are not that focused on women. For example, most graphic cigarette warnings only depict damage in men and not on women. And one more thing, tobacco companies are currently increasing its advertisements to women, and sees them as its growth market in advent of increased scrutiny from authorities.

The vast majority of women are never aware of this. Though the research study advocates for increased emphasis in women in tobacco cessation programs, it seems the best recommendation for women is to avoid tobacco altogether. That includes first-hand and second-hand smoke because the effects of smoking in women can be far worse than in men.

Are You Infertile Because You're Smoking?

Infertility is not an issue that only women worry about; men can also contribute to a couple's inability to conceive a baby. Many people, smokers and non-smokers alike, do not realize that smoking cigarettes impairs fertility in both men and women. If you are a smoker and are interested in having children than pay attention - your habit may be hindering your ability to experience the joys of parenting. Let's take a look at some of the ways that smoking impacts the fertility of both men and women; smoking damages the reproductive capabilities of each sex in a different way.

Let's start by looking at how smoking affect male fertility. Research conducted at the University of Buffalo (New York) in the United States shows that smoking significantly decreases a man's ability to father a child. Sperm from chronic smokers was tested and it was discerned that nearly 2/3 of the sperm failed the test that measures whether or not sperm can successfully fertilize an egg. The results are quite astounding; chronic smokers experienced a 75% decline in fertility compared to their non-smoker counterparts.

Researchers have determined that tobacco smoke decreases sperm count and affects the mobility of sperm - they are unable to swim to and fertilize the egg before they die. Smoking also affects men's hormonal cycles and can even contribute to erectile dysfunction. Additionally, smoking harms the DNA of sperm and in the event that the damaged sperm do fertilize the egg, the weakened DNA can be passed on to the child.

The good news is that quitting smoking can immediately begin reversing the fertility problems caused by tobacco smoke. The sperm count will increase, hormones will balance, and damaged DNA will be replenished. Problems like erectile dysfunction will also sort themselves out once the body begins to return to normal after clearing the system of tobacco toxins during the first few weeks of smoking cessation.

Now let's move on to how smoking harms the reproductive capacities of women. Researchers estimate that female smokers have approximately 75% of the fertility of their non-smoking counterparts. Smoking is linked to a variety of issues that affect a woman's fertility, and these problems (along with the rate of infertility) increase depending on how many cigarettes a woman smokes per day; especially if it is ten or more. Smoking damages the fallopian tubes, increases the risk of miscarriage, and causes unhealthy changes in the cervix and uterus. It can also make your menstrual cycle irregular as it has the ability to shake up your hormone cycle.

One of the most damaging side effects smoking has on a woman's fertility is the fact that is damages the eggs. It makes them weak and damages the DNA sequences. This is especially harmful because the damage is IRREVERSIBLE. Unlike men who continuously generate sperm throughout their lifetime, women are born with a finite set of eggs and they do not generate more. Thus, any damage that the eggs incur is permanent and irreversible. The more you smoke, the more you damage your eggs, and this increases miscarriage, and if you are able to conceive a child, it increases the chance of birth defects and other genetic abnormalities in your offspring.

If you are interested in having children and experiencing a fulfilling life as a parent, then smoking cigarettes is not helping your case. Remember that smoking is a habit and you have the power to take charge of your life and create a healthier way of living by building new habits that promote happiness and wellness. Get rid of that last package of cigarettes today and start a new chapter of your life that will not only benefit you, but also benefit the lives of the children that you want to have.

Pancreatic Cancer and Smoking

Pancreatic Cancer and Patrick Swayze

Most people these days are aware of the link between pancreatic cancer and smoking. Patrick Swayze's death from pancreatic cancer helped firmly to imprint in the mind of the public the association between this deadly disease and cigarette smoking. Patrick himself recognised that his habit may have contributed to his condition. Even so, Patrick continued to smoke and was often photographed smoking in public. He even lit up as he left the clinic where he was receiving treatment. Patrick was diagnosed with stage IV disease. At this stage of the diagnosis, the cancer has already spread from the original tumour site rendering a cure almost impossible. Often the cancer has already spread when symptoms of the disease become obvious. In fact just over 50% of pancreatic cancer sufferers have metastatic disease at diagnosis. Perhaps Patrick became fatalistic. I suppose there was little point in quitting after such a grim prognosis. He probably thought that he didn't need the added stress of undergoing nicotine withdrawal. And although I am fervently anti-smoking I can sympathise with his predicament.

Pancreatic Cancer Prognosis

This cancer carries a bad prognosis and only 5% of sufferers will survive beyond a year and median survival is only 5 months. This median time, in relation to cancer, means that 50% of patients are dead 5 months post diagnosis. Less than 2% of patients make it beyond 5 years. Patrick survived 20 months following his diagnosis. This may have been because of his lifelong regime of physical fitness, despite his smoking habit.

Smoking and Pancreatic Cancer

So what are the risk factors in contracting this deadly disease? Smoking, as discussed earlier, is considered a major cause of pancreatic cancer. Smoking has been linked to many cancers due to the fact that carcinogenic chemicals in cigarette smoke are rapidly distributed to every corner of the body by the bloodstream. Research shows that regular cigarette smokers increase their risk for pancreatic cancer by about 2 fold. The good news for ex-smokers is that risk reduces to similar levels experienced by non-smokers 15 years after smoking cessation.

Other Risk Factors 

Let us be honest, it is not all about smoking. Other factors are also influential. Age, as in many cancers, has major role to play and 80% of pancreatic cancer occurs in the 60-80 age bracket. Men are more likely to develop the disease than women. This may come down to the fact that smoking incidence is higher in men. Other important risk factors include sugar diabetes, chronic pancreatitis, peptic ulcer surgery and diet. Meat rich diets increase risk, while diets high in fruit and vegetables reduce risk. Luckily, for me, neither alcohol nor coffee drinking are considered as risk factors.
When you start to smoke you never think of the consequences. This is because most smokers start young. If you start smoking at 16 you are not thinking about possible health problems that may occur 30, 40, or 50 years down the line. Bad habits in our teenage years may continue and smoking is more than a bad habit; it is an addiction. And by their very nature addictions are very hard to break.