ASL Information on Prostate and Testicular Cancer

Know your Options!

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Links to Transcripts and Video Clips:

  1. Introduction
  2. Meet the people of the group
  3. What is Prostate Cancer?
  4. Prostate Cancer risk?
  5. How is Prostate Cancer detected?
  6. Should I get screened for Prostate Cancer?
  7. What are the symptoms for Prostate Cancer?
  8. Prostate Cancer treatment overview
  9. Treatment alternative: Watchful waiting
  10. Prostate Cancer treatment: Surgery
  11. Prostate Cancer treatment: Radiation
  12. Prostate Cancer treatment: Hormones
  13. Prostate Cancer treatment: Cryosurgery
  14. Prostate Cancer treatment: Chemotherapy
  15. Testicular Cancer: Introduction
  16. Testicular Cancer: Description
  17. Testicular Cancer risk
  18. How is Testicular Cancer detected?
  19. Do men die from Testicular Cancer?
  20. Is there screening avalaible for Testicular Cancer
  21. How is testicular cancer diagnosesd?
  22. How is testicular cancer treated?
  23. How about clinical trials?
  24. Prostate and Testicular Cancer summary

I.    Introduction

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Hello, my name is Tom Galey.

And my name is Thom Duva.

We are here to talk with you today about two very important topics: prostate cancer and testicular cancer. Cancer is a disease where there is uncontrolled growth and abnormal cells which if not controlled can result in death. As deaf men employed at Deaf Community Services of San Diego, we know that it is especially hard for deaf and hard of hearing men to get the health information they need. Several friends of ours have joined us today to bring you more information about these cancers so that you can help yourself and the people you love. Prostate cancer happens in the prostate which is a gland located below your bladder. It is the most common cancer in American men, and it usually occurs in men over age 50. Testicular cancer happens in the cells of the testicles. It is the most common cancer occurring in men ages 15-34.

We decided to talk about these two cancers together so that both younger and older men can inform each other about these diseases. Gathering information about potential benefits and risks of screening and treatment for prostate and testicular cancers lets you make informed decisions about what to do for your health. After understanding your options and discussing your situation with your doctor, you can decide whether or not to have regular screening exams for these cancers.

Once we finish our meal, we will join you for a question and answer session about these two cancers. Tom will talk to you first about prostate cancer, and then I will talk with you about testicular cancer.

II.    Meet the Group

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We’ve introduced ourselves, but we don’t know all of your names.

Hello my name is Gener.

Hi, I’m Tom.

Hello, I’m Marie. And my name is Francise. I’m John.

Hello, I’m Bill. My name is Patty.

Hi, I’m Jared. I’m Cathy. I’m Dino. And I’m Matt.

Let’s start by explaining what cancer really is. Your body contains trillions of cells. Cells are like building blocks for your body. Cells with similar functions form groups within our bodies. Every day, old cells are dying, and new ones are replacing them. Your body makes new cells when one cell makes identical copies of itself. Sometimes a cell makes a mistake when it copies itself and produces a damaged cell.

These damaged cells can divide very rapidly and create a lump of damaged cells. This is called a tumor. There are two different types of tumors. One is called benign and the other is called malignant. The first type, a benign tumor, is not cancer nor is it dangerous but most of the time they will need to be removed. The second type, the malignant tumor, is dangerous, can spread throughout the body and grow uncontrollably. This is cancer. Now I’d like to share a medical term with you: metastasis. This is when one cell from that group of damaged cancer cells we mentioned earlier breaks off and travels through the body. This is what causes cancer to become life threatening. Malignant tumors are life threatening because the damaged cells grow uncontrollably and squeeze out the good cells. Then, the body cannot function.

Now, let’s talk about prostate cancer. Here are the four topics that we will discuss about prostate cancer:

  1. description
  2. risk
  3. detection
  4. treatments.

III.    Prostate Cancer?

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So, what is prostate cancer?

Number 1:

Description of prostate cancer. Your prostate gland is the size of a walnut and is located below your bladder. It surrounds your urethra which is a tube that carries urine and semen out of your body through your penis. Prostate cancer happens when a damaged cell in your prostate gland multiplies to make a malignant tumor. We don’t know exactly what causes the damage to happen. The function of your prostate gland is to create and release some of the fluid found in semen.

When you get older, it is common for your prostate gland to become slightly bigger. This is called Benign Prostatic Hyperplasia (BPH). As the gland grows larger, it can push on the urethra tube and cause problems with the flow of urine.

But remember, but this enlargement is not cancer.

IV.    Prostate Cancer Risk

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How do I know if I am at risk for prostate cancer?

Number 2:

Risk of prostate cancer. Prostate cancer is the most common type of cancer in American men, not including skin cancer. Men who are over the age of 50 are at risk for this disease, although other factors besides age can increase your risk. African-American men are more than twice as likely to develop prostate cancer as other racial groups.

If you have a family member with prostate cancer, you are at increased risk for developing this cancer. Also, a diet high in fat and low in fiber may also increase your risk of getting prostate cancer. Each year, 189,000 men get prostate cancer. In other words, 1 out of every 6 men in this country will get prostate cancer sometime in his lifetime and 1 out of every 32 men in the United States will die from prostate cancer.

If your prostate cancer is found early, you will have more treatment options from which to choose.

V.    Detection

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What is early detection?

Number 3:

Detection of prostate cancer. Early detection means that you find the tumor before it has spread to other sites in your body. Late detection means that you find the tumor after it has already spread to other parts of the body. What are the methods of early detection of prostate cancer?

There are no early warning symptoms for prostate cancer. However, your doctor has two screening exams that can find prostate cancer in its early stages. One is a Digital Rectal Examination, which we will call DRE, and the other is a blood test that measures Prostate Specific Antigen (PSA) levels.

Your prostate gland sits right in front of your rectum, so the doctor can feel it easily. During the DRE, the physician places a gloved finger into your rectum and feels for any hard lumps on the back and side of your prostate gland.

The rectal exam does not detect all tumors. Therefore, you should also have a blood test. The screening test measures Prostate Specific Antigen (PSA) levels in the blood. If the PSA level is high you may have prostate cancer or some other serious health issue. Lower levels mean you do not necessarily have prostate cancer. Prostate cells normally release small amounts of this material into your blood. When cancer develops, you have more cells producing PSA, and this causes your PSA level to increase. Other conditions will create the same elevation of PSA levels. The blood test alone does not detect all tumors either. Having both the rectal exam and the blood test gives you the best information.

VI.    Screening

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Should I get screened for prostate cancer?

You and your doctor need to decide whether or not you should receive an annual screening exam for prostate cancer. This decision will be based on your risks for getting prostate cancer, your general health, and your feelings about the benefits and risks of prostate cancer treatments.

If I decide to get screened for prostate cancer, when should I begin? Men who are age 50 or over should be screened for prostate cancer. If you are an African-American man or have a family member with prostate cancer, you should start getting screened between ages 40-45.

If you decide to screen for prostate cancer, you should get a Rectal Examination and a PSA blood test once every year. It is important to remember that it is your personal choice whether to undergo screening for prostate cancer. You and your doctor can determine what is best for you.

VII.    Symptoms

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What are the symptoms of prostate cancer?

Early prostate cancer produces no symptoms.

However, with screening tests, doctors have a better chance of finding prostate cancer when it is in the early stages. Symptoms of prostate cancer may occur in the later stages of the disease after the tumor has become very large or has spread to other parts of the body. With late stage prostate cancer, you may experience pain when urinating, difficulty beginning to urinate, blood in your urine, a constant feeling that you need to urinate, or a desire to urinate more often, especially in the middle of the night. Late stage prostate cancer can also cause bone pain, especially in your back.

There is also a common enlargement of the prostate gland that happens with age.

This is called Benign Prostatic Hyperplasia or BPH. It can produce the same symptoms as late stage prostate cancer. This enlargement has nothing to do with cancer, but you should still see your doctor to help manage this condition. What if my screening tests suggest that there may be a tumor in my prostate? Probably the doctor will want to take a very small sample of your prostate to examine under a microscope. This is called a biopsy. How is the doctor going to do this? He will give a shot to numb the area around your rectum to make the procedure less painful. Then a second long, thin wire will be used to extract a sample from the prostate to be examined. If the examination shows cancer, the doctor may suggest other tests to see if the cancer has spread to other parts of your body.

VIII.    Treatment

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If I have prostate cancer, what happens to me next?

Number 4:

The possible treatments are watchful waiting, surgical removal of the prostate, radiation therapy, cryosurgery, hormone therapy, and chemotherapy. The earlier you find the tumor, the more options for treatment that you have. You should be aware that there are no clear rules about the best way to treat prostate cancer. You and your doctor need to choose your treatment based on your personal needs. You should consider the size of your tumor, your PSA level, how abnormal the cells are, the speed of your tumor’s growth, your age, your general health, and your feelings about the treatment side effects.

Some prostate cancers grow slowly and some grow very quickly. Currently, it is impossible for doctors to tell how fast the tumor is growing just by examining the cells. Research is underway that will someday help doctors to know which cancers will grow rapidly and need treatment and which cancers will grow slowly and can be watched. Since treatment decisions are not simple, it is a good idea to get a second or even a third doctor’s opinion. Let’s talk a bit about your choices.

IX.    Watchful Waiting

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In certain cases, you and your doctor might decide not to make an immediate treatment decision. The doctor will observe and monitor your cancer over months or years. This choice may be suggested for older men or men with serious health problems. Watchful waiting is most commonly offered as an option when the cancer is found early, when it appears to be slow growing, and when it is producing no symptoms.

The risk of watchful waiting is the possibility that the cancer can spread and become difficult to cure. The benefit of watchful waiting is that you do not have to go through the inconvenience, expense, and side-effects of treatment.

X.    Surgery

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In some cases, the doctor will suggest removing your prostate.

This procedure surgically removes the prostate from your body. However, if they remove your prostate, you will experience short-term and possibly permanent negative side effects. First, for several weeks or months you may have trouble holding your urine. This is called incontinence. For some men this problem will not go away. Second, you may lose your ability to have an erection. Often, important connections to your penis need to be cut during the removal of your prostate, especially if your tumor surrounds those connections. There are new surgical techniques that can avoid cutting those connections to the penis. Depending on the size and location of the tumor, this may or may not be an option. The loss of erection is temporary for some men and permanent for others. Be sure to choose a surgeon who specializes in prostate cancer surgery.

XI.    Radiation

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Radiation therapy, another treatment option, uses very strong X-rays to kill the cancer cells. It can be used as a treatment alone or in combination with other treatments.

There are two ways to deliver radiation treatment. First, X-ray beams can be aimed directly at the prostate cancer cells from an external machine.

Second, you can have tiny radiation seeds the size of grains of rice injected into your prostate which will release constant, low amounts of radiation to kill your cancer cells. The radiation will still kill some healthy cells in that area of your body. This may cause temporary or permanent side effects like diarrhea, a burning feeling in your bladder, difficulty holding your urine, frequent urination, or inability to have an erection. The loss of ability to have an erection will develop gradually over one or more years after the radiation, if you experience this side effect. Except for problems with erections, most of the side effects usually last only about 2 weeks after you stop radiation.

XII.    Hormones

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Testosterone is a hormone found mostly in men and often encourages the cancer cells in your prostate to grow.

Hormone therapy uses drugs to block the hormone testosterone in your body.

The side effects of hormone therapy may include tiredness, upset stomach, growth of breasts, decreased sexual desire, loss of ability to have an erection, and hot flashes. Softening of the bone or osteoporosis can happen with long-term use of hormone therapy.

Hormone therapy alone does not cure prostate cancer. It is combined with other treatments, like radiation.

XIII.    Cryosurgery

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The doctor makes a small incision in your groin and uses an ultrasound picture to guide a probe to the prostate tumor. The probe will freeze and kill the cancer cells. This is a new treatment that offers an alternative to surgery and radiation for some men. Cryosurgery can cause inability to have an erection or loss of bladder control. Cryosurgery can only be used when the tumor is detected early, before it has spread to other parts of the body. Since the procedure is new, the long-term effects of the cryosurgery are still unknown.

XIV.    Chemotherapy

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If your cancer has spread outside your prostate to other places like your bones, your doctor may suggest chemotherapy after hormone therapy has been used and no longer works.

Chemotherapy uses drugs in the form of pills or injections that kill any cells in your body that are dividing quickly. Cancer cells divide rapidly. However, so do some other healthy cells, like those in your mouth, your stomach, your intestines, your bones, and your hair. Therefore, the drugs can also kill healthy cells in those places.

Chemotherapy can cause mouth sores, tiredness, weakness, hair loss, diarrhea, and an upset stomach. Most cases of prostate cancer do not respond to chemotherapy, but this is under investigation.

XV.    Introduction to Testicular Cancer

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Now it’s time to discuss testicular cancer and I’ll turn the floor over to Thom for that portion of the presentation.

Thank you, Tom. As Tom mentioned, I’ll be discussing testicular cancer. I am only 28 years old, so does that mean that I don’t have to worry about cancer? Cancer can happen to anyone at any age. Prostate cancer usually happens to men over age 50.

Testicular cancer is one cancer that usually occurs in younger men. Here are the four topics that we will discuss about testicular cancer: 1) description, 2) risk, 3) self exam, 4) treatment.

XVI.    Testicular Cancer Description

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Number 1: Description of Testicular Cancer.

Testicular cancer happens just like prostate cancer. A cell in your testicle makes a mistake when it copies itself. The damaged cell makes more damaged cells and forms a malignant cancer tumor. Your two testicles are groups of cells that make sperm and some hormones. They rest inside the sac of skin called the scrotum that lies beneath your penis.

XVII.    Testicular Cancer Risk

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How do I know if I am at risk for testicular cancer?

Number 2:

Risk for Testicular Cancer.

Testicular cancer is most common in young men ages 15-40. If you have a testicle that did not descend naturally into the scrotum or if you have testicular cancer in another family member, you are at increased risk for this type of cancer. Also, Caucasian men are at higher risk for testicular cancer than other racial groups.

XVIII.    Testicular Cancer Detection

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What are the symptoms of Testicular Cancer?

Number 3:

Detection of Testicular Cancer. Symptoms of testicular cancer might include tender breasts, a lump on the testicle, lower back pain, a dull ache in the groin or abdomen, swelling of the testicles, or a sense of heaviness in the scrotum or lower abdomen. Although, many men experience no symptoms of testicular cancer.

XIX.    Do Men Survive?

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Do men die from testicular cancer?

Your chance of surviving testicular cancer is very good.

About 7,400 men in the United States get this cancer each year. Research estimates that the cure rate of testicular cancer is more than 90% for both early and late stage cancers. Let me give you two examples. We have one group of 100 men with early detection and another group of 100 men with late detection. Looking at each group five years later, 95 of the men with early detection are still alive. Of the group of men with late detection, 75 are still alive. Because it is easy for men to find testicular cancer early, 60% of men who get testicular cancer find it in its early stages.

XX.    Testicular Screening

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It is your decision whether or not you think you should perform testicular self-exam.

You and your doctor should discuss your risks for testicular cancer and decide whether self-screening would help you. If you choose to do the testicular self-exam, you should perform it once every month while you are between the ages of 15 and 40 years old.

You should do the exam after a warm shower or bath so that the scrotum is relaxed. First, look in the mirror for any swelling. Next, examine each testicle in the following way. Place your thumb in front of the testicle and your middle and index fingers on the back. Roll the testicle around to feel for lumps. Have your doctor show you how to perform a testicular self-exam. You will feel the tube structure at the back of the testicle. This is normal and does not get cancerous lumps. Cancer lumps usually appear on the sides and in front of the testicles. Sometimes and infection or bruise can feel like a tumor, but you should still contact your doctor if you find anything has changed.

XXI.    Testicular Diagnosis

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What happens if I find a lump in my testicle?

If you find a lump, you should go to your doctor. The doctor will feel the lump and decide whether it is a problem. He or she may give you some medicine and see whether the lump disappears. Usually, the doctor will take an ultrasound image of your testicle. If the ultrasound shows a tumor, the doctor will remove your testicle.

The doctor may also order some blood tests to check for substances which suggest cancer is present. More than 95% of testicular tumors are malignant, so the testicle is always removed. Unlike prostate cancer, it is not advised to take a biopsy of the testicular tumor because this can spread the cancer into other areas. Instead, the doctor will make a cut in your groin and remove the entire testicle. Only the testicle with the cancer tumor is removed. The surgery lasts about 45 minutes and you usually stay in the hospital overnight. If your doctor suspects that the tumor has spread, he or she will order some images to check other parts of your body.

XXII.    Treatment

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What are my treatment options for testicular cancer?

Number 4:

Treatment for prostate cancer.

Your treatment depends on your particular cancer tumor. When cancer is found in a testicle, the testicle is always removed. When the cancer is just in the testicles, radiation sometimes follows the surgery. If your cancer has already spread, chemotherapy may also be necessary. Most men are still able to have erections and stay sexually active after treatment. In addition, since you still have another testicle with sperm, it is still possible for you to have children. Talk to your doctor before your surgery if you want to have children.

XXIII.    Clinical Trials

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I have heard friends talk about clinical trials.

What are they?

Clinical trials are experiments and research done to provide more treatments options. You should keep an open mind to these trials. These studies find new ways to treat cancer and other diseases.

Clinical trials also find ways to prevent cancer and reduce its symptoms. You should ask your doctor about any clinical trials that could benefit you. The National Cancer Institute has lots of information about clinical trials. They will help you to make an informed treatment decision. The best idea is to stay open to the possibility of clinical trials because they can offer new solutions for you and for other people with similar problems.

XXIV.    Summary

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Well, we hope that this video has answered some of your questions and concerns about these two types of cancer.

Let’s summarize a few important things for you. Between the ages of 15 and 40, men should talk to their doctors about performing monthly testicular self-exams and about getting testicular exams as part of their doctor visits. At age 50, you should talk to your doctor and decide whether to begin yearly PSA test and Digital Rectal Exams for prostate cancer. You should consider this option earlier at age 40 if you have a family member with prostate cancer or if you are African American. This decision should be based on your risks for getting prostate cancer, your general health, and your feelings about the treatment options. The better you understand these cancers, the more power you have to make the right choices for your own body and health. You can call the American Cancer Society and the National Cancer Institute for more information or visit their web sites. With what you’ve learned today, you can make a difference for yourself and your community by being informed and by making responsible decisions about cancer screening. We enjoyed sharing this information with you and hope you will share it with many others. Together, we can improve the health of the Deaf and Hard-of-Hearing communities by making sure they have the most accurate and current information available. Remember, this video was prepared in 2002. New information about prostate and testicular cancers is always developing. Check the following sources for the latest information.