Pathways and Signposts

- PROSTATE CANCER -
Understanding Your Diagnosis

Someone to talk to…
who understands.

Us TOO has TWO terrific resources to
help you understand your diagnosis.
• Pathways for New Prostate
Cancer Patients

2. Signposts along the
Pathway of Prostate Cancer

Use these two brochures
together to navigate your
diagnosis AND YOUR
JOURNEY.

who understands.

Brochure #1

Pathways for New
Prostate Cancer Patients
You Don’t Need to Walk Alone

Begin Your Journey with
Education and Support
as Solid as the Ground
You Walk On

The path you choose
is unique… like you. Someone to talk to…
who understands.

Brochure #2

Signposts
Along the Pathway of
Prostate Cancer

Understanding Diagnostic
Tests and Procedures to
Monitor Prostate Cancer

Signposts along the pathway are designed to identify where you are
and point out the most efficient and effective route toward your
desired destination, a healthy you. who understands.

Brochure #1 - Pathways Receiving the news that you
have prostate cancer is
overwhelming. Information,
opinions, stories, and emotions
can cause confusion. Many
Information for people find credible, unbiased
Peace of Mind education and support
valuable.

The Pathways brochure
provides you with information to
enable you to assume an
You’re at the Trailhead: integral, self-directed role in
making decisions during your
Define Which Path You’ll journey with prostate cancer.
Take by Understanding
Your Choices

Brochure #1 - Pathways Us TOO Has
More Than
Us TOO is Here to 300 Support
Accompany You on Group
Your Journey. Chapters
Worldwide
Us TOO International Prostate
Cancer Education & Support
Network was started as a 501(c)
(3) not-for-profit organization in
1990 by prostate cancer survivors
to serve prostate cancer patients
and their families.

who understands.

Brochure #1 - Pathways
Good News:
Physicians are More
It’s Better to Skilled than Ever to
Travel with a Team Treat Prostate Cancer

Take your time to choose the right
physician/staff team that you can
trust and that makes you feel
comfortable and confident. Carefully
assess your needs and match them
accordingly.

You want to be sure they include
you as an integral member of the
decision-making process.

A UROLOGIST,
Specialists You A RADIATION ONCOLOGIST
A PHYSICIAN ASSISTANT (PA)
May Encounter
A SOCIAL WORKER
Along The Way.
A NUTRITIONIST
NURSES
A THERAPIST
An ANESTHESIOLOGIST
A PATHOLOGIST
A MEDICAL ONCOLOGIST

Understanding Your Cancer
The more educated you are about
Getting the Lay your cancer, the more in-control and
confident you will feel in making
of the Land treatment choices that are unique to
you.

Monitoring markers such as your
PSA level, the core needle biopsy,
your Gleason Score, and other tests
your physician may suggest will help
you to understand your cancer.

Important Information
Understanding You Need to Understand:
- The Prostate
Your Cancer
- Normal Prostate
Cells
- Cancerous Prostate
Cells
- What Causes
Normal Cells to
Become Cancerous?


You Need to Know Where
Location,
Your Cancer is Located
location,
location… You can gain an understanding of
what type of cancer you have and
where it is located by talking with
your physician, and having a basic
knowledge of clinical terminology.
Knowing the stage of your cancer,
and how fast your cancer is
expected to grow, will help you

determine which treatment is best
suited to your healthcare needs
and lifestyle expectations.

PSA (prostate-specific
antigen) is a protein made by
the prostate.
Understanding
The PSA test measures the
PSA level of PSA in the
bloodstream.
A small amount of PSA is
present in the bloodstream
• Establish a baseline. when the prostate is healthy.
• Track PSA over time However, when the prostate
• Pay attention to begins to make too much
velocity and doubling PSA, it can be a sign of
time. prostate disease.
We are all unique, PSA
levels vary from person to
person.

Brochure #1 - Pathways • Used to diagnose prostate cancer.
• Usually performed by a urologist.
• The doctor inserts a needle through
the rectum wall into the prostate
Understanding gland.
• The needle removes a cylinder of
Core Needle Biopsies tissue, usually about 1/2-inch long
and 1/16-inch across.
• Most urologists take 8 – 18
samples.
• The tissue sample is sent to a
pathologist to see if cancer is
For additional present.
• If cancer is present, the pathologist
information about
will assign it a Gleason Score.
Needle Biopsies,
see the Signposts
brochure, page #4. Note FALSE NEGATIVES: Even with many samples,
biopsies can sometimes miss a cancer if none of the
biopsy needles pass through it. This is known as a
“false negative” result. If your doctor still suspects
prostate cancer (due to a high PSA level, for
example) a repeat biopsy may be needed.


Cancer Stages Help Plan Your Route

Knowing the stage of your cancer provides important
information for you and your physician as you explore
your treatment options. There are treatment options
specific for early and advanced stages of cancer. It can
be helpful to refer to the two lobes of the prostate to
describe the cancer’s location and in planning treatment.

Stage I (T1 tumor)
Stage II (T2 tumor)
Stage III (T3 tumor)
Stage IV (T4 tumor)


Gleason Score Provides a
Compass for Decision-Making

PART #1 – What is a Gleason Score?

A Gleason Score describes different types of cells to classify
tumors by their microscopic appearance. The score helps to
estimate:
 how fast the cancer is likely to grow, and
 a patient’s life expectancy.

The Gleason Score is made up of two numbers which are
determined by a pathologist and then added together. The first
number indicates the type of cancer cells that are most numerous
in the tissue sample. The second number indicates the type of
cancer cells that are second most numerous. The total Gleason
Score is determined by adding a primary and secondary score
pattern for each lesion i.e. 3+4=7.


Gleason Score Provides a
Compass for Decision-Making

PART #2 – Gleason Scores and What They Mean

The lower the score, the better the prognosis.
2 to 4 Cancer is very low on an aggression scale
5 to 6 Cancer is mildly aggressive
7 Cancer is moderately aggressive
8 to 10 Cancer is highly aggressive

This score helps to determine the
appropriate type of treatment FOR YOU.


Empower Yourself by
Understanding Treatment Options

 Prostate Cancer is typically a slow growing cancer.
 Stay calm and take your time, up to a few months, to
explore your options and make a treatment decision.
 Oftentimes, a combination of treatments will be
recommended to treat your cancer, for example radiation
and hormone therapies.
 Seek the best treatment for you.

 Once you’re given a treatment recommendation from a
physician specialist, it is a good idea to get a second or
third opinion from the same type of specialist, as well as
other specialists.


Treatment Options

Study pages #6-7
Discuss the information
with your doctor and
your loved ones.


Special considerations

For Hormone-Resistant,
or Androgen-Independent Prostate Cancer
Hormone-resistant or androgen-independent prostate
cancer that has metastasized (Stage N+ and M+)
may require treatments such as:
• Systemic Radiation Therapy, used to reduce
pain and symptoms,
• Estrogen Therapy
• P450 Enzyme Inhibitors
• Chemotherapy.


Clinical Trials/Emerging Treatments

Worldwide, research efforts are underway to discover
new types of treatment. There are several types of
emerging treatments, including:
• Vaccine therapy
• Gene therapy
• Targeted Medications
Ask your physician if there is a clinical trial that may
be appropriate for you or visit www.clinicaltrials.gov or
www.ustoo.org for more information.


Side Effects

Side effects vary with each treatment
option. This is an important topic to
discuss with your physician to determine
which side effects you might experience,
how mild or severe they might be, how
long they might last and what you can do
to either prevent them or lessen their
intensity.


A Prostate Cancer Patient’s Journey
from Diagnosis Through Recovery

During each phase of your journey with prostate cancer, you will find
support in different places. Use available resources such as Us TOO
and communicate openly with your healthcare provider(s), supportive
family, friends, other patients and survivors.


ASK QUESTIONS:
Gather Information from Your Guides

Plan on meeting with three specialists:
* urologist
* radiation oncologist
* medical oncologist.
Although each physician will recommend a course of treatment,
the final decision remains with you, the patient—with the help and
support from your family.

Your Objectives:
1. Determine the status.
2. Evaluate the treatments.
3. Gather accurate information.
4. Select a treatment.
.


MANAGING THE ROAD TO RECOVERY

Recovery from treatment is different for everyone. Once you
have selected your treatment option, talk with survivors who can
help you understand what you can expect during your recovery
process. Remember to include physician specialists,
supportive family members and friends who can provide
various levels of support during your treatment and recovery
phases.
* Set your expectations accordingly
* Recovery Requires Preparation
* Review Ten Tips to Help you Through Recovery (page #10)
with your loved ones BEFORE you begin treatment(s).


SEEK SUPPORT & HAVE HOPE

You are now equipped with the information you
need to take your first steps toward treating and
managing your prostate cancer. You can live with
prostate cancer.
Seek out other men have been treated with
prostate cancer. They can provide a wealth of
information and support as you travel on your
own treatment path.
Chinese Proverb—“To know the road ahead,
ask those coming back.”

DO YOU NEED OR WANT MORE INFORMATION
ON THE TESTS AND PROCEDUCES
TO DIAGNOS AND MONITOR
PROSTATE CANCER?

IF SO, CONTINUE ON….

who understands.

Brochure #2 - Signposts Prostate cancer diagnosis is rarely
Understanding the result of one test or one medical
procedure.
The Diagnostic
Process Diagnosis is generally the result of a longer
process, including several screening and
diagnostic tests and much analysis.

This is true whether you are:

• receiving your first diagnosis
• monitoring your progress after receiving
treatment,
or perhaps facing recurrent disease.

The tests, tools, and screening procedures you
experience in the diagnostic process are like
signposts on a journey, designed to
show you where you are & point the way.

Signposts along the pathway are designed to identify where you are
and point out the most efficient and effective route toward your
desired destination, a healthy you.

Brochure #2 - Signposts Doctors use four key tools for
an initial prostate cancer
diagnosis:
Understanding • Blood • Touch
The Diagnostic • Tissue • Image.
The results of these four types
Process of tests provide basic
diagnostic information, such as
the stage of your cancer and
your Gleason Score.
THE You and your care team can
BASICS use the results of these tests &
tools …

… to determine the best
course of treatment for YOU.
.

Brochure #2 - Signposts

Beyond the Basics—CLARIFICATION

As you review the chart on pages 3–5, you will
notice several tests in addition to the basic
diagnostic tests. These additional tests can
provide clarity on certain aspects of your prostate
cancer diagnosis. Many decisions about treatment
options become clearer based on the information
provided by these test results.

NOTE: Be sure to get copies of all your test results. This can be vitally
important as you move from one medical professional to another. You may
also want to graph your test results for better communication and
understanding.


Knowledge is Power
Test, Procedures and Tools

Study pages 3-5 to learn more about important tools for your journey.
Talk with your doctors and your loved ones about your questions and/or concerns.


You Are Your Best Advocate

This is the time to be your best advocate. Take the
time to learn about the diagnostic process. Understand
your diagnosis and what is happening in your body.
Reach out for support and ask questions.

Us TOO is here for you as you learn. Our goal is to
provide support, information, and a safe place for
you to share and learn. You are not alone.

who understands.

You Are Not Alone

Us TOO International®
Prostate Cancer Education & Support Network
5003 Fairview Avenue
Downers Grove, IL 60515-5286
phone 630-795-1002
fax 630-795-1602
www.ustoo.org

Prostate Cancer HelpLine:
1-800-80-Us TOO (808-7866)

who understands.

Pathways and Signposts

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