Produced 2009 by Accessible Format Production, RNZFB, Auckland
This edition is a transcription of the following print edition:
Copyright © 2008, Cancer Society of New Zealand Inc.
PO Box 12700, Wellington
Fourth Edition 2008: ISBN 0-908933-75-4
Third Edition 2005: ISBN 0-908933-64-9
Second Edition 2001: ISBN 0-908933-46-0
First Edition 1993: ISBN 0-908933-08-8
Our aim is to provide easy-to-understand and accurate information on cancer and its treatments. Our patient information booklets are reviewed and updated by cancer doctors, specialist nurses and other relevant health professionals to ensure the medical information is reliable, evidence-based and up-to-date. The booklets are also checked by consumers to ensure they meet the needs of people with cancer.
This edition of Prostate Cancer/Matepukupuku Repeure includes a new feature in response to suggestions from those who review our booklets, and to meet the needs of our readers.
Our key messages and important sections have been translated into te Reo Māori. Our translations have been provided by Hohepa MacDougall and have been peer-reviewed by his colleagues.
Bowel Cancer/Mate Whēkau Pukupuku
Breast Cancer/Te Matepukupuku o ngā Ū
Chemotherapy/Hahau
Eating Well/Kia Pai te Kai
Got Water?/He Wai?
Lung Cancer/Mate Pukupuku Pūkahukahu
Melanoma/Tonapuku
Radiation Therapy/Haumanu Iraruke
Secondary Breast Cancer/Matepukupuku Tuarua ā-Ū
Sexuality and Cancer/Hōkakatanga me te Mate Pukupuku
Understanding Grief/Te Mate Pāmamae
What do I tell the Children?/He aha he kōrero māku ki āku tamariki?
Being Active When You Have Cancer
When Someone Has Cancer
When You Have Cancer
This booklet has been prepared to help you understand more about prostate cancer – a cancer of the prostate gland found only in men. It gives information about diagnosis, treatment, practical support and the emotional impact of cancer.
We hope this information will answer some of the questions you may have.
We cannot tell you which is the best treatment for you. You need to discuss this with your own doctors. However, we hope this information will answer some of your questions and help you think about the questions you want to ask your doctors.
We also include information about support services you may like to use.
If you find this booklet helpful, you may like to pass it on to your family and friends.
The words in bold are explained in the glossary at the end of the booklet.
What is cancer? - 4
The beginnings of cancer - 4
How cancer spreads - 5
The prostate - 7
What is prostate cancer? - 8
How common is prostate cancer? - 9
Causes of prostate cancer - 9
Symptoms - 12
How is prostate cancer diagnosed? - 13
Digital rectal examination (DRE) – 13
Blood test (PSA) – 13
Ultrasound examination and biopsy – 14
How is the biopsy interpreted? – 14
The Gleason Score – 15
What does the Gleason Score mean? - 15
Staging the cancer - 16
Bone scan - 17
X-rays - 17
CT scan – 17
Pelvic lymph node dissection - 18
Treatment - 24
The treatment team - 25
Management of localised prostate cancer - 26
Watchful waiting – 26
Surgery - 26
Advantages of radical prostatectomy – 27
Side effects of radical prostatectomy - 27
Radiation therapy - 28
Advantages of radiation therapy – 29
Side effects of radiation therapy – 29
Hormone treatment in conjunction with radiation therapy - 30
Treatment for advanced prostate cancer - 30
Hormone treatment - 31
Orchidectomy – 31
LHRH therapy – 31
Anti-androgen therapy – 32
Side effects of hormone treatment - 32
Transurethal resection of the prostate gland - 33
Making decisions about treatment - 38
Talking with doctors - 39
Talking with others - 40
A second opinion - 40
Taking part in a clinical trial - 40
After treatment - 44
Support - 46
Emotional support - 46
Talking with your children - 48
Cancer Society Information and Support Services - 48
Cancer support groups - 49
Prostate Cancer Foundation - 50
Home care - 50
Palliative care services - 50
Financial assistance - 50
Interpreting services - 51
What can I do to help myself? - 53
Diet and food safety - 53
Exercise - 55
Relaxation techniques - 55
Complementary and alternative therapies - 55
Seeking advice from health professionals - 57
Improving incontinence - 57
Sexuality and prostate cancer - 62
Questions you may wish to ask - 66
Suggested websites - 70
Glossary – 71
Notes - 76
Page 4
Cancer is a disease of the body’s cells. Our bodies are always making new cells to replace worn-out cells, or to heal damaged cells after an injury. This process is controlled by certain genes: the codes that tell our cells how to grow and behave. Cancers are caused by damage to these genes. This damage usually happens during our lifetime, although a small number of people inherit a damaged gene from a parent when they are born.
Normally, cells grow and multiply in an orderly way. However, damaged genes can cause them to behave abnormally. They may grow into a lump, which is called a tumour. Tumours can be benign (not cancerous) or malignant (cancerous). Benign tumours are surrounded by a capsule and do not spread to other parts of the body.
Diagram:
Transcriber's Note: This is a four step diagram.
Step 1: Cross-section of part of a body. On the outside are normal cells. Just below the normal cells is the basement membrane. Below the basement membrane runs the lymph vessels and then the blood vessels.
Step 2: Some of the normal cells on the surface have become abnormal cells.
Step 3: Abnormal cells multiply (cancer in situ). The number of abnormal cells has increased dramatically but it hasn't spread past the basement membrane.
Step 4: Malignant or invasive cancer. The abnormal cells have crossed over the basement membrane and have reached the lymph vessel and blood vessel.
End of Note.
End of Diagram.
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Diagram:
Transcriber's Note: Cross section of a cancerous part of someone's body. On the surface is a lump of abnormal cells which form the primary cancer. This is labelled local invasion. This lump has broken through the basement membrane which typically lies below the normal cells. The abnormal cells now have access to the lymph and blood vessels. When the abnormal cells travel through these vessels they can form a metastasis.
The picture is labelled as follows: "Cells move away from primary tumour and invade other parts of the body via blood vessels and lymph vessels." End of Note.
End of Diagram.
Malignant tumours invade into the surrounding tissues, and may form a secondary cancer or metastasis in another part of the body. For a cancer to grow bigger than the head of a pin, it must grow its own blood vessels. This is called angiogenesis.
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He mate tēnei ka pā ki ngā pūtau (cells) o te tinana. He kaha ō tātou tinana ki te mahi pūtau i ngā wā katoa, hei whakahou i ngā pūtau kua kore he kaha, kua mate rānei i ngā wharanga ka pā ki te tinana. Arā ētahi tino momo ira (genes) kei te whakahaere i tēnei mahi: ko ngā tohu e aki ana i ō tātou pūtau kia pēhea te tipu me te whano. Ka ahu katoa mai ngā matepukupuku i ngā tūkinotanga ka pā ki ēnei ira. Kāore e kore ka pā ngā tūkino nei i roto i te wā o tō tātou oranga engari, ka whiwhi ētahi tāngata i taua ira kua tūkinotia, mai i ō rātou mātua i te wā whānau mai rātou.
I te nuinga o te wā, pai noa iho te tipu me te rauroha haere o ngā pūtau. Heoi anō rā, mēnā kua tūkinotia ētahi, tērā pea, ka āhua rerekē te whanonga. Tērā pea ka tipu hei pukupuku ā, e kīia ana he puku (tumour). Ko ētahi puku ka kīia he marire (kāore e puta te matepukupuku); ko ētahi atu ka kīia he marere (he matepukupuku). Uwhitia ai ngā pukupuku marire e tētahi pōtae, ā, kāore e rauroha ki wāhi kē o te tinana.
Whakaeke ai ngā pukupuku marere ki roto i te kikokiko noho tata ā, tērā pea ka puta he matepukupuku tuarua ki wāhi kē o te tinana, kīia ai tēnei he metastasis. Ki te tipu nui ake te matepukupuku i te rahi o te māhunga o tētahi pine, me tipu anō ōna ake ia toto. Kīia ai ēnei ko te angiogenesis.
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The prostate is a small gland, normally about 4 cm across, found only in men. It sits just below the bladder and surrounds the top part of the urethra – the tube that carries urine from the bladder and semen from the sex glands to the outside of the body via the penis.
Diagram:
Transcriber's Note: Cross-section of a man's sexual organs both inside and outside the body. The penis hangs down outside the front of the body. Running down the centre of the penis is the urethra which leads from the bladder to the outside of the body. A layer of fatty tissue is located above the penis. Behind this layer is the pubic bone and behind this bone is the bladder. Below the bladder and surrounding the top part of the urethra is the prostate gland. The ball-shaped testes lie below the penis. The testes are surrounded by sack-like skin called the scrotum. The rectum is located near the rear of the body behind the bladder. The anus is located at bottom of the rectum where it meets the outside of the body. End of Note.
End of Diagram.
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The prostate produces most of the fluid that makes up semen. The growth and development of the prostate depends on the male sex hormone, testosterone, which is produced by the testes (testicles). It is common for the prostate gland to get larger as men grow older.
This enlargement is called benign prostatic hyperplasia (BPH). This condition is the usual cause of the urinary symptoms that older men complain of, and prostate cancer is only occasionally responsible for these symptoms.
Prostate cancer is a malignant tumour of the prostate gland. Early prostate cancers are contained within the prostate gland and are called localised cancers.
Spread of the cancer to the surrounding tissues is known as extracapsular spread, and these tumours are described as being locally advanced.
There is a collection of small lymph glands near the prostate that are part of the lymphatic system – one of the body’s natural defences against infection. Lymph glands filter out bacteria and other harmful agents. A network of very thin lymph vessels connects the major lymph glands in the abdomen, pelvis, groin, neck and armpits. Cancer that develops in the prostate may spread (or metastasise) via the lymphatic system or blood stream to other parts of the body, such as the bones.
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Prostate cancer occurs mainly in men aged over 50 years and is the most common cancer among New Zealand men. Around 3000 men are diagnosed with prostate cancer in New Zealand each year.
The causes of prostate cancer are not yet fully understood, but the risk of developing prostate cancer increases with age. The risks are also higher if other family members have developed this cancer.
There is some evidence to support that a diet that is high in animal fat increases the chance of developing prostate cancer. While it is not possible to make clear recommendations about a particular diet, a lower fat, high fruit and vegetable diet is linked with a reduced risk of a number of chronic diseases and is an overall recommendation towards improving health.
He repe (gland) pakupaku te repeure, āhua 4 henimita te whānui, e kitea ai i roto i te tāne anake. Noho ai te repeure ki raro ake o te tōngāmimi (bladder), me tōna karapoti i te wāhanga o runga te taiawa mimi (uretha) – te ngongo kawe i te mimi mai i te tōngāmimi, me te waitātea mai i ngā repe taihemahema ki waho o te tinana
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mā te ure. Kei te taiaki taihema o te tāne, te testosterone, te tikanga o te tipu me te whakawhanaketanga o te repeure. Ka hangaia te testosterone i roto i ngā raho (testes, testicles). Ko te tikanga, ka nui te tipu haere o te repeure i te wā pakeke haere ai te tāne.
Kia ai tēnei tipu nui ko te benign prostatic hyperplasia (BPH). Konei te take nui e kaha puta ana ngā tohumate roma mimi e kōrerohia ana e ngā tāne e pakeketia haere ana ā, oti rā, iti noa te wā ko te matepukupuku repeure te take e puta ai ēnei tohumate.
He puku marere te matepukupuku repeure o te repeure. Kei roto i te repeure ngā matepukupuku repeure ā, kīia ai he matepukupuku tūwāhi.
Kīia ai te matepukupuku ka rauroha ki te kikokiko noho tata, ko te rauroha extracapsular, ā, kua kīia ēnei pukupuku, he tūwāhi whakamua.
He kohinga repe waitinana (lymph) pakupaku e noho tata ana ki te repe tātea, ā, he wāhanga tēnei o te pūnaha waitinana (lymphatic system), tētahi o ngā wawaotanga whakapokenga o te tinana. Tātari ai ngā repe waitinana i ngā kitakita (bacteria) me ērā momo mea kino. Hono ai he kōtuinga waitinana (lymph vessels) iaia tino tūpuhi ki ngā repe waitinana matua kei roto i te puku, i te
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papatoiake, i te tapatapa, te kakī, me ngā kiekie. Tērā pea ka rauroha mā te pūnaha waitinana, te matepukupuku (metastasise) ka tipu i roto i te repeure ki wāhi kē o te tinana, pērā ki ngā kōiwi.
Puta ai tēnei mate ki roto i ngā tāne, neke atu i te 50 tau te pakeke ā, koinei te matepukupuku nui rawa atu e pā ana ki ngā tāne o Aotearoa. Āwhiwhi ki te 3000 ngā tāne kua kitea kei te mate i te matepukupuku repeure ki Aotearoa ia tau, ia tau.
Kāore i te tino mōhiotia te take e puta ai te matepukupuku repeure, heoi anō rā, ka piki te mōrea mō te matepukupuku repeure i te wā pakeke haere ai. Ka piki hoki te mōrea mehemea kua pā kē tēnei mate ki ētahi atu o tō whānau.
Kua puta he paku kōrero taunaki e tautoko ana i te kōrero – ko te kaha o te kai mōmona kararehe tētahi āhua whakapiki i te mōrea o te puta o te matepukupuku repeure. Ahakoa kāore e taea te kōrero motuhake mō tētahi rārangi kai pai rawa atu, e mōhiotia ana te hāngai o te whakaiti i te kai mōmona, te kaha ki te kai huarākau me te huawhenua, me te kitea o te heke o te mōrea o te maha o ngā tahumaero, ā, he tohu nui mō te whakapiki i te hauora.
Page 12
Prostate cancer that hasn’t spread to other parts of the body usually causes no symptoms. Many men over 50 have urinary symptoms, such as:
passing urine more frequently
difficulty urinating – starting or stopping
poor flow of urine
getting up at night more frequently to urinate.
These symptoms are usually due to pressure on the urethra from an enlarged prostate (benign, not cancerous). If prostate cancer has occurred without the above symptoms the first symptoms to present could be due to the cancer having spread from the prostate gland:
pain or burning when urinating
blood in the urine
pain in the lower back, hips or ribs.
It is important to have all symptoms checked by a doctor to exclude a cancer.
Page 13
A number of tests can be performed to help determine if you have prostate cancer. You may have some or all of the following tests:
The first test is usually an examination of the prostate gland through the back passage (rectum). This is called a digital rectal examination.
The doctor puts a gloved finger into your rectum and feels the prostate through the rectal wall. If your doctor finds anything suspicious, such as irregularity in the shape or texture of the prostate, a biopsy may be arranged.
A blood test may be done to check for the presence of prostate-specific antigen (PSA). There are many causes for a high PSA, including benign enlargement of the prostate and inflammation or infection of the gland (prostatitis), but a high PSA can also be caused by prostate cancer.
An elevated PSA test merely indicates your risk of having prostate cancer is higher compared to a person with a normal PSA. A general rule of thumb is that if you have a PSA higher than four, the risk of cancer is sufficiently great to consider a biopsy. The higher the PSA is above four, the greater the risk of cancer.
Page 14
However, in older men a small elevation in PSA level may be normal. If cancer is present, changes in PSA levels can be used to monitor whether the cancer is growing slowly or quickly.
In a biopsy, a sample of tissue is removed from the body. For a biopsy of the prostate, a small needle is directed into the prostate, guided by an ultrasound probe in the rectum, (this is called transrectal ultrasound or TRUS). The probe is the size and shape of a middle finger and shows the shape and condition of the prostate.
Usually several cores of prostate tissue are withdrawn from different parts of the gland and sent to a pathologist for examination under a microscope. There will be discomfort associated with this procedure. Talk to your specialist about options for sedation. The biopsies are important to help you and your specialist make decisions about treatment.
Tissue taken during the biopsy is looked at under a microscope. If there are malignant cells present, these are assessed for their aggressiveness.
Page 15
This assessment is called grading and the most common way of grading prostate cancer is to give the cells a Gleason Score. Your specialist will use this information to help with decisions regarding treatment.
The Gleason grading system assigns a grade (indicated by a number from 1 to 5) to the most prominent pattern of cells in the cancer, and another grade (1 to 5) to the second most common pattern. Grade 1 is the least aggressive cancer and grade 5 the most aggressive. The two numbers are then added together to produce the Gleason Score. The total score can be anywhere from 2 (1+1) to 10 (5+5).
The scores measure differentiation, the medical term used to describe how closely cancer cells resemble normal cells. Well differentiated cancer cells look very much like normal cells of the same type and are able to carry out some functions of normal cells. Poorly differentiated and undifferentiated tumour cells are highly disorganised and abnormal looking.
As a general rule, the more the cells look like normal cells under the microscope, the slower growing they are.
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The greater the difference in the appearance of the cell from what is normal, the higher the number that is assigned on the Gleason Score.
Gleason 2, 3, 4 – Most like normal cells, well differentiated, slow growing, low probability of metastasis, low grade.
Gleason 5, 6, 7 – Can behave like normal cells or like aggressive cells, moderately differentiated, moderate probability of metastasis, moderate grade.
Gleason 8, 9, 10 – Least like normal cells, poorly differentiated, high probability of metastasis, high grade.
Staging is a process of assessing the extent of a tumour. The staging of the primary tumour is made using the digital rectal examination.
A tumour may:
be confined to the prostate
be locally advanced, which means it has spread beyond the prostate but not to distant parts of the body
or be metastatic, which means it has spread to other parts of the body.
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While the Gleason Score reflects what the cancer looks like under the microscope, the stage of the cancer reflects where the cancer is found.
Tests, such as a bone scan, or a CT scan (computerised tomography) may be used to check for metastatic tumours. You may also be offered a pelvic lymph node dissection.
A bone scan may be used to look for any spread of cancer to your bones. A very small amount of radioactive material is injected into a vein to highlight abnormal areas in the bone, which may be due to cancer.
A scanning machine is then used to see if the radioactive material collects in any areas of your bones.
X-rays of the chest and bones may be done to find out whether or not the cancer has spread to these areas.
The CT scan is a special type of X-ray that gives a three-dimensional picture of the organs and other structures (including any tumours) in your body.
It usually takes about 30–40 minutes to complete this painless test.
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Your doctor may wish to operate to remove some of the lymph nodes, also known as lymph glands, in your pelvis close to your prostate (pelvic lymph node dissection) in order to find out the extent of the prostate cancer.
The lymph glands will then be examined under a microscope to see if the cancer has spread through the lymphatic system. This procedure can be done during laparoscopy (key-hole surgery), which avoids major surgery to open the abdomen, or during surgery to remove the prostate (radical prostatectomy).
Kāore e puta he tohumate mehemea kāore anō te matepukupuku repeure i rauroha ki wāhi kē o te tinana. He nui ngā tāne pakeke ake i te 50 tau ka whai tohumate ā-mimi, pērā ki:
te nui ake o ngā wā haere ai ki te wharepaku
te uaua ki te mimi – te tīmata me te mutu
te pōturi o te rere o te mimi
te kaha ake o te oho i ngā pō ki te mimi.
I te nuinga o te wā, puta ai ēnei tohumate nā te pēhanga ki runga i te taiawa mimi nā te whakarahinga o te repeure (he marire, ehara i te marere).
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Mēnā ka puta te matepukupuku repeure me te kore o ēnei tohumate, tērā pea ko ngā tohumate tuatahi, ko ngā tohu o te rauroha o te repeure ki wāhi kē o te tinana:
mamae i te wā mimi ai
toto kei roto i te mimi
mamae a raro ake o te tuarā, te hope, ngā rara rānei.
He mea nui kia tirohia ō tohumate e te rata, kia mōhiotia ehara i te matepukupuku.
He maha ngā whakamātautauranga hei whakatau mehemea kei te pāngia koe ki te matepukupuku repeure. Tērā pea ka whakamahia tētahi o ēnei e whai ake nei, te katoa ranei:
I te nuinga o te wā ko te whakamātautau tuatahi, ko te whakamātautau i te repeure mā te tero (retum). Kīia ai tēnei he whakamātautau tero ā-mati.
Ka purua e te rata tōna mati kua ūhia ki te karapu mati, ki roto i tō tero, kātahi ka whāwhā i te pātū tero. Inā ka kitea tētahi mea rerekē, pēra ki te rerekē o te āhua, te kākano (texture) rānei o te repeure, tērā pea ka whakaritea he biopsy.
Page 20
Tēra pea ka tangohia he toto ki te titiro mehemea he akiaki paturopi hāngai-repeure (PSA) (prostate-specific antigen). He nui ngā take e puta ai te PSA, tae noa ki te whakarahinga o te repeure me te pupuhi, te whakapokenga rānei o te repe, heoi anō rā, ko tētahi take e puta ai te PSA kaha rawa, ko te matepukupuku repeure.
Ki te whakaatu mai te whakamātautau PSA kua āhua piki te kaha o te PSA, he tohu tēnei he nui ake te mōrea mōu mō te pānga o te matepukupuku repeure, ki tētahi atu e pai ana tana PSA. Ko te tikanga whānui, ki te kaha ake tō taumata PSA i te tau whā, ka nui ake te mōrea mō te puta o te matepukupuku. Otirā, kāore he māharahara mō te paku piki o te PSA i roto i ngā tāne kua pakeketia.
Mehemea kua puta te matepukupuku, ka whakamahia ngā whakarerekētanga ka kitea i roto i ngā whakamātautau PSA hei aroturuki mehemea kei te pōturi te tipu o te matepukupuku, kei te tere rānei te tipu.
I roto i te whakamātautau biopsy, ka tangohia he tauira kiko mai i te tinana. Mehemea ko te biopsy o te repeure, ka werohia he ngira ki te repeure mā te ārahitanga o tētahi pūwhāwhā (e kīia ai he tatangi pāorooro ā-tero). He pērā te rahi o te pūwhāwhā ki te māpere (middle finger), ā, ko tōna mahi he whakaatu mai i te āhua me
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te pai o te repeure. Ko te tikanga, ka āhua nui tonu ngā uho kiko ka tangohia mai i ngā wāhanga rerekē o te repe, ka tuku ki te kaimātai tahumaero (pathologist) hei whakamatautau mā te karu whakarahi (microscope). Kāore e kore ka āhua mamae te tangata i muri mai. Me kōrero ki tō mātanga e pā ana ki te kōwhiringa mō te whakamoe i a koe. He mea nui ngā biopsy kia āhei kōrua ko tō mātanga ki te kōrero mō te maimoa pai mōu.
Tirohia ai te kiko ka tangohia i te biopsy ki raro i te karu whakarahi. Mehemea ka kitea he pūtau marere kei roto, ka arotakea mō te whakariri. Kīia ai tēnei momo arotake he māhititanga (grading), ā, i te nuinga o te wā, ka whakamahia ko te Gleason Score i te taha o ngā pūtau hei tūāhua mō te māhiti i te matepukupuku repeure. Mā tō mātanga e whakamahi ēnei pārongo hei whakatau ko tētahi te maimoa pai.
Whakarite māhiti ai te pūnaha māhiti a Gleason (mā te tohu o tētahi tau mai i te 1 ki te 5), ki te taha o ngā pūtau whai i te tauira nui rawa atu i roto i te matepukupuku, kātahi ka whakarite māhiti anō (1 ki te 4) mō te tauira nui rawa atu tuarua. Ko te māhiti 1 te matepukupuku iti ake te kino ā, ko te māhiti 5 te mea kino rawa te matepukupuku. Ka tāpiria ngā tau e rua nei kia puta ko te Gleason Score. Ka taea te putanga o te tāpeke, mai i te 2 (1+1) ki te 10 (5+5).
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Ka ine ngā tatauranga i te rerekētanga (differentiation). Koinei te kōrero hauora mō te tata o te āhua o ngā pūtau matepukupuku ki ngā pūtau pai. He rite tonu ngā momo matepukupuku rerekētanga pai ki ngā momo pūtau pai, me tā rātou āhei ki te kawe i ngā mahinga pērā ki ngā pūtau pai. Engari ngā momo pūtau matepukupuku kāore i te pai te rerekētanga, kāore hoki i te pai te mahinga me te anuanu o te āhua. Ko te tikanga, ki te āhua rite ngā pūtau i raro i te karu whakarahi ki ngā mea pai, kei te pōturi ake te tipu.
Mehemea he nui ake te rerekētanga o ngā pūtau ki ngā mea pai, ka nui ake te tau ka puta i runga i te Gleason Score.
Gleason 2, 3, 4 –Tata ki ngā pūtau pai, pai te rerekētanga, pōturi te tipu, iti pea te metastasis, iti pea te taumata.
Gleason 5, 6, 7 – He whanonga pērā ki ngā pūtau pai, ki ngā pūtau whakariri rānei, he ngāwari te rerekētānga, he ngāwari pea te puta o te metastasis, he māhiti ngāwari.
Gleason 8, 9, 10 – Kāore i tino tata te āhua ki ngā pūtau pai, kāore i te pai te rerekētanga, ka kaha ake te puta o te metastasis, he māhiti nui.
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He hātepe tēnei mō te arotake i te whānuitanga o te pukupuku. Ka whakamahia te arotakenga o te pukupuku tuatahi mā te whakamātautau tero ā-mati.
Ko ngā pukupuku:
ka noho ki roto i te repeure
kua tīmata rānei te puta tata, arā kua rauroha ki tua atu o te repeure engari kaua ki tawhiti o te tinana
kua metastatic kē rānei, arā, kua rauroha ki wāhi kē o te tinana.
Ahakoa ko tā te Gleason Score e whakaata ana, ko te āhua o te matepukupuku, ka tirohia anō i raro i te karu whakarahi, ko tā te taumata matepukupuku e whakaata ana, ko te wāhi e kitea ai te matepukupuku.
Tērā pea ka whakamahia ngā whakamātautau, pērā ki te matawai (scan) kōiwi, ki te matawai CT (computerised tomography), ki te tirotiro mō ngā pukupuku metastatic. Tērā pea ka hoatuna he tuakitanga pono taikiri papatoiake (pelvic lymph node dissection).
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Your doctor will use a range of criteria to help determine the type of treatment to recommend. They include the volume or size of the prostate, the Gleason Score, the pattern of growth, the PSA, and the area where the cancer is located.
Treatment considerations vary from one man to another, depending on the age of the man, the stage of the cancer, the tumour grade, and the presence or absence of other serious medical conditions.
Options your doctor will consider include:
watchful waiting
surgery
radiation therapy
hormone therapy
a combination of the treatments listed above.
In general, radical (or curative) treatment will be required by patients aged 70 years or younger who have no evidence of metastases, and are otherwise in reasonable general health.
Most patients aged 80 years or more don’t need treatment, unless their cancer is an aggressive one or it is causing symptoms.
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For patients aged 70-79 years, the side effects of treatment and the impact on a person’s quality of life are important factors to consider, and some patients may elect for a ‘watchful waiting’ policy.
From the time that you are first diagnosed with prostate cancer you will be cared for by one or more of a team of health professionals including:
Your family doctor, who will often be the first person you see
A Urologist, a surgeon who specialises in genito-urinary conditions
Radiation Oncologists, doctors who specialise in the use of radiation in the treatment of cancer
Hormonal treatment is managed by Urologists and Radiation Oncologists
Radiation Therapists, people who prepare you and give you your treatment
Oncology Nurses, Urology Nurses, Continence and Impotence Advisers who will help you through all stages of your cancer experience
Dietitians, who will recommend the most suitable foods to eat
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Social Workers, Physiotherapists and Occupational Therapists, who will advise you on the support services that are available and help you get back to normal activities.
Ideally, your hospital should have all available means of diagnosis and treatment, although this will not be the case in some areas.
Some older patients prefer to take a watchful waiting approach. These patients need to consider their general state of health, the stage of the cancer and its rate of growth. The possible risks in delaying treatment have to be compared with the impact of the treatment.
You will need to be examined regularly to check the cancer is not growing more quickly than expected.
If watchful waiting is suggested for you, ask your doctor:
How often will you need to schedule check-up appointments?
Which tests will be done and at what intervals?
If the cancer has not spread beyond the prostate, the whole gland can be surgically removed.
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This is called radical prostatectomy, and the operation is done to try to cure the cancer. Surgery is performed through an incision in the lower abdomen and the entire prostate is removed from the body, with the bladder being joined back on to the bladder outflow pipe (urethra). This operation requires a stay of five to seven days in hospital. It would be usual to go home with a urinary catheter in place for two to three weeks. You should be able to resume normal activities within six weeks.
If the cancer is located within the prostate, a surgical operation may cure the disease because surgery removes the prostate, including the tumour. Once the prostate is totally removed the PSA should remain undetectable.
A radical prostatectomy can cause urinary incontinence (loss of bladder control) to a greater or lesser degree in some patients.
Impotence (erectile dysfunction) can be a result of this surgery. Even though the operation can be performed in a nerve sparing way in order to protect the nerves that are important for the erection of the penis, impotence may still occur. See later sections in this booklet for managing these side effects.
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Radiation therapy uses high-energy X-rays to destroy cancer cells and may be used as an alternative or additional treatment to surgery. This form of treatment works best when the cancer is confined to the prostate.
The radiation can be precisely targeted to cancer sites. Treatment is carefully planned to do as little harm as possible to your normal body tissue.
The treatment is usually given over several weeks. The length of treatment will depend on the size and type of the cancer and on your general health. Radiation therapy may also be used to relieve pain caused by secondary cancers in the bones, or to shrink obstructions in your lymphatic or urinary systems.
There are three types of radiation therapy for prostate cancer:
External beam radiation – a beam of X-rays from a linear accelerator machine is focused on the area affected by cancer. Therapy is usually given daily for five days each week, for a period of about seven weeks.
Low-dose rate brachytherapy – tiny radioactive seeds are inserted permanently into the prostate gland. This form of treatment may be successful for small tumours which are located within the gland. This therapy may also be used with a shortened course of external beam radiation in patients with more advanced cancer.
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High-dose rate brachytherapy – needles are placed in the prostate and radioactive sources can then be temporarily placed into the prostate down the hollow needles.
High-dose rate brachytherapy is always used after a shortened course of external beam radiation.
Low dose-rate brachytherapy is currently only available outside the public hospital system.
Radiation therapy may cure prostate cancer that is localised to the prostate. It avoids removal of the prostate and problems associated with radical prostatectomy. Patients receiving brachytherapy are able to return to usual activities soon after the implant.
Some men may experience the following side effects when undergoing radiation therapy:
tiredness
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bowel symptoms, such as pain and bleeding from proctitis (inflammation of the rectum) and diarrhoea. Although these symptoms usually disappear after the end of treatment, a small number of men will continue to experience bleeding from the bowel.
urinary disturbances such as increased frequency and a burning sensation. Discuss these symptoms with your doctor.
impotence – about 50 percent of men experience difficulty achieving/or maintaining an erection following a course of radiation.
Hormone treatment in conjunction with radiation therapy may be offered. Clinical trials are running to determine the advantages of this treatment. Early results indicate this form of treatment successfully reduces the number of cancer cells at the start of radiation therapy.
If the cancer has spread, then your doctor will discuss various treatments for specific problems caused by the cancer.
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Hormones are substances that occur naturally in the body. They control the growth and activity of cells and may be used to treat prostate cancer. Prostate cancer needs the male hormone testosterone for growth so it is possible to slow down or shrink the cancer by reducing the body’s testosterone levels.
All hormonal therapy is aimed at either removing from the body or counteracting the effect of the male hormone testosterone.
There are a number of different approaches:
Orchidectomy or (orchiectomy American spelling) is a procedure where the testicles are surgically removed through a cut in the scrotum. An orchidectomy permanently deprives the body of testosterone.
The advantage of orchidectomy is that it is a one-off procedure, but the disadvantage is that any side effects are permanent. Side effects include impotence and loss of sex drive. Hot flushes and mild weight gain are also common side effects.
Luteinising hormone-releasing hormones (LHRH) lower the amount of testosterone in the body. LHRH therapy is usually given as a monthly or three-monthly injection.
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The side effects of LHRH therapy are similar to those of orchidectomy.
Anti-androgens block the action of testosterone in stimulating a cancer. The advantage of this type of therapy is that some men maintain their erections and sexual drive.
They are occasionally used in combination with one of the other forms of hormonal treatment, although there are questions about whether this combination approach is as effective as was previously thought.
Hormone treatment for prostate cancer can cause loss of libido, weight gain, hot flushes, swelling of the breasts, fluid retention and progressive hardening of the arteries.
A possible side effect of long-term anti-androgen therapy is osteoporosis (weakening of the bone due to the loss of bone density). Men on this therapy should discuss with their doctors ways to preserve bone density, for example adequate dietary calcium, vitamin D and regular exercise.
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Surgery may sometimes be carried out to remove blockages in the urinary tract. This operation is called a transurethral resection of the prostate (TURP) and is performed by passing a resectoscope up the urethra. This type of operation is also used to treat benign prostatic hyperplasia.
He maha ngā paearu ka whakamahia e tō rata ki te whakarite i te momo maimoa ka taunakitia. Ko ētahi paearu, ko te rahi, ko te nui o te repeure, ko te PSA, ko te wāhi i kitea te matepukupuku.
He nui tonu ngā rerekētanga maimoa ki waenganui i te tāne, tae noa ki tōna pakeke, te wāhanga o te matepukupuku, te taumata o te pukupuku, me te puta o ētahi atu mate hauora nui.
Ko ngā kōwhiringa ka whakaarohia e tō rata
Te tiaki mataara
Te hāparapara (surgery)
Haumanu iraruke
Haumanu taiaki
He kōwhiringa o ngā mea i runga
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I te nuinga o te wā, ka whakahaerehia he maimoa wāwāhi tikanga (hahau rānei) mō ngā tāne i raro ake i te 70 tau te pakeke, mehemea kāore anō i puta te metastases, me te pai o tō rātou hauora. Kāore ngā tāne pakeke ake i te 80 e whai maimoa, i tua atu i ngā matepukupuku whakariri, kei te whakaputa rānei i ngā tohumate. Mō ngā tūroro kei waenganui i te 70 ki te 79 ngā tau, me te pai hoki ō tō rātou oranga, tērā pea ka whai kē ētahi tūroro i te kaupapahere, tiaki mataara.
Tiaki mataara
Ki ētahi tūroro pakeke, he pai ake ki a rātou te tiaki mataara. Me whakaaro ēnei tūroro ki tō rātou hauora, te wāhi o te matepukupuku, me te āhua o tōna tipu. Me whakaaro mō te mōrea o te waiho i te maimoa, ki te puta o ngā pānga weriweri i te wā o te maimoatanga.
Mehemea kāore anō te matepukupuku i rauroha ki tua atu i te repeure, ka taea te tango i te katoa o te repe mā te hāparapara. Kīia ai tēnei he radical (prostatectomy wāwāhi tikanga), ā, whakamahia ai tēnei hei huarahi whakaora i te matepukupuku. Whakamahia te hāparapara mā tētahi motunga ki te puku o raro, ā, ka tangohia te katoa o te repeure mai i te tinana. Ka whakahonoa anō
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te tōngāmimi ki te taiawa mimi. Me noho te tangata ki te hōhipera mō ngā ra e rima ki te whitu. Ka pai noa iho te hoki ki te kāinga me te mau i tētahi roma mimi mō te toru wiki. Te tikanga, kia pau te ono wiki, ka ora anō te tangata.
Whakamahi ai te (haumanu iraruke) i ngā hihi pūngao kaha ki te patu i ngā pūtau matepukupuku ā, tērā pea ka whakamahia tēnei i tua atu i te mahi hāparapara, hei maimoa tāpiri rānei ki te mahi hāparapara. Pai ake tēnei maimoa mēnā kei te noho te matepukupuku ki roto i te repeure anake. Ka taea te whakahāngai i ngā iraruke ki te wāhi o te matepukupuku. Āta maheretia te maimoa kia iti ake te whaipānga ki ngā kiko pai.
Ko te tikanga, ka whāia tēnei maimoa mō ngā wiki āhua maha tonu. Mā te rahi o te matepukupuku me tōna momo e tohu mai te roa o tō maimoa. Tērā pea ka whakamahia te haumanu iraruke hei whakaiti ake i te mamae ka puta nā runga i te matepukupuku tuarua ki ngā kōiwi, ki te whakapakupaku rānei i ngā hōtaetae i roto i tō pūnaha waitinana, pūnaha mimi rānei. E toru ngā momo haumanu iraruke mō te matepukupuku repeure.
Iraruke hihi ā-waho – ka whakahāngaitia he hihi whakaahua roto, mai i tētahi pūrere kātere rārangi (linear accelerator machine), ki runga i te wāhanga whai i te matepukupuku, ka hoatuna te haumanu ia rā, ia rā, mō ngā rā e rima o te wiki, mō te whitu wiki.
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Brachytheraphy horopeta iti auau – ka purua he kākano ira rukeruke (radioactive) ki roto i te repeure. Tērā pea ka angitu tēnei maimoa mō ngā pukupuku iti kei roto i te repe. Tērā pea ka whakamahia tēnei maimoa i te taha o tētahi whāinga poto e whai ana i te i te iraruke hihi ā-waho mō ngā tūroro kua kaha rawa te matepukupuku.
Brachytheraphy horopeta kaha auau – ka purua he pūwero (ngira) ki roto i te repeure, mā reira ka āhei te rau atu i ngā pū iraruke mō te wā poto, mā roto i ngā pūwero. Whakamahia ai te brachytheraphy horopeta kaha i ngā wā katoa whai muri mai i tētahi whāinga poto o te iraruke hihi ā-waho. Kei te wātea te brachytheraphy horopeta iti auau i waho anake o te pūnaha hōhipera tūmatanui.
Tērā pea ka hoatuna he maimoa taiaki i te taha o ngā haumanu iraruke. E whakahaeretia ana ētahi whakamātautau haumanu ki te whakawā i ngā painga o tēnei maimoa. E kitea ana ngā huanga tuatahi, he pai tēnei momo maimoa mō te whakaiti i ngā pūtau matepukupuku i te timatatanga o te haumanu iraruke.
Mehemea kua rauroha te matepukupuku, ka kōrero tō rata ki a koe mō ngā maimoa mō ngā raruraru hāngai, puta ai nā runga i te matepukupuku.
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He hanga tūturu puta noa te taiaki, kei roto i te tinana. Ko tana mahi he tiaki i te tipu me te mahi a ngā pūtau, ā, tērā pea ka taea te whakamahi hei maimoa i te matepukupuku repeure. He mea nui te testosterone taiaki mō te tipu o te matepukupuku repeure nā reira ka taea te whakapōturi, ki te tīngongo i te matepukupuku mā te whakaiti i ngā taumata testosterone o te tinana. He hāngai katoa ngā haumanu taiaki ki te tango i te testosterone taiaki mai i te tinana, ki te whakatāraro (counteract) i te pānga o te taiaki testosterone tāne.
He maha ngā momo huarahi:
He hātepe te orchidectomy (ko te orchiectomy ki te tuhi Amerika) mō te tango hāparapara i ngā raho mā tētahi motu ki te pūkoro raho. Mā te orchidectomy e aukati ukauka te testosterone mai i te tinana.
Ko te pai o te orchidectomy, he tukanga kotahi noa iho, heoi anō rā, ko te taha weriweri, ki te puta he pānga kino, ka noho ukauka aua pānga. Ko ngā mea weriweri ka puta ko te paraheanga (impotence), me te kore hiahia ai. Ko te putanga o te werawera me te piki o te taumaha tinana ētahi o ngā pānga weriweri.
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Ko tā te Luteinising Hormone-releasing Hormones (LHRH), he whakaiti ake i te testosterone kei roto i te tinana. Ko te tikanga, ka hoatuna he haumanu LHRH hei werohanga i ia marama, ia 3 marama rānei. He rite ngā pānga weriweri ki ērā o te orchidectomy.
Ko tā te anti-androgen, he ārai i te mahi a te testosterone ki te whakaata i te matepukupuku. Ko te pai o tēnei momo haumanu, ko te kaha tonu o te tū o te ure me te hiahia ai. I ētahi wā ka tautokorua ki te taha o tētahi atu momo maimoa taiaki, ahakoa kei te rere ngā pātai mō te whaikiko o tēnei aronga tautokorua, ki tērā i whakaarohia i te wā ki mua.
Sometimes it is difficult to make decisions about what is the right treatment for you. You may feel that everything is happening so fast that you do not have time to think things through. However, it is important not to be rushed into a decision – it must be the right one for you.
While some people feel they are overwhelmed with information, others may feel that they do not have enough. Understanding your illness, the possible treatment and side effects will help you to make the right decision for you.
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If you are offered a choice of treatments, including no treatment for now, you will need to weigh their advantages and disadvantages. If only one type of treatment is recommended, ask your doctor to explain why other treatment choices have not been advised.
The risk of not having treatment needs to be weighed against the risk of side effects from treatment. You may want to ask your doctor questions like: “Can I expect to live longer if I have treatment?”, “If I have treatment, is there a risk that my quality of life could worsen because of the side effects?” and “Are there other treatment options for me?”
You may want to see your doctor a few times before making a final decision on treatment. It is often difficult to take everything in, and you may need to ask the same questions more than once. You always have the right to find out what a suggested treatment means for you, and the right to accept or refuse it.
Before you see the doctor, it may help to write down your questions. There is a list of questions to ask your doctor at the end of this booklet, which may help you. Taking notes during the session can also help. It is helpful to take a family member or friend with you to take part in the discussion, take notes or simply listen. Some people find it is helpful to record the discussion.
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Once you have discussed treatment options with your doctor, you may want to talk them over with someone else, such as family or friends, specialist nurses, your family doctor, the Cancer Society, the hospital social worker or chaplain, your own religious or spiritual adviser, or another person who has had an experience of prostate cancer. Talking it over can help you to sort out what course of action is right for you.
You may want to ask for a second opinion from another specialist. Your specialist or general practitioner can refer you to another specialist and you can ask for your records to be sent to the second doctor.
You may be interested in looking for information about prostate cancer on the internet. While there are very good websites, you need to be aware that some websites provide wrong or biased information. We recommend that you begin with the Cancer Society’s site (www.cancernz.org.nz) and use our links to other good cancer websites.
Research into the causes of prostate cancer and into ways to prevent, detect and treat it is continuing.
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Your doctor may suggest that you consider taking part in a clinical trial. You could also ask if there is a clinical trial for your particular kind of cancer.
Clinical trials are a vital part of the search to find better treatments for cancer, and are conducted to test new or modified treatments and see if they are better than existing treatments. Many people all over the world have taken part in clinical trials that have resulted in improvements to cancer treatment. However, the decision to take part in a clinical trial is always yours.
If you are asked to take part in a clinical trial, make sure that you fully understand the reasons for the trial and what it means for your treatment.
Before deciding whether or not to join the trial, you may wish to ask your doctor:
What is the standard treatment if I do not participate in the trial?
What is the potential benefit?
Which treatments are being tested and why?
What tests are involved?
What are the possible risks or side effects?
How long will the trial last?
Will I need to go into hospital for treatment?
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What will I do if any problems occur while I am in the trial?
If the treatment I receive in the trial is successful for my cancer, is there a possibility of carrying on with the treatment after the trial?
If you decide to join a randomised clinical trial, you will be given either the best existing treatment or a promising new treatment.
You will be chosen at random by computer to receive one treatment or the other, but either treatment will be appropriate for your condition. In clinical trials, people’s health and progress are carefully monitored.
If you do not want to take part, your doctor will discuss the best current treatment options with you.
Kei a koe te tikanga ki te tirotiro ki ngā whaihua pai, ki ngā whaihua rerekē ake rānei mehemea ka hoatuna he kōwhiringa maimoa ki a koe, tae noa ki tō kore hiahia whai maimoa mō tēnei wā. Ki te taunaki tō rata i te maimoa kotahi, uiuitia atu kia whakamārama a ia i te tāke kāore ia i kōrero mō ētahi atu kōwhiringa maimoa.
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Me tiro ki te mōrea o te kore whai maimoa, me te mōrea o ngā pānga weriweri mai i te taha whai maimoa. Tērā pea ka hiahia tuku pātai pēnei koe ki tō rata: “Ka roa ake taku noho ora ki te whai au i te maimoa?”, Ki te whai rānei au i te maimoa, ka puta te mōrea mō te pai o taku kounga oranga nā runga i ngā pānga weriweri o te maimoa?”, ā, “He kōwhiringa maimoa e wātea ana mōku?”
Tērā pea ka hiahia kite koe i tō rata i te maha o ngā wā i mua i tō whakataunga whakamutunga. He uaua tonu ki te pupuri i ngā kōrero katoa, ā, tērā pea ka hoki anō koe ki ētahi o aua pātai. Kei a koe te tikanga ki te mōhio, he aha ngā painga o tētahi maimoa e whakaarohia ana mōu, me te tikanga ki te whakaae atu, ki te whakahē rānei.
Mutu ana tō kōrero ki tō rata mō ngā kōwhiringa maimoa, tērā pea ka hiahia koe ki te kōrero ki tētahi atu, pērā ki te whānau, ki tētahi hoa rānei, ki ngā tapuhi mātanga, tō rata whānau, te Rōpū Matepukupuku, te tauwhiro (Social Worker) hōhipera, te minita o te hōhipera, tōu ake minita, pouārahi hāhi rānei, tētahi atu tangata kua whai wheako i te matepukupuku repeure. Mā te kōrero ki ētahi atu e āwhina i a koe ki te whiriwhiri i te huarahi pai hei whāinga mōu.
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Kei te haere tonu ngā mahi rangahau i te take e puta ai te matepukupuku repeure me ngā huarahi ki te ārai, ki te rapu, me te whakaora i te maimoa. Tērā pea ka puaki tō rata i te whakaaro kia whai koe i tētahi whakamātautau haumanu mō tōu ake momo matepukupuku.
He mea nui ngā whakamātautau haumanu hei pou kimi i ngā maimoa pai rawa atu mō te matepukupuku. Whakahaeretia ai ēnei ki te whakamātautau i ngā maimoa pai ake, ki ngā maimoa e whakahaerehia ana i nāianei. Tini tonu ngā tāngata kua uru ki ngā whakamātautau haumanu whaihua mō te whakapai ake i ngā maimoa matepukupuku, huri noa i te ao. Otirā, kei a koe tonu te tikanga i ngā wā katoa, inā hiahia koe ki te whakauru ki ngā whakamātautau haumanu.
Ki te whakauru koe ki tētahi whakamātautau haumanu, me mārama koe ki ngā take e whakahaerehia ana te whakamātautau haumanu me tōna hāngai ki tō maimoa.
During your illness you will be monitored frequently. After the completion of your treatment, you may need to have regular check-ups. Your doctor will decide how often you will need these check-ups as everyone is different. Check-ups will gradually become less frequent if you have no further problems.
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Many people worry that any pain or illness is a sign that the cancer is coming back. This is usually not the case but if you are worried about whether the cancer is going to come back, ask your doctor what to expect. You may feel less worried if you know exactly what to look out for and what you do not have to worry about.
If the cancer returns, you may need further treatment. It is important to report any new symptoms to your doctor.
You might feel worried or depressed when your treatment is over and have time to realise what has happened to you. You may find it helpful to continue in or join a cancer support group to help you through the months ahead.
Ka aroturukina auauhia koe i te wā o te mate. Ka mutu ana tō maimoa, tērā pea me kaha tonu tō haere kia tirotirohia koe. Mā tō rata e whiriwhiri te auau o tō haere kia tirohia koe nā te rerekētanga o tēnā, o tēnā e mate ana. Ā tōna wā, ka iti ake tō haere kia tirohia mēnā kāore i te ara ake anō he raruraru.
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Men react in different ways when they learn they have prostate cancer. Feelings can be muddled and change quickly. This is quite normal and there’s no right or wrong way to feel.
It may be helpful to talk about your feelings with your partner, family members and friends or with a counsellor, social worker, nurse, doctor, psychologist or your religious/spiritual adviser. Talking to other men with prostate cancer may also help.
Sometimes you may find your family and friends do not know what to say to you; they may have difficulty with their feelings as well. Some people may feel so uncomfortable they avoid you.
They may expect you to lead the way and tell them what you need. You may feel able to approach people directly and tell them what you need, or you may prefer to ask a close family member or friend to talk to other people for you.
Anyone you tell needs time to take it in and to come back with his or her questions and fears – just like you. You can help them to adjust, just as they can help you.
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But remember that while you are having treatment your needs should come first. If you do not feel like talking, say so. If there are practical things they can do to help, say so. If you cannot cope with any more visitors, say so. Some friends are better at doing something practical to help than they are at sitting and talking. Everyone is different.
When someone is diagnosed with cancer, routines and family roles may change. The person who was the major source of income might now be unable to work and may be dependent on others.
A partner who was sharing chores may now have to take on extra tasks or get a job. Maintaining your usual social life and hobbies and interests may be difficult or impossible for a while.
Cancer is not a normal event so it is important to acknowledge this and not try to carry on with everything as before. There are a number of ways that may help you cope, for example:
preparing simpler meals
being more relaxed about housekeeping standards
asking family to help more around the house.
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How much you tell children will obviously depend on how old they are. Young children need to know that it is not their fault that you have cancer. They also need to know that you may have to go into hospital.
Slightly older children can probably understand a simple explanation of what is wrong. Adolescent children can obviously understand much more. All children need to know what will happen to them while you are in hospital, who will look after them and how their daily life will be affected.
Sometimes children rebel or become quiet. Keep an eye on them or get someone else to and get help if you need it; for example, from the school counsellor or a hospital social worker, family or friends.
What do I tell the children?/He aha he korero maku ki aku tamariki? is a booklet of helpful advice for people with cancer who have children in their lives. You can receive a copy from your local Cancer Society, by phoning 0800 CANCER (226 237), or by downloading it from our website, www.cancernz.org.nz.
Local Cancer Societies provide confidential information and support. The Cancer Information Service is a Cancer Society service where you can talk about your concerns
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and needs with specially trained nurses. Call your local Cancer Society and speak to support services staff or phone 0800 CANCER (226 237). Local Cancer Society centres offer a range of services for people with cancer and their families.
These may include:
volunteer drivers providing transport to treatment
accommodation while you’re having treatment
support and education groups
volunteer support visitors.
The range of services offered differs in each region so contact your local centre to find out what is available in your area.
Cancer support groups offer mutual support and information to people with cancer and their families. It can help to talk with others who have gone through the same experience. Support groups can also offer many practical suggestions and ways of coping. Ask your hospital or local Cancer Society for information on cancer support groups in your area.
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The Prostate Cancer Foundation offers support for men with prostate problems and their families. The Foundation can be contacted on 0800 627 277.
Nursing care is available at home through district nursing or your local hospital – your doctor or hospital can arrange this.
You may be entitled to assistance with household tasks during your treatment. For information on the availability of this assistance, contact your hospital social worker or district nursing service at your local hospital.
Palliative care services may be offered by your local hospital or hospice. These services have particular expertise in dealing with pain and other symptoms, and can offer emotional support for you and your family when you are no longer receiving treatment for your cancer.
Help may be available for transport and accommodation costs if you are required to travel some distance to your medical and treatment appointments. Your treatment centre or local Cancer Society can advise you about what sort of help is available.
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Financial help may be available through your local Work and Income office. Work and Income (0800 559 009) has pamphlets and information about financial assistance for people who are unable to work. Short-term financial help is available through the Sickness Benefit and longer-term help is provided through the Invalids Benefit. Extra help may be available; for example, accommodation supplements and assistance with medical bills.
New Zealand’s Health and Disability Code states that everyone has the right to have an interpreter present during a medical consultation.
Family or friends may assist if you and your doctor do not speak the same language, but you can also ask your doctor to provide an interpreter if using family members is inappropriate or not possible.
He maha ngā tauhohenga (reactions) rerekē ka puta inā ka mōhio te tāne kua pā he matepukupuku repeure. Ka pōraru te ngākau, ka tērā te huri. He āhua tēnei ka puta i te nuinga o te wā, ehara i te mea kua takoto he kōrero mō te tika, mō te hē rānei o te putanga ngākau.
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He pai te kōrero mō ō kare ā-roto me tō hoa, tō whānau, ō hoa, tētahi poutohutohu, tētahi tauwhiro, tētahi tapuhi, tētahi rata, kaimātai hinengaro, ki tō pouārahi hāhi/wairua hoki. Tērā pea he pai ki te kōrero ki ētahi atu tāne whai i te matepukupuku repeure.
I ētahi wā, tērā pea kāore tō whānau me ō hoa e mōhio he aha he kōrero, hei kōrero ki a koe; tērā pea kei te taumaha hoki ō rātou ngākau. Tērā pea ka nui te manawarau o ētahi, ka huri rātou ki te karo i a koe. Tērā pea kei te tiaki kē rātou kia kōrero kē koe mō ōu hiahia i te tuatahi. Tērā pea ka āhei koe ki te kōrero hāngai atu ki a rātou mō ōu hiahia, ki te kōrero rānei ki tētahi o te whānau, tō hoa rānei, hei kawe kōrero mōu.
Me āhei ngā tāngata ka kōrero atu koe, ki te whai wā ki te hoki mai ki a koe me ō rātou pātai, ō rātou wehi rānei – pērā ki a koe. Ka āhei koe ki te āwhina i a rātou kia waia, pērā i tā rātou āwhina i a koe kia waia? Heoi anō rā, kia maumahara, ko ōu hiahia kē te mea nui i te wā e whai ana koe i ngā maimoa. Ki te kore koe e hiahia kōrero, me whāki atu. Ki te hōhā koe i te maha o ngā manuhiri, whāki atu. He pai ake ētahi hoa ki te āwhina ā-ringa, ki te noho noa iho, pahupahu haere ai. He rerekē ngā tāngata katoa.
Kāore e kore ka huri ngā whakahaerenga me ngā kawenga whānau i te wā e puta ai te matepukupuku ki tētahi. Tērā pea ko ia e whiwhi matua ana i ngā moni utu, te tangata kua kore e āhei ki te mahi, kua whakawhirinaki ki ētahi atu.
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Tērā pea ka taka ngā mahi ki te hoa, ka mate rānei te hoa āwhina ki te kimi mahi. Ka uaua, kāore e taea rānei, te whai kia rite tonu tō toiora pāpori me ō runaruna.
Ehara te matepukupuku i te takahanga noa iho, nā reira he mea nui ki te maumahara i tēnei, ā, kaua hoki e whai kia rite ngā mea katoa ki te wā e pai ana koe. He maha tonu ngā huarahi hei āwhina i a koe, pērā ki:
te whakarite kai māmā ake te tunu
te noho pārore ake e pā ana ki ngā paerewa tiaki whare
te tono i tō whānau kia nui ake te āwhina i a koe mō ngā mahi o te whare.
Many people feel that there is nothing they can do when they are told they have cancer. They feel out of control and helpless for a while. However, there are practical ways you can help yourself.
A balanced, nutritious diet will help to keep you as well as possible and cope with any side effects of treatment. The Cancer Society’s booklet called Eating Well/Kia Pai te Kai gives useful advice and recipes.
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Phone your local Cancer Society office or call 0800 CANCER (226 237) for a copy of this booklet, or download the booklet from our website at www.cancernz.org.nz. The hospital will also have a dietitian who can help.
Food safety is of special concern to cancer patients, especially during treatment, which may suppress immune function. To make food as safe as possible it is recommended that patients follow the guidelines below:
Wash your hands before eating.
Keep all aspects of food preparation clean, including washing hands before preparing food and washing fruit and vegetables.
Keep raw meats separate from cooked food.
Handle raw meat, fish, poultry and eggs with care and clean thoroughly any surfaces that have been in contact with these foods.
Cook meat, poultry and fish thoroughly and use pasteurized milk and juices.
Refrigerate food promptly to minimise bacterial growth.
When eating in restaurants avoid foods that may have bacterial contamination, such as sushi and raw or undercooked meats, fish, poultry and eggs, and food from salad bars.
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If there is any concern about the purity of your water, for example, if you have well water, have it checked for bacterial content.
Many people find regular exercise helps. Research has indicated that people who remain active cope better with their treatment. It is important to find an exercise that suits you. Talk to your health professional for suggestions.
Some people find relaxation or meditation helps them to feel better. The hospital social worker, nurse or Cancer Society will know whether the hospital runs any relaxation programmes, or may be able to advise you on local community programmes.
Complementary therapy is a term used to describe any treatment or therapy that is not part of the conventional treatment of a disease. It includes things like:
acupuncture
relaxation therapy/meditation
yoga
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positive imagery
spiritual healing/cultural healing
art
aromatherapy/massage.
Complementary methods are not given to cure disease, but they may help control symptoms and improve wellbeing. Alternative therapy is a term used to describe any treatment or therapy that may be offered as an alternative to conventional treatments. It includes things like:
homeopathy
naturopathy
Chinese herbs.
Alternative treatments are sometimes promoted as cancer cures. However, they are unproven, as they may not have been scientifically tested or, if tested, they were found to be ineffective.
It is important to let your doctor know if you are taking any complementary or alternative therapies because some treatments may be harmful if they are taken at the same time as conventional treatments.
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If you feel uncomfortable or unsure about your treatment, it is important that you discuss any concerns with those involved in your care, including your general practitioner.
A man may have continence problems after a radical prostatectomy. This is usually temporary. Very few people continue to have significant incontinence on a long-term basis.
Kegel exercises that involve exercising the muscles of the pelvic floor help many men regain bladder control after prostate surgery. It is advisable to start these exercises before starting treatment as normal sensations may be confused for several weeks afterwards.
Ask your doctor, a nurse or a physiotherapist for information about pelvic floor exercises. In some areas there are specialist continence advisory nurses. Rarely, men may need further surgery to implant an artificial sphincter (shut-off valve) if incontinence persists or worsens.
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He maha ngā tāngata e mahara ana kāore e taea e rātou he aha ka whakamohiotia atu ana kei te pāngia ki te matepukupuku. Kua mahara rātou kua kore ō rātou mana whakahaere, kua paraheahea mō te wā. Heoi anō rā, arā tonu ētahi huarahi whaikiko hei āwhina i a koe.
Ka āwhina te matairārangi kai kaiora, whārite hoki, kia noho pai ai koe ki tērā e taea ana e koe, me te tū pakari ki ngā pānga weriweri kei te taha o ngā maimoa. He whaikiko ngā tohutohu me ngā tohutaka kei roto i te pukapuka a te Rōpū Matepukupuku e kīia ana ko te Eating Well/Kia Pai te Kai.
Waea atu ki tari o te Rōpū Matepukupuku ki tō rohe, me waea atu rānei ki 0800 CANCER (226 237) mō tētahi tārua o tēnei pukapuka, me tango ake rānei i te paetukutuku www.cancernz.org.nz. Kei te hōhipera tētahi matanga-ō hei āwhina.
He mea nui rawa atu te haumaru kai mō ngā tūroro matepukupuku, tae noa ki te wā o te maimoa, i te mea kei kaupēhi i te kawenga ārai mate. Kia noho haumaru ai te kai, me whai ngā tūroro matepukupuku i ngā aratohu i raro ake nei:
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Horoia ō ringaringa i mua i te kai.
Kia noho mā katoa ngā āhuatanga mō te taka kai, tae noa ki te horoi ringaringa i mua i te taka kai me te horoi i ngā huarākau me ngā huawhenua.
Me āta nanao i te mīti mata, ika mata, me te heihei mata me te āta horoi i ngā wāhi kua pā atu ēnei kai. Me noho wehe ngā mīti mata i ngā mīti māoa.
Me kaha te tunu i te mīti, te heihei me te ika, me te inu i te miraka pasteurised me ngā wairanu.
Kia tere tonu te whakamātao kai hei whakaiti ake i te tipu o te kitakita.
I ngā wā kai ki roto i ngā wharekai me karo i te kai tērā pea ka whai tāhawahawa kitakita, pērā ki te sushi, ki te mīti mata, ika mata, heihei mata me te hēki mata, tae noa ki ngā kai mai i ngā wāhi kai huamata.
Whakaritea kia tirohia tō wai mō te kaha o te kitakita i roto, mehemea he māharahara ōu mō te pai o te wai, pērā ki te poka wai.
He maha ngā tāngata e kite ana i te pai o te mahi korikori auau. E tohu ana ngā rangahau, ka pai ake te maimoa mō te maha o ngā tāngata mehemea kei te kori tinana rātou. He mea nui te kimi kori tinana pai mōu. Me kōrero ki tō ngaio hauora mō ētahi whakaaro.
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He kōrero te haumanu rerekē mō ngā maimoa me ngā haumanu kāore i te whai i ngā āhuatanga motuhake mō te maimoa i te tahumaero. Tae noa ki ngā ahuatanga pēnei:
te acupuncture
te haumanu pāroretanga/whakamanatūria
te yoga
te whakaataata pai
te whakaoranga wairua/ whakaoranga ahurea
te toi
te aromatherapy/te mirimiri.
Kāore e hoatuna ngā huarahi tautoko, huarahi rerekē hei whakaora mate, heoi, tērā pea ka āwhina ki te tiaki i ngā tohumate me te whakapai ake i te toiora. He kīanga ēnei kupu hei kōrero mō te maimoa, mō te haumanu ka whakaratoa hei kōwhiringa haumanu ake, i tua atu i ngā maimoa ōkawa.
Anei ētahi:
homeopathy
naturopathy
amiami hainamana (Chinese herbs).
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Whakatairangatia ai ngā maimoa rerekē hei kaupapa whakaoranga matepukupuku. Heoi rā, kāore anō i pono ēnei i te mea kāore anō i whakamātauria ā-pūtaiao, Mehemea i whakamātauria, kua kitea kē kāore he hua.
He mea nui ki te whakamōhio atu i tō rata mehemea kei te whai koe i tētahi maimoa tautoko, rerekē hoki, inā hoki, he takakino mēnā ka whāia i te wā e whai ana koe i tētahi maimoatanga motuhake.
Tērā pea ka puta he raruraru mimi turuturu mō te tāne i muri mai i te pokanga raho wāwāhi tikanga. He rangitahi noa iho tēnei. Itiiti noa iho ngā tāngata ka raruraru i te mimi turuturu mō te wā roa.
He āwhina pai ngā korikori Kegel e whakamahi ana i ngā uaua o te papatoiake. He nui tonu ngā tāne kua hoki mai te kaha ki te pupuri i te mimi, whai muri mai i te hāparapara repeure.
He pai te tīmata i ngā mahi kori tinana i mua i te tīmatatanga o ngā maimoa kia kore ai e pōraruraru, i te mea ka kōroiroi ngā āhuatanga mō te maha o ngā wiki whaimuri mai.
Uiuitia tō rata, tētahi tapuhi, tētahi kaikōmirimiri rānei e pā ana ki ngā mahi korikori papatoiake i runga i te papa. Kua tū he tapuhi mātanga kaitohutohu mimi turuturu ki ētahi takiwā. Itiiti noa iho ngā tāne e matea ana kia hoki tuarua ki te whakatō sphincter tāwhaiwhai (he katirere) i te mea e ngana ana tonu te raruraru mimi turuturu.
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Men who have had treatment for prostate cancer may experience changes in their sexual functioning and fertility. Ask your doctor what is likely to be the outcome in your case.
It is often assumed that sexual intercourse involves the successful penetration of one’s partner and that this is the only way to achieve the pleasure of an orgasm. However, men can still enjoy a sexual relationship and have an orgasm without the need to have an erection or achieve penetration. Men may find it difficult to talk to their partners for fear of failure or rejection but these fears are often mistaken. Sexual relationships are built on many things like love, trust and common experiences.
Following radical prostatectomy or radical radiotherapy a man will no longer ejaculate semen so he will have a ‘dry’ orgasm. Some men say this feels totally normal, while others say the orgasm does not feel as strong, long lasting or pleasurable.
Sexual partners need to develop different skills to achieve a non-penetrative orgasm. It will probably take longer to reach an orgasm, which means there will be more time to enjoy the mutual pleasures of intimate bodily contact. This is often dismissed as foreplay when penetrative sexual intercourse is seen as the goal of sexual activity.
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Keep in mind that no matter what kind of cancer treatment you have, you will almost always be able to feel pleasure from touching.
There are practical ways to help overcome impotence, including:
Physical devices such as vacuum pumps and constriction rings can help you to achieve and maintain an erection.
Drug treatments, such as:
injections given straight into the penis to achieve an erection work on many men
oral drugs, such as Viagra, Cialis or Levitra are options to discuss with your doctor. These drugs cannot be used by men who take nitrate-based medicine for heart problems.
If you find the loss of your sex life or changes in your sex life disturbing you should discuss this with your doctors and, if you are in a relationship, with your partner. It may be helpful to have some sexual counselling – ask your specialist, your GP or your local Cancer Society if there are any counsellors in your area who specialise in sexual counselling. There may also be a specialist impotence advisory service in your area where you can discuss treatment options. Talking to another man who has had this experience following treatment for prostate cancer may be helpful.
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You may find the Cancer Society’s booklet Sexuality and Cancer/Hokakatanga me te Mate Pukupuku helpful. You can obtain it from your local Cancer Society, by phoning 0800 CANCER (226 237), or by downloading it from our website at www.cancernz.org.nz.
Tērā pea ka puta mai ngā wheako rerekē e pā ana ki ngā āhuatanga ai me te kikiri (fertility). Uiuitia tō rata e pā ana ki ngā āhuatanga tērā pea ka puta mōu.
Whakaarohia rawa te mahi ai ko te mahi ekeeke i tō hoa, ā, koinei anake te huarahi ki te whai kia puta te whakahari o te tokomauri (orgasm). Oti rā, ka taea tonu e te tāne te uru ki ngā hononga hōkaka me te whai tokomauri ahakoa kāore i tora te ure, kāore hoki i taea te ekeeke. He uaua mō ngā tāne ki te kōrero ki ō rātou hoa i te mea he mataku nō rātou kei ākiritia rātou, heoi anō rā, e hē ana te whakaaro pēnei. He nui ngā taha hanganga o te hononga hōkaka pērā ki te aroha, te pono me ngā wheako maha.
I muri mai i te hāparapara wāwāhi tikanga, i te hāparapara haumanu iraruke rānei, kua kore te tāne e āhei ki te tupere, ki te tuha waitātea, nā reira ka maroke kē te tupere. Ki ētahi, he pai noa iho tēnei, ki ētahi atu kāore i pai te tupere, kāore i kaha te tuha, kāore i roa rawa, ā, kāore hoki i tino reka.
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Me whakapakari pūkenga hōu ētahi hoa moe kia taea ai te tupere me te kore ai. Tērā pea ka āhua roa ake te puta o te tupere, nā reira ko te tikanga ka roa ake te wā mō te awhiawhi me te tuku i ngā āhuatanga hōkaka pērā ki te whakapiripiri o ngā tinana.
Me maumahara, ahakoa he aha te maimoa matepukupuku e whai ana koe, ka rongo koe i te pai me te whakahari o ngā mahi pā tinana.
He huarahi anō mō te whakaeke i te paraheanga, tae noa:
ki ngā taputapu pērā ki te papu hororē (vacuum pumps) ngā rīngi kukutitanga hei āwhina kia noho tora tō ure.
te maimoa whakapōauau, pērā ki:
ngā werohanga hāngai ki te ure kia puta ai te tora o te ure o ngā tāne.
ngā whakapōauau ā-waha pērā ki te Viagra, Cialis me te Levitra rānei ngā kōwhiringa hei kōrero me tō rata. Kāore i te pai kia whakamahia ēnei e ngā tāne e kai ana i ngā rongoa pākawa mō te raruraru manawa.
Mehemea kei te raruraru tonu koe mō te kore āhei ki te ai, me kōrero koe ki tō rata, ā, mehemea he hoa tōu, tērā pea me whai tohutohu hōkaka – uiuitia tō mātanga, tō rata, te tari Rōpū Matepukupuku tata ki a koe mehemea he kaitohutohu kei roto i tō rohe e hāngai ana ki ngā mahi tohutohu ā-hōkaka – pātaitia tō rata, ā, mehemea kei roto koe i tētahi hononga, me kōrero hoki ki tō hoa.
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Tērā pea he ratonga tohutohu paraheanga mātanga kei tō rohe hei matapaki i ngā kōwhiringa maimoa. Tērā pea me whakawhirinaki atu koe ki tētahi tāne whai wheako whaimuri i ōna maimoatanga hei āwhina i a koe.
Tērā pea he āwhina te pukapuka a te Manatōpū Matepukupuku e kīia ana ko te Sexuality and Cancer/ Hōkakatanga me te Matepukupuku. Ka taea tēnei mai i te Rōpū Matepukupuku i tō rohe, mā te waea atu rānei ki te nama 0800 CANCER (226 237), mā te tango ake rānei mai i tō matou paetukutuku www.cancernz.org.nz.
Ask as many questions as you want to. It’s easy to forget the questions you want to ask when you see your specialist or nurse, so write them down as you think of them and take your list with you to your appointment. Here are some questions you may like to ask:
What type of cancer do I have?
How extensive is my cancer? What stage is it?
What treatment do you advise for my cancer and why?
Are there other treatment choices for me?
What are the risks and possible side effects of each treatment?
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How long will the treatment take? Will I have to stay in hospital?
If I need further treatment, what will it be like and when will it begin?
How much will it cost if I decide to be treated privately?
How frequent will my check-ups be and what will they involve?
Will I be able to continue working? If not, when will I be able to return to work?
When can I drive again?
Will the treatment affect my sexual relationships?
Will the treatment affect my fertility?
Will I be affected by incontinence?
If I choose not to have treatment either now or in the future, what services are available to help me?
Are there any problems I should watch out for?
I would like to have a second opinion. Can you refer me to someone else?
Is my cancer hereditary?
If there are answers you do not understand, feel comfortable to say:
“Can you explain that again?”
“I am not sure what you mean by…”
“Would you draw a diagram, or write it down?”
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Kia kaha te tuku pātai. He māmā noa iho te wareware i ngā pātai ka tae atu ana koe ki te kite i tō mātanga, tō tapuhi rānei, nā reira me tuhi kē koe i ō pātai i te wā puta ai, kātahi ka hari i ō tuhinga pātai i te wā e haere anō koe ki te whai tohutohu, Anei ētahi pātai tērā pea ka hiahia koe ki te whai:
He aha te momo matepukupuku kua pā ki a au?
Pēhea rawa te kaha o taku matepukupuku? Kei tēhea wāhanga?
He aha te maimoa e whakaarotia ana e koe mō taku matepukupuku?
He kōwhiringa maimoa atu anō e wātea ana mōku?
He aha ngā mōrea me ngā pānga weriweri i te taha o ngā maimoa?
Pēhea te roa o te maimoatanga? Me noho au ki te hōhipera?
Mehemea me hoki anō au mō ētahi maimoa, ka pēhea te haere, āhea tīmata ai?
E hia te utu mehemea ka huri au ki te whai maimoa i te tūmataiti?
He aha te auau o ngā hui tirotiro i a au, a, ka pēhea te haere?
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Ka taea tonu e ahau te haere ki te mahi? Ki te kore, āhea rā anō?
Ā hea au ka āhei ki te taraiwa anō?
Ka puta he painga ki ōku hononga hōkakatanga nā runga i te maimoa?
Ka pā he raruraru ki taku paraheatanga nā te maimoa?
Ka pā te raruraru mimi turuturu ki a au nā te maimoa?
Ki te kore au e hiahia whai maimoa i nāianei, ā kō ake rānei, he aha ngā ratonga e wātea ana hei āwhina i a au?
He aha ngā raruraru me tūpato au?
E hiahia ana ahau kia tirohia e tētahi atu. Ka taea e koe te tohu i a au ki tētahi atu?
I heke mai te matepukupuku ki a au mai i ōku tīpuna?
Mehemea kāore koe i te mārama ki ētahi whakautu, kaua e mataku ki te ki:
“Ka taea e koe te whakamārama mai anō?”
“Kāore au i te mārama ki tō kōrero?”
“Ka taea e koe te tā pikitia, te tuhi mai rānei?”
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This booklet is part of a series called Understanding Cancer, which is published by the Cancer Society. These booklets, and booklets from the Living with Cancer series can be viewed and downloaded from our website, www.cancernz.org.nz.
The following websites also have information on prostate cancer:
Cancer BACKUP (UK) www.cancerbackup.org.uk
Cancer Council of New South Wales www.cancercouncil.com.au
Cancer Council Victoria (Australia) www.cancervic.org.au
Lions Australian Prostate Cancer www.prostatehealth.org.au
National Cancer Institute (USA) www.cancer.gov/cancerinfo
Prostate Cancer Foundation of New Zealand www.prostate.org.nz
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The suggested websites are not maintained by the Cancer Society of New Zealand. We only suggest sites we believe offer credible and responsible information, but we cannot guarantee that the information on such websites is correct, up-to-date or evidence-based medical information.
We suggest you discuss any information you find with your cancer care health professionals.
benign – a tumour that is not malignant, not cancerous and won’t spread to other parts of the body.
benign prostatic hyperplasia (BPH) – a non-cancerous enlargement of the prostate gland.
biopsy(ies) – the removal of a small sample of tissue from the body for examination under a microscope to help in diagnosing a disease.
bladder – hollow organ that stores urine.
brachytherapy – a form of radiation therapy where the radiation source is placed into the area of the body being treated.
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cells – the ‘building blocks’ of the body. A human is made of millions of cells, which are adapted for different functions. Cells are able to reproduce themselves exactly, unless they are abnormal or damaged, as are cancer cells.
computerised tomography (CT) scan – a technique for constructing pictures from cross sections of the body, by X-raying the part of the body to be examined from many different angles.
differentiation – medical term used to describe how closely cancer cells resemble normal cells.
digital rectal examination (DRE) – a way to diagnose prostate abnormalities: the doctor puts a gloved finger into your rectum and feels the prostate through the rectum wall.
genes – the template or pattern that governs the way the body’s cells grow and behave. Each person has a set of many thousands of genes inherited from both parents. Genes are found in most cells of the body (red blood cells do not have genes).
Gleason Score – a system for grading prostate cancer tumours according to size and appearance.
grading – refers to the differentiation of cancer cells when examined under the microscope.
impotence – inability to have an erection.
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lymph nodes / lymph vessels / lymphatic system – lymph nodes are small, bean-shaped structures which are part of the lymphatic system.
The lymphatic system is part of the immune system, which protects the body against ‘invaders’, like bacteria and parasites. It is a network of small lymph nodes connected by very thin lymph vessels, which branch into every part of the body. The lymph nodes filter the lymph to remove bacteria and other harmful agents, such as cancer cells.
malignant – a tumour that is cancerous and will spread if it is not treated.
metastasis – when cancer has spread from the original site to another part of the body. It can also be called secondary cancer.
orchidectomy/orchiectomy – surgical removal of the testes (testicles).
pelvic lymph node dissection – surgical removal of some lymph glands for dissection to determine if the cancer has spread.
prostate-specific antigen (PSA) – a protein normally produced by prostate cells. Tests of PSA levels are used in the diagnoses and monitoring of prostate cancer. This involves a simple blood test.
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prostatitis – an inflammation of the prostate.
radiation therapy – the use of particular forms of radiation, usually X-rays or gamma rays, to kill cancer cells.
radical prostatectomy – the surgical removal of the prostate gland.
rectum – the last 12-15 cm of the large bowel leading to the outside of the body.
resectoscope – an instrument to remove tissue that causes obstruction in the bladder or urethra.
testes (testicles) – two egg-shaped glands that produce semen and sex hormones.
testosterone – a male sex hormone produced by the testes which stimulates male sexual activity and the growth of other sex organs including the prostate.
transrectal ultrasound (TRUS) – an ultrasound probe is inserted into the rectum so that ultrasound scans of the prostate can be made.
transurethral resection of the prostate (TURP) – surgery via the urethra to remove blockages in the urinary tract.
tumour – a new or abnormal growth of tissue in or on the body, which may be benign or malignant.
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urethra – tube that carries urine from the bladder and semen from the sex glands to the outside of the body via the penis.
urinary catheter – artificial tube inserted to drain urine from the bladder into a collecting bag.
urinary incontinence – loss of bladder control, or urinary leaking.
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You may wish to use this space to write down any questions for, or advice given by, your doctors, nurses or health providers at your next appointment.
Whakamahia tēnei wāhi wātea hei tuhi pātai e hiahia ana koe ki te pātai i tō rata, ngā tapuhi, ngā kaiwhakarato hauora rānei mō te wā e hoki atu ai koe.
Transcriber's Note: Blank page for your notes. End of Note.
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National Office
P.O. Box 12700, Wellington 6011
Telephone: (04) 494-7270
Auckland Division
PO Box 1724, Auckland 1140
Telephone: (09) 308-0160
Covering: Northland
Waikato/Bay of Plenty Division
PO Box 134, Hamilton 3240
Telephone: (07) 838-2027
Covering: Tauranga, Rotorua, Taupo, Thames and Waikato
Central Districts Division
PO Box 5096, Palmerston North 4441
Telephone: (06) 364-8989
Covering: Taranaki, Wanganui, Manawatu, Hawke’s Bay and Gisborne/East Coast
Wellington Division
52 Riddiford Street, Wellington 6021
Telephone: (04) 389-8421
Covering: Marlborough, Nelson, Wairarapa and Wellington
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Canterbury/West Coast Division
PO Box 13450, Christchurch 8141
Telephone: (03) 379-5835
Covering: South Canterbury, West Coast, Ashburton
Otago/Southland Division
PO Box 6258, Dunedin 9059
Telephone: (03) 477-7447
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Prostate Cancer / Matepukupuku Repeure
We would like to read what you thought of this booklet, whether you found it helpful or not. If you would like to give us your feedback please fill out this questionnaire, cut it out, and send it to the Editor at the address at the bottom of the following page.
Transcriber's Note: Blank areas for you to fill in are indicated by the word blank. Tick boxes are indicated by the words (Tick box). End of Note.
1. Did you find this booklet helpful?
Yes (Tick box)
No (Tick box)
Please give reason(s) for your answer: blank
2. Did you find the booklet easy to understand?
Yes (Tick box)
No (Tick box)
Please give reason(s) for your answer. blank
3. Did you have any questions not answered in the booklet?
Yes (Tick box)
No (Tick box)
If yes, what were they? blank
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4. What did you like the most about the booklet? blank
5. What did you like the least about the booklet? blank
6. Any other comments? blank
Personal information (optional)
Are you a person with cancer, or a friend/relative/whānau? blank
Gender: Female (Tick box); Male (Tick box)
Age: blank
Ethnicity (please specify): blank
Thank you for helping us review this booklet. The Editorial Team will record your feedback when it arrives, and consider it when this booklet is reviewed for its next edition.
Please return to: The Editor, Cancer Society of New Zealand, PO Box 12700, Wellington.
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The Cancer Society of New Zealand offers information and support services to people with cancer and their families. Printed materials are available on specific cancers and treatments. Information on living with cancer is also available.
The Cancer Society is a major funder of cancer research in New Zealand. The aim of research is to determine the causes, prevention and effective methods of treating various types of cancer.
The Society also undertakes health promotion through programmes such as those encouraging SunSmart behaviour, eating well, being physically active and discouraging smoking.
The Cancer Society receives no direct financial support from Government so funding comes only from donations, legacies and bequests. You can make a donation by phoning 0900 31 111, through our website, or by contacting your local Cancer Society.
The Cancer Society would like to thank for their reviews, advice and contributions:
Professor Brett Delahunt - Deputy Dean and Chairman of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, Wellington
Associate Professor David Lamb - Blood and Cancer Centre, Wellington Hospital, Wellington
Dr Frank Kueppers - Urologist, Christchurch Hospital, Christchurch
Associate Professor Chris Atkinson - Medical Oncologist, Oncology Service, Christchurch Hospital, Christchurch and the Cancer Society of New Zealand’s Medical Director
Meg Biggs, Julie Holt and Liz Wright - Cancer Society Information Nurses
Sarah Stacy-Baynes - Editor
We also thank the people who have experienced cancer, review editions and offer many valuable suggestions.
Cancer affects New Zealanders from all walks of life, and all regions of our beautiful country. This cover photo of flowering Pohutukawa trees in Woody Bay was taken by Rob Suisted.
Many thanks to the Cancer Society volunteers who agreed to be photographed for our booklets covers.
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For cancer information and support phone 0800 CANCER (226 237)
www.cancernz.org.nz