Tablished by biopsy, the extent of cancer spread can be determined via the following tests: ct scan (computer tomography scan); bone scan (because prostate cancer usually metastasizes into the bones – vertebral column, pelvis femur (thigh bone); mri – magnetic resonance imaging, can be performed to closely evaluate the prostate capsule and whether the adjacent seminal vesicles are invaded. viagra no prescription   as with all carcinomas, following the above work-up for diagnosing the aggressiveness of the tumor (gleason score) and the extend of the tumor spread, the ‘stage’ of the tumor will be determined, which will help to decide on the appropriate form of treatment and help to define the prognosis. viagra daily use vs 36 hour This is usually done by the tnm system, where: t – stands for tumor and is divided into several subcategories, from tx (tumor cannot be assessed) to t0, t1 and t2 cancers, which are still confined within the prostate tissue, whereas t3 and t4 express the extend of spread beyond the prostate;    n – stands for (lymph) nodes, from nx (cannot be evaluated) to n1, n2 and n3, depending on the  size and number of lymph nodes involved; m – stands for metastasis, with mx (cannot be assessed), m0 for no distant metastasis and m1 (a, b and c) describing metastases in various close or distant organs. buy viagra canada   the tnm stage is important for deciding on the most appropriate form of therapy. viagra 5 mg indications   treatment: therapy has to be decided upon each individual, as age, grade and stage of the cancer have to be considered. viagra coupon   thus, if the patient is in advanced age and the cancer a small low grade cancer, close surveillance via the psa test (and possibly repeated biopsies over time) may be the most desirable form of treatment. what does the generic viagra pill look like   in younger patients, there are a number of treatment options available, again, depending on the gleason grade and clinical stage of the tumor: surgery – ‘radical prostatectomy’, may be the treatment of choice, if the cancer is confined to the prostate gland and has not yet penetrated the boundaries of the prostate. buy viagra   the surgery includes the removal of the entire gland including its capsule, surrounding tissue and seminal vesicles. viagra practical jokes   this operation carries a high risk of subsequent permanent impotence as well as loss of bladder control with urinary incontinence and even loss of bowel control. viagra 100mg sildenafil Radiation therapy – may be done prior to surgery, in order to shrink the tumor mass, after surge. generic viagra buy viagra canada