Prostate cancer is a disease in which cells in the prostate gland
become abnormal and start to grow uncontrollably, forming tumors. It is the second-leading cause of cancer deaths among men in the United States. However, when detected in its early stages, prostate cancer can be effectively treated and cured. Factors such as age, family history and a diet high in fat may increase the risk for developing prostate cancer. It is more common in men over age 50 and African-American men. There are usually no symptoms of prostate cancer in the early stages.
Two tests are commonly used to help detect prostate cancer:
• One is the digital rectal exam (DRE), in which a doctor examines the prostate through the rectum to find hard or lumpy areas known as nodules.
• The other is a blood test used to detect a substance made by the prostate called “prostate-specific antigen” (PSA). Elevated PSA readings can be a sign of prostate cancer.
These are not perfect tests. Many men with a mildly elevated PSA do not have prostate cancer, and men with prostate cancer may have normal PSA levels. Also, the digital rectal exam does not detect all prostate cancers. The most comprehensive way to detect prostate cancer is to use both the PSA test and DRE.
Prostate cancer can only be definitively diagnosed by performing a biopsy, in which a small sample of your prostate tissue is removed and examined under a microscope to identify abnormal cancer cells. The urologists in our clinic perform the prostate biopsy in our procedure clinics using local anesthesia. This is also offered with general sedation through outpatient surgery.
Prostate cancer treatment depends on several factors, including:
• How advanced the cancer is
• Your health and other medical conditions
• Your age and life expectancy
• The potential side effects of treatment
Prostate cancer can be treated with watchful waiting, hormone therapy, radiation therapy, chemotherapy or surgery:
• Watchful waiting is often the preferred treatment for men who have slow-growing cancers or limited life expectancy due to age or medical conditions. This involves regular checkups and monitoring of cancer growth. Active treatment may be recommended if symptoms worsen.
• Hormone therapy aims to control prostate cancer by limiting the supply of hormones that cancer cells need to grow, particularly testosterone. It is typically used in more advanced cases of prostate cancer.
• Brachytherapy is a type of internal radiation in which radioactive material in the form of “seeds” is placed into or near a tumor in the prostate gland. With this procedure, high doses of radiation can be delivered to the immediate area of the tumor, minimizing damage to nearby tissues.
• Chemotherapy uses drugs to slow or reverse the spread of prostate cancer in advanced cases. The drugs are injected into the bloodstream and poison the rapidly dividing cancer cells.
• Intensity-modulated radiation therapy (IMRT) is an advanced method of high-precision radiotherapy that uses computer-controlled X-ray accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor
• Surgery is typically performed when tumors are still confined inside the prostate during early stages of prostate cancer. Surgery is intended to remove all cancerous tissue and cure the cancer. Surgical options include the following:
Open radical prostatectomy is a major surgical procedure to remove the entire prostate, along with both seminal vesicles and other surrounding tissues, including a section of the urethra and part of the sphincter muscle. Radical prostatectomy is a recommended treatment option for patients whose cancer is localized, or confined to the prostate, and for younger patients who have a high-grade tumor.
• Da Vinci Robotic surgery uses small laparoscopic instruments that are inserted through small incisions in the abdomen to dissect and remove the cancerous prostate gland. This procedure is less painful and requires a shorter period of recovery than radical prostatectomy but achieves the same level of cancer control.
• Cryosurgery is less invasive than traditional surgery, involving only a small incision or insertion through the skin, and uses liquid argon gas to destroy cancerous tissue. For years, cryosurgery has been used to treat skin cancers. Now, physicians are using the procedure in cancer treatment of the liver, prostate, pancreas and kidney.