Conditions and Treatments

Prostate Cancer

Prostate cancer is the second most common cancer in American men. One in 6 men will get the disease in their lifetime and an estimated one out of 35 men in the U.S. will die from prostate cancer. When detected at an early stage and localized, most prostate cancers can be cured.

RISK FACTORS

The exact causes of prostate cancer are not known. However, there are some things that have been proven to be linked to prostate cancer. You are at a higher risk for prostate cancer if

  • You are African-American
  • You are over 50 years of age
  • You have one or more first-degree relatives (father or brother) who have had prostate cancer
  • You eat large amounts of red meat

SYMPTOMS OF PROSTATE CANCER

In the early stages of prostate cancer, there usually are no symptoms. If symptoms do occur, they can include

  • Difficulty starting or holding back urine
  • The need to urinate often, especially at night
  • Weak or interrupted urine flow
  • Pain or burning during urination
  • Difficulty with having an erection
  • Painful ejaculation
  • Blood in the urine or semen
  • Pain or stiffness in the lower back, hips, pelvis or upper thighs

Since the prostate surrounds your urethra, any change in your prostate can cause problems with urination and ejaculation. These symptoms can also be caused by other diseases or disorders which are not cancerous, but only your urologists determine their cause.

DIAGNOSIS OF PROSTATE CANCER

If your screening tests show signs of a possible problem, your doctor will likely refer you to an urologist.  The urologist may recommend a prostate biopsy. Using a local anesthetic and ultrasound guidance, the urologist will insert a tiny needle into the prostate and remove a small amount of cells for laboratory testing.

If cancer is detected, additional testing such as a bone scan or a CT ultrasound may be recommended. Once prostate cancer has been diagnosed, the urologist will stage the disease to determine the extent of the cancer (i.e., the “T” stage) and whether it has spread beyond the prostate gland to the surrounding tissues. The T stage is divided into the following categories:

T1: Doctor is unable to feel the tumor or see it with imaging (e.g., Transrectal ultrasound)

T1a: Cancer is found incidentally during a transurethral resection (TURP) for benign prostatic enlargement. Cancer is present in less than 5% of the tissue removed and is low grade (Gleason < 6).

T1b: Cancer is found after TURP but is present in more than 5% of the tissue removed or is of a higher grade (Gleason > 6)

T1c: Cancer is found by needle biopsy that was done because of an elevated PSA

T2: Doctor can feel the tumor when a digital rectal exam (DRE) is performed but the tumor still appears to be confined to the prostate

T2a: Cancer is found in one half or less of only one side (left or right) of the prostate

T2b: Cancer is found in more than half of only one side (left or right) of the prostate

T2c: Cancer is found in both sides of the prostate

T3: Cancer has begun to spread outside the prostate and may involve the seminal vesicles

T3a: Cancer extends outside the prostate but not to the seminal vesicles

T3b: Cancer has spread to the seminal vesicles

T4: Cancer has spread to adjacent organs, such as the urethral sphincter, rectum and/or wall of the pelvis
You will also be given a “Gleason Score” which grades the surrounding tissue and helps the urologist predict how the cancer may progress.

TREATMENTS FOR PROSTATE CANCER

The earlier prostate cancer is detected, the more treatment options will be available to you.  Based on the prostate cancer grade and stage, your age, overall health status and personal lifestyle, your urologist will discuss treatment options with you. 

TREATMENT OPTIONS

SURGERY

A radical prostatectomy is a surgical procedure which removes the cancerous prostate gland. The high skilled and experienced urologists of Central Maryland Urology utilize the most advanced techniques to reduce side effects and surgical complications. One such technique is the state of the art, da Vinci robotic surgical system which many of our urologists at hospitals throughout metro Atlanta to perform a radical prostatectomy. Robotic assisted prostatectomy allows precise surgical removal of the prostate while preserving important structures for urinary control and sexual function.

RADIATION THERAPY

High energy rays or particles of radiation are used to kill cancer cells either by external beam or internal implantation (brachytherapy).

BRACHYTHERAPY

An outpatient procedure, performed while the patient is under anesthesia, in which tiny, radioactive seeds are placed inside the prostate gland, using ultrasound, to attack the cancer.

CRYOSURGERY

During an outpatient procedure while the patient is under anesthesia, thin needles which produce very cold sub-zero temperatures are inserted into the prostate gland using ultrasound. Freezing destroys the prostate gland and cancerous tissue. Cryotherapy can be repeated and used as a secondary treatment when other treatments fail.

HORMONE THERAPY

Used in certain cases to reduce the levels of male hormones in the body which can make the prostate cancer shrink or grow more slowly.

CHEMOTHERAPY

Used in the case of advanced disease or if the cancer is not responding to other therapy.

IMMUNOTHERAPY

Is a treatment that is designed to help the immune system (the body’s natural defense) fight disease. The immune system is made up of imune cells found in the body. These cells work as the body’s natural defense against all types of illness, including prostate cancer. PROVENGE is the only FDA- approved treatment that uses the body’s immune system to fight prostate cancer.