Prostate Cancer

Prostate cancer develops in the prostate, a small walnut-shaped gland that’s part of a man’s reproductive system. Prostate cancer is very common, affecting one out of every nine men.

Causes of Prostate Cancer #

Experts aren’t sure why some cells in the prostate gland become cancerous (malignant). Genetics appear to play a role. For example:

• You’re two to three times more likely to get prostate cancer if your father, brother or son has the disease.

• Inherited mutated (changed) breast cancer genes (BRCA1 and BRCA2) and other gene mutations contribute to a small number of prostate cancers.

Symptoms of Prostate Cancer #

• Frequent, sometimes urgent, need to urinate, especially at night.

• Weak urine flow or flow that starts and stops.

• Painful urination (dysuria).

• Fecal (bowel) incontinence.

• Painful ejaculation and erectile dysfunction (ED).

• Blood in semen (hematospermia) or urine.

• Lower back pain, hip pain and chest pain.

• Leg or feet numbness.

Diagnosis of Prostate Cancer #

Digital rectal exam #

Your provider inserts a gloved, lubricated finger into the rectum and feels the prostate gland, which sits in front of the rectum. Bumps or hard areas could indicate cancer.

Prostate-specific antigen (PSA) blood test #

The prostate gland makes a protein called protein-specific antigen (PSA). Elevated PSA levels may indicate cancer. Levels also rise if you have BPH or prostatitis.

Biopsy #

A needle biopsy to sample tissue for cancer cells is the only sure way to diagnose prostate cancer. During an MRI-guided prostate biopsy, magnetic resonance imaging (MRI) technology provides detailed images of the prostate.

Treatment of Prostate Cancer #

Active surveillance #

• With this approach, you get screenings, scans and biopsies every one to three years to monitor cancer growth.

• Active surveillance works best if the cancer is only in the prostate, slow-growing and not causing symptoms.

Watchful Waiting #

• Watchful waiting sounds similar to active surveillance, but is often used in older or frailer patients.

• Similar to active surveillance, this approach does not involve definitive treatment at diagnosis.

• However, the testing is much less frequent, and focuses on symptom management.

Brachytherapy #

A form of internal radiation therapy, brachytherapy involves placing radioactive seeds within the prostate. This approach helps preserve surrounding healthy tissue.

External beam radiation therapy #

With external beam radiation therapy, a machine delivers strong X-ray beams directly to the tumor. Intensity-modulated radiation therapy is a form of external radiation therapy that delivers powerful doses of radiation to the disease site.

Systemic therapies #

Your provider may recommend systemic therapies if cancer has spread outside of the prostate gland. These therapies include chemotherapy, androgen deprivation hormone therapy and immunotherapy.

Focal therapy #

• Focal therapy is a newer form of treatment focusing on treating only the area of the prostate affected by cancer.

• You may be able to try this treatment if cancer hasn’t spread.

• Focal therapy options include high-intensity focused ultrasound (HIFU), cryotherapy, laser ablation and photodynamic therapy.

Prostatectomy #

• This surgical procedure removes the diseased prostate gland.

• Surgeons can perform laparoscopic prostatectomy and robotic radical prostatectomy through small abdominal incisions.

• These procedures are less invasive than an open radical prostatectomy, which requires a larger abdominal incision, although both are effective in cancer removal.