Prostate cancer

Prostate cancer is caused by the abnormal growth of cells in the prostate, a walnut-sized gland that is part of the male reproductive system. As abnormal cells grow, they may form a tumor and can attack nearby tissues. It is important to know, however, that certain symptoms of prostate cancer can also be caused by other noncancerous conditions, including benign prostatic hyperplasia (BPH) and prostatitis.

Because of this discrepancy, it is important to talk with your doctor to discuss your personal level of risk and whether you need to be screened. While we may not know exactly what causes prostate cancer, the following factors may increase your risk of developing the disease:

• Age — Prostate cancer occurs most often in men older than age 65. It occurs in about one in 14 men between the ages of 60 and 69.
• Family history — If men in your family have had prostate cancer, you may have a high risk of developing prostate cancer yourself. If you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2), or a very strong family history of breast cancer, your risk of prostate cancer may also be higher.
• Obesity — Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.
• Race — African American men carry a greater risk of prostate cancer than men of other races.

Located below the bladder and in front of the rectum, the prostate has many functions in the body, including secreting prostate specific antigen (PSA), aiding in urine control and producing seminal fluid that nourishes and transports sperm. As you get older, these functions become more vulnerable to complications, making it progressively more important to be proactive and speak with your doctor about prostate cancer screenings.

If you are between the ages of 40 and 54, you should begin speaking in earnest with your doctor about screenings, particularly once they have covered the recommended guidelines, including uncertainties, risks and potential benefits. For men with an average risk of developing prostate cancer, the greatest benefit occurs between the ages of 55 and 69. Screening tests you may encounter include:

• Digital rectal examination (DRE) — In a digital rectal exam, or, traditional prostate exam, your doctor inserts a gloved finger into your rectum to inspect your prostate. They can feel if there are any hard lumps on your prostate gland that could be tumors.
• PSA testing — This blood test detects your levels of PSA, a protein produced by the prostate.

If it is determined that you have cancer, our prostate cancer specialists will conduct a physical and a biopsy before reviewing your symptoms, medical history and family history. Upon review, if additional testing is required, you may receive one or more of the following:

• Genetic testing of hereditary genes for cancer
• Genomic testing of prostate tissue
• Prostate magnetic resonance imaging (MRI)
• Transrectal ultrasound
• Tumor biomarker test

Prostate cancer treatment is guided by the stage and grade of your condition. We bring together surgical, medical and radiation oncologists to administer single, dual or additional combinations of therapies — whatever you need. Regardless of the severity of your condition, you can be confident that you are receiving the highest level of care.

Early-stage prostate cancer treatment

If the cancer is small and localized, there are a few treatment options your doctor may recommend. These can range from surgical to minimally invasive, to completely noninvasive.

Active surveillance

Active surveillance involves regular monitoring by your doctor, examining your PSA blood levels, as well as your prostate through regular physical exams. However, taking this route involves no immediate treatment. It is mainly for low grade prostate cancer, which is likely not to cause you much harm.

Radiation therapy for prostate cancer

Radiation therapy uses X-rays to destroy cancer cells and shrink tumors. Our therapists specialize by tumor type, using advanced technologies and radiation treatments, including focused ultrasound. They also coordinate care with your surgeon, medical oncologist, navigator and primary care physician to ensure precise and accurate treatment. There are three primary types of radiation therapy, including:

• Brachytherapy — This involves your doctor implanting radioactive seeds into the prostate to deliver targeted radiation treatment.
• Conformal radiation therapy — This treatment shapes radiation beams so that they target the precise cancer area, minimizing the risk to healthy tissue.
• Intensity modulated radiation therapy (IMRT) — While similar to conformal radiation therapy, IMRT is able to use radioactive beams with varying degrees of intensity.

Prostate cancer surgery

Surgery may be recommended to remove the prostate, a procedure called a radical prostatectomy. If your condition requires surgery, our surgeons use advanced robot-assisted techniques, allowing them to perform complex surgical procedures through smaller incisions. These surgical methods afford you less pain, faster recovery times and shorter hospital stays.

Advanced-stage prostate cancer treatment

As cancer grows, it can spread throughout the body. If it spreads or comes back after remission, your treatment options may change. We typically use two treatment methods for advanced-stage cancers, including:

• Chemotherapy — This type of cancer treatment uses drugs to destroy cancer cells, and may be used in combination with radiation therapy and other treatments.
• Hormonal therapy — Androgens are male hormones. The main androgens are testosterone and dihydrotestosterone. Blocking or reducing these hormones appears to stop or delay the growth of cancer cells.

We understand a cancer diagnosis can be overwhelming. That’s why we offer comprehensive support services to ensure we meet your educational, nutritional and psychological needs.