Prostate cancer is the most common cancer in American men. It is diagnosed in 200,000 men each year. It occurs when some cells in the prostate become abnormal. Nearly all prostate cancers start in the gland cells.
Prostate cancer screening involves a rectal exam and a simple blood test for a protein called prostate specific antigen, or PSA. PSA is produced by the normal prostate, but can be produced at higher levels and at a more rapid rate by a prostate with cancer.
Annual screening is recommended for all men once they reach age 50. Men at higher risk, including those with a family history of prostate cancer or men of African-American descent, are recommended to begin screening at age 45. Based on the results of the two screenings, a decision is made regarding the degree of risk for harboring prostate cancer.
Screening and early treatment have increased survival rates in recent years.
Prostate cancer may not cause any signs or symptoms at its earliest stage. It is often detected on a blood test for a protein called prostate specific antigen, or PSA. Some men may develop a lump in the prostate gland which may be felt during a routine digital rectal exam.
Some men may experience changes in urinary or sexual function and should see their physician to evaluate the condition. These symptoms may include:
- The need to urinate frequently, especially at night
- Difficulty starting urination or holding back urine
- Weak or interrupted flow of urine
- Painful or burning urination
- Blood in the urine or semen
- Frequent pain or stiffness in the lower back, hips or upper thighs
- Difficulty in having an erection
- Painful ejaculation
If prostate cancer is suspected, a TRUS biopsy may be recommended. This ultrasound-guided biopsy can be used to diagnose prostate cancer in patients with an abnormal digital rectal exam or elevated PSA. This office-based procedure performed under local anesthetic in about 10 minutes is very well tolerated.
If cancer is diagnosed, the next step is to establish the “stage.” Staging includes the PSA level, result of the rectal exam, and grade or aggressiveness of the cancer determined by the biopsy. Staging may also include the results of radiographic imaging to help determine if there is any spread of the cancer to other organs.
Treatment is tailored to each patient. Options may include observation or “watchful waiting” for older men with low-grade and slow-growing tumors, medical therapies, radiation and surgery. The treatment decision should be made with a urologist, but may also include consultation with a family doctor and radiation oncologist. St. Luke’s offers advanced options for prostate cancer, including robotic prostatectomy.
Treatment options for prostate cancer may include the following:
- Robotic Prostatectomy
- Radiation Therapy
- External Beam Radiation Therapy (EBRT)
- Intensity Modulated Radiation Therapy (IMRT)
- Promising Therapies and Clinical Trials
The minimally-invasive robotic prostatectomy is the most advanced, minimally invasive surgical option for qualified prostate cancer patients. It results in small incisions, decreased pain, significant reduction in blood loss and faster recovery. While this technique provides excellent cancer control, it simultaneously improves quality of life by sparing nerves for erectile function and preserving the bladder control mechanism, further decreasing the risk of urinary incontinence.
For additional information on programs, services and locations, download and print the following PDFs: