Prostate cancer is the second-most diagnosed cancer in men. Skin cancer is the first. Approximately 1 in 6 men will have prostate cancer during his lifetime, usually when they’re 65 or older. Advances in early detection and treatment have greatly improved survival rates — about 2.5 million men in the U.S. who have been diagnosed with this cancer are still alive today.
Prostate cancer rarely has symptoms until it reaches an advanced stage. That’s why it’s so important to see your primary care physician or urologist for a PSA (prostate-specific antigen) screening or DRE (digital rectal exam) beginning at age 50 to 55, with regular follow-up exams. If you are African-American or have a family history of prostate cancer, you should begin your screening at age 40. Screening can detect prostate cancer in the earliest, most treatable stages. Advanced prostate cancer symptoms in men may include symptoms, such as:
- Difficulty passing urine, including a slow or weak stream
- Frequent urination, especially at night
- Blood in the urine
- Trouble getting an erection
- Pain in hips, back, chest/ribs, which may indicate that cancer has spread to bones
- Weakness or numbness in the legs or feet
- Loss of bladder or bowel control from cancer that has spread and is pressing on the spinal cord.
Many other conditions can also cause these symptoms. See your urologist for an accurate diagnosis.
Keep active surveillance
For older men who have no symptoms of prostate cancer, but whose tests indicate that cancer is present, sometimes the best approach is just to keep an eye on the situation. Your urologist will closely monitor your condition and then initiate a treatment plan if the cancer begins to grow.
Minimally Invasive Surgery
- Robotic Prostatectomy
The surgeon removes the cancerous prostate with robotic technology, which is extremely precise and causes much less nerve damage than traditional surgery. This type of surgical therapy for prostate cancer also allows the surgeon to remove lymph nodes depending on the risk of lymph nodes harboring microscopic areas of prostate cancer. This decision is based on how aggressive a patient’s specific prostate cancer is.
Transurethral resection of the prostate (TURP)
This procedure allows removal of tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This is typically a type of treatment for an enlarged prostate, and is not used in an attempt to cure prostate cancer.
This fairly new, minimally-invasive treatment (also called cryosurgery or cryoablation) can treat early stage prostate cancer by freezing it. Extremely cold gases are introduced into the tumor via needles while the patient is anesthetized. There is evidence that cryosurgery is not as effective as radiation for advanced prostate tumors. Cryotherapy tends to have considerably higher rates of erectile dysfunction than radiation or radical prostatectomy, but does have a place in select patients.
- High Intensity Focused Ultrasound (HIFU)
Technology that produces pin-point-focused heat to destroy cancerous tumors. “Full HIFU” treats the entire prostate, while “focused HIFU” destroys only designated portions of the gland, leaving surrounding tissue unharmed. Studies indicate that HIFU may cause fewer/lesser side effects than other treatments.
- Intensity Modulated Radiation Therapy (IMRT)
A highly-customized treatment for prostate cancer, IMRT delivera precise radiation to the tumor while minimizing the dose of radiation to the surrounding tissue. The strength of the multiple high-energy x-ray beams can be adjusted in 3D to accommodate the size, location and stage of the cancer.
Male sex hormones can accelerate the rate of prostate cancer growth. Drugs, surgery, or other hormones are used to reduce the level of male hormones or block their function.
Chemotherapy may be an appropriate treatment option if the cancer has spread outside the prostate gland. Chemo can slow the cancer’s growth and alleviate the discomfort of some symptoms. However, chemotherapy for prostate cancer rarely cures the cancer.
Provenge® is a cancer vaccine that directs the body’s immune system to attack prostate cancer cells. It is custom-made for each man, not mass produced. It is used primarily to treat advanced prostate cancer that is not responding to initial hormone therapy.
Knowledge about the causes, prevention, detection, and treatment of prostate cancer is advancing every day.
Scientists are studying genes linked to prostate cancer to better understand how the cancer develops. This knowledge could result in drugs that target the genetic changes that cause cancer.
Research is ongoing about the preventive powers of certain foods, vitamins, minerals. Other studies are investigating the possibility that some of these substances may increase the risk of developing prostate cancer.
Researchers are working on ways to improve the PSA test to make it more accurate and better at finding prostate cancer in the earliest stages. Tests based on other tumor markers are being developed, as is a urine test that indicates the presence of a certain prostate cancer antigen.