About Prostate Cancer
According to the National Cancer Institute, prostate cancer is the second-most common type of cancer among men in the United States.
- Prostate cancer strikes 1 in 7 males in their lifetimes
- Nearly 233,000 patients in the United States will be diagnosed with prostate cancer in the next year1
- Men over 45 years of age are most at risk and although rare, younger men can get the disease
- The risk rises dramatically as you age, especially for those 65 years and older
- With early diagnosis and treatment, survival rates are over 90%
- Early recovery of continence (bladder control) and erectile potency is possible and with the latest medical advancements, probable
1National Cancer Institute, http://www.cancer.gov/cancertopics/types/prostate, accessed Jan. 5, 2014.
Published data suggests that one of the most important factors to beating prostate cancer is early diagnosis and accurate treatment by experienced physicians and surgeons. Florida Hospital Global Robotics Institute (GRI) maintains one of the most experienced, world-class medical teams for urologic cancer in the country.
Understanding and Detecting the Disease
Before choosing a treatment, it’s important to understand the disease and research all treatment options available to you.
The prostate is an organ at the base of the bladder where the urethra, which is used for urine flow, goes through. Left untreated, prostate cancer can lead to symptoms such as erectile disfunction, loss of bladder control and pain when urinating. It may also metastasize, spreading cancer cells to other parts of the body.
The American Urological Association does not recommend screening in men under the age of 40. Men between the ages of 40 to 54 with the average risk of developing prostate cancer are also not recommended for routine screening. Men between the ages of 55 to 69 should weigh the potential harms of screening with the benefits, considering that prostate cancer mortality is prevented in 1 in every 1,000 men who are screened over a decade. In men who decide to be screened, based on their values and preferences, routine intervals of two years or more are recommended. Finally, routine PSA screening in men 70 years and above, or any man with less than a 10 to 15 year life expectancy, is not recommended.
The Florida Hospital Cancer Institute, with the American Urological Association and American Cancer Society’s recommendations in mind, developed the following guidelines. At age 40, men with a life expectancy greater than 10 to 15 years should be considered for prostate screening. Doctors should assist patients in making the decision using the following risk categories. Very high risk men with more than one first degree relative diagnosed with prostate cancer should begin the screening conversation at age 40. High risk men, who are either African American or have one first degree relative with prostate cancer diagnosed before age 65, should begin the conversation at 45. Men with average risk should begin the conversation at age 50. Men who have a life expectancy less than 10 to 15 years should not be screened. The Florida Hospital Cancer Institute states that screenings should include a PSA blood test and digital rectal exam and the interval of these tests should be discussed with each patient.
If a PSA score comes back high or a lump is found during the digital exam, the doctor will likely recommend lab tests and an ultrasound biopsy be taken of the prostate. The biopsy is performed via the rectum and is the only way to prove if there is cancer in the prostate. If there is, a Gleason Score is assigned based on the aggressiveness of the cancer found. Together with the lab tests, PSA results and stage of cancer observed, these help the doctor make recommendations for treatment.
Prostate Cancer Risk Factors
- Age: This is the main risk factor for prostate cancer. It is rare in men younger than 45 years old. However, with advanced screening, we have diagnosed and treated men as young as 30. The chance of getting prostate cancer goes up sharply as a man gets older. In the United States, most men with prostate cancer are over 65 years old.
- Family History: Risk is higher if his father or brother had prostate cancer.
- Race: Prostate cancer is more common in African American men than in white and Hispanic men. It is less common in Asian and Native American men.
- Certain Prostate Changes: Men with high-grade prostatic intraepithelial neoplasia (PIN) prostate cells may be at increased risk. These cells look abnormal under a microscope.
- Diet: Some studies suggest that men who eat a diet high in animal fat or meat may be at increased risk. Men who eat a diet rich in fruits and vegetables may have a lower risk.
Prostate Cancer Symptoms
There are usually no symptoms in the early stages of prostate cancer. Unlike many other cancers, prostate cancer is a very slow-growing disease. In fact, you are likely have prostate cancer for years before it is even detected. That’s why it is so important to get regular prostate screenings. However, any urinary problems should be evaluated by a physician.
Call your doctor if you experience:
- Frequent urination, especially at night
- Weak urine flow
- Urine flow that starts and stops (or is difficult to start or stop)
- Pain or burning during urination
- Blood in the urine and semen
- Persistent pain in the lower back, hips and thighs
- Difficulty getting an erection
Prostate Cancer Treatment – Consider the Options
There are many factors that can impact prostate cancer treatments and the suitability of options for your cancer depend on a number of things:
- Stage and aggressiveness of your prostate cancer
- Your physical symptoms
- Your current state of health and age
- Your physiology
- Possible side effects
- Personal preference for treatments
Several treatment options are available today, all offering potential benefits and risks. These may include:
- Active Surveillance/Observation: Formerly called "watchful waiting," which includes more-frequent testing to stay on top of the progress of the disease
- Surgical Options:
- Open Prostatectomy: Traditional surgery to remove the prostate
- Laparoscopic Prostatectomy: Using special tools through small incisions to remove the prostate
- Robotic-Assisted Radical Prostatectomy: Combination of laparoscopic tools and precision robotic technology to assist surgeon
- Cryotherapy: Using the extremely cold temperatures produced by liquid nitrogen or argon gas to eradicate abnormal tissue
- Radiation Options:
- External Beam Radiation (Conformational RT, IMRT, Proton Beam RT): Very precise methods of applying radiation therapy
- Brachytherapy: Putting radioactive "seeds" directly in the prostate
- Hormone Therapy: Used to prevent the production and use of androgens. While not curative, hormones prevent the tumor from growing and are used in conjunction with radiation or surgery.
- HIFU (High Intensity-Focused Ultrasound): Uses focused sound waves to create extreme heat at a focal point to destroy abnormal tissue. HIFU is not approved by the FDA and there is no long term data on this treatment.
It is very important to consider all aspects of a procedure. Remember, there is no single, “best treatment” that applies to everyone. Each treatment must be customized to a patients’ own needs. Prostate cancer is very slow growing, so it’s important to take the time you need to get a second opinion and talk to your urologist about your treatment options before making your decision.
For more prostate cancer information or to learn about candidacy requirements for robotic prostatectomy, contact us today.