Prostate cancer – which develops in the walnut-sized gland located just below the bladder – is the second most common cancer in men, after skin cancer. It’s a slow-growing cancer that most often affects men over age 65, and it’s highly treatable when diagnosed early.
Prevention and detection
What causes prostate cancer is still unknown, so it’s not considered preventable. But some factors increase a man’s risk of prostate cancer, including:
- Age – The risk of developing prostate cancer increases steadily after men reach age 50. About 60 percent of cases arise in men older than 65.
- Ethnicity – African-American men and Caribbean men of African ancestry have a significantly higher risk of developing prostate cancer than do men of other races.
- Family history of prostate cancer
- Genetic variations
Talk to your doctor about your risk factors to determine when prostate cancer screening is right for you. Screening tests take place in the doctor’s office and include a PSA (prostate-specific antigen) blood test and a digital rectal exam (DRE).
By measuring the level of PSA in the blood stream, your doctor can detect possible indicators of early stage disease. With a DRE, we can identify any physical abnormalities of the prostate that could be signs of cancerous growths.
Normal results from these two exams can help reassure you that it’s unlikely you have prostate cancer, or abnormal results will let doctors know they need to perform a biopsy.
Diagnosis
If you experience abnormal results from a PSA test or DRE, a biopsy is the only way to get an accurate diagnosis. Many doctors will perform an ultrasound-guided biopsy to diagnose prostate cancer, but this procedure can result in completely missed or poorly staged prostate tumors because the sampling is systematic versus targeted.
A new technology available at UT Southwestern combines ultrasound with magnetic resonance imaging (MRI) for a more targeted biopsy and a more accurate diagnosis. Combining these two imaging techniques gives us a clearer picture of the prostate so we can see suspicious areas better and retrieve biopsy samples directly from them.
A specialized pathologist studies the tissue samples, and if cancer is detected, the pathologist will stage and grade the tumor. A tumor’s stage describes its size and if it has spread. The grade is a measure of how quickly the tumor is likely to grow and spread.
Treatment options
The stage and grade of the prostate cancer tumor play an important role in determining the right treatment path, as do a patient’s age, overall health, and personal preferences.
Not all prostate cancers require immediate treatment. If your tumor is very slow growing, your doctor may recommend ongoing surveillance of your tumor and treatment only if it grows or changes.
When prostate cancer requires treatment, your doctor will discuss the options with you. You may require one or more treatments, and the order of the treatments depends on your particular situation.
Treatment options include:
- Surgery – A radical prostatectomy is a surgical procedure to remove the prostate. It can be done minimally invasively by a urologist with or without the use of a surgical robot.
- Radiation therapy – This technique, performed by a radiation oncology team, uses high-energy rays (radiation beams) to kill the prostate cancer cells.
- Medical treatment – Medical treatment, administered by a medical oncology team, includes chemotherapy (the use of cancer-killing drugs), hormone therapy to reduce the level of male hormones in the body, an immunotherapy treatment called Sipuleucel-T, and drugs to prevent the spread of cancer to the bones.
In addition, clinical trials give eligible prostate cancer patients access to the most promising new therapies, often years before they are available to the public.
Life beyond cancer
Following treatment for prostate cancer, many men will be able to get back to their normal lives. However, you may experience side effects including erectile dysfunction, incontinence issues, or anxiety about the cancer returning or getting worse.
Talk to your health care team about the risk of side effects or any that you may be experiencing. Treatments are available, as are support services, so you never have to feel unsure or alone during your cancer journey and beyond.
