September is Prostate Cancer Awareness Month. Because of the prevalence of prostate cancer, awareness is important.

Prostate cancer is the second most common cancer in American men, behind skin cancer. The American Cancer Society estimates that almost 200,000 new cases of prostate cancer will be diagnosed during 2020. 1 in 9 men will be diagnosed within his lifetime.

Prostate cancer is more likely to develop in African American men and older men. About 60 percent of cases are diagnosed in men 65 or older. Prostate cancer is rare in men under 40. The average age at diagnosis is 66.

Over 30,000 men will die from prostate cancer during 2020, the American Cancer Society estimates. More men die from prostate cancer than any other cancer except for lung cancer. About 1 man in 41 will die of prostate cancer.

Though those statistics seem dismal, most men with prostate cancer don’t die from it. More than three million men in the United States who were diagnosed with prostate cancer are still alive today. Early detection, when the cancer is caught early by screening, increases the chances of surviving prostate cancer.

Prostate Cancer Screening

Early detection helps improve the chances of surviving prostate cancer. Men should begin prostate cancer screening at 40. It has two parts.

First is the Prostate Specific Antigen (PSA) blood test. Blood is drawn from your arm and analyzed in a lab to detect the levels of PSA. PSA is a protein made by normal and cancerous cells in the prostate gland. The higher the level of PSA in the blood, the more likely it is that prostate cancer is present. Other conditions can elevate PSA.

The second part of prostate screening is a digital rectal exam (DRE). During the DRE, a doctor checks the prostate gland for abnormalities, bumps, and hard areas that may be cancer. To do this, a doctor inserts a gloved, lubricated finger into the rectum. Though a DRE may be uncomfortable, it’s usually painless and very quick.

Both parts of the prostate screening are essential as they provide valuable data to your urologist. Having both tests provides a more complete view of your health to your urologist.

Results of the screening are unique to each patient based on his age and other factors. There is no standard result that indicates cancer. Your urologist will review your results. If they indicate an elevated likelihood of cancer, your urologistwill recommend additional testing.

Screening Guidelines

Comprehensive Urologic Care recommends the following screening guidelines:

Age

Screening Recommendation

Under 40 Not recommended.
40 – 49 Recommended at least once in your forties to determine baseline. Frequency determined by your doctor based on your results and risk factors.
50 – 69 Recommended yearly unless your doctor suggests a different frequency.
70+ Recommended for men with more than 10 years of life expectancy. Frequency determined by your doctor. Not recommended for men with less than 10 years of life expectancy

When a Biopsy is Needed

A biopsy is the only way to know with certainty if a man has prostate cancer. If your urologist thinks you might have prostate cancer, they will do a biopsy. Small samples of the prostate are removed during a biopsy. A pathologist uses a microscope to examine the sample. The pathologist is looking for anything that indicates cancer. A biopsy can be done in a urologist’s office or an outpatient surgery center.

Fusion Biopsy

Comprehensive Urologic Care now offers the Fusion Biopsy. This is the most advanced biopsy technique for accurate prostate cancer detection and diagnosis. A Fusion Biopsy allows for precise targeting of suspicious areas. This increases the chances of catching high-risk cancer.

Treatment for Prostate Cancer

All prostate cancers are different. Treatment is best when it’s tailored to the individual. Options for treatment include active surveillance, radical prostatectomy, radiation therapy, cryotherapy, and androgen deprivation.

Active Surveillance

Not all prostate cancers require immediate treatment. Instead, they can be monitored, which includes regular PSA screenings, DRE, and prostate biopsies. Active surveillance allows for a better quality of life. If there is evidence of the cancer progressing, treatment is offered. This type of treatment requires an early diagnosis of cancer.

Radical Prostatectomy

During a prostatectomy, the prostate gland, seminal vesicles, and associate tissues are removed. A prostatectomy can be performed with the da Vinci robot or in an open procedure. Because cancer cells are often scattered throughout in an unpredictable manner, the entire prostate gland must be removed. When surgery is done robotically, patients have great outcomes, including a shorter hospital stay, less postoperative pain, and faster return of urinary continence. Our surgeons have performed over 1,000 robotic prostatectomies with excellent results.

Radiation Therapy

For this treatment, high energy x-rays are used to kill cancer cells. There are different ways of delivering radiation therapy.

  • Intensity Modulated Radiation Therapy and Image Guided Radiation Therapy (IMRT and IGRT). During this treatment, radiation energy is conformed to the tumor. Patients undergo IMRT and IGRT five days a week for eight weeks. Each treatment lasts only a few minutes. While being treated, the prostate and surrounding structures are imaged daily to allow for a more precise, focused treatment.
  • Brachytherapy. During a short outpatient surgical procedure, small radioactive seeds are implanted into the prostate. They gradually release radiation and destroy cancer cells.
  • Proton Therapy. This radiation therapy focuses a different form of energy than x-rays on the prostate.

Androgen Deprivation

Prostate cancer grows in the presence of testosterone, a hormone produced in the testicles. Androgen deprivation uses medications to lower or block the effects of testosterone. This causes cancer to shrink or slow in its growth. These medications are typically given via injection. While androgen deprivation can’t cure prostate cancer, it can extend a patient’s life. It’s used when cancer recurs or sometimes to supplement radiation therapy.

Deciding on Prostate Cancer Treatment

Treatment for cancer takes into consideration the uniqueness of every patient and every cancer. Treatment decisions factor in age, medical history, cancer grade and stage, and treatment goals. Interested in discussing prostate cancer and treatment options? Ready for your first or your due for your next prostate screening? Schedule an appointment today.

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