Prostate cancer is the type of cancer that forms in the tissues of the prostate — a small gland in the male reproductive system. It is the most common type of cancer among men in the United States. According to the National Cancer Institute, an estimated 233,000 new cases will be diagnosed this year.
Signs of prostate cancer include problems related to urination due to the growth of the prostate gland. Symptoms can include trouble with passing urine, urinating more frequently during the day and Nocturia — excessive urination during the night. In many cases, no symptoms will be present.
Physicians will administer a number of tests to detect abnormalities and diagnose prostate cancer.
A rectal exam will assess whether the prostate gland feels abnormal or has a nodule on either side. The PSA test measures the blood level of PSA, a protein that is produced by the prostate gland. The higher a man's PSA level, the more likely it is that he has prostate cancer. Ultrasounds and biopsies may also be performed.
A Gleason score is given to the cancer based upon its microscopic appearance on the biopsy. Cancers with a higher Gleason score are more aggressive and will have a poorer prognosis.
Once diagnosed, the risk factors of the patient will be evaluated and the patient will be placed into one of the following groups: low-risk, intermediate-risk or high-risk. Three main factors are taken into consideration when determining the proper category for a patient — a digital rectal exam (DRE), PSA score and Gleason score.
There are many treatment options available to patients diagnosed with prostate cancer. The risk factors as well as the overall life expectancy of the patient will be taken into consideration to help determine the best treatment option. If patients are identified as high-risk, further testing such as a CT Scan, bone scans or MRI might be necessary.
The most popular forms of treatment for patients with prostate cancer include active surveillance, radiation therapy, surgery and hormone therapy.
Active surveillance is often used for patients deemed low-risk. No cancer treatment is provided during surveillance, but the doctor closely monitors the cancer for any changes.
Radiation therapy and surgery are equally effective, so the course of treatment is generally the patient's choice. With external beam radiation, using image guidance and intensity modulated radiation therapy, the cancer will be treated daily with radiation localized to the cancer in the prostate by a radiation oncologist.
There are a number of options for patients choosing surgery. Robotic prostate surgery is the surgical method of choice and involves removing the entire prostate gland to eliminate the cancer.
Androgen deprivation therapy (ADT) is a form of treatment often used for patients considered intermediate or high-risk. The goal is to reduce levels of male hormones, called androgens, and to prevent them from reaching prostate cancer cells.
If you believe that you may suffer from some indicators of prostate cancer, follow up with your primary care physician.
Dr. Richard Matter is with KentuckyOne Radiation Oncology.