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Prostate Cancer

Prostate cancer is the most common type of cancer in men (other than skin cancer). Prostate cancer occurs when cancerous cells grow in the prostate gland, a walnut-shaped organ located below the bladder in males which aids in the development of semen. Prostate cancer can be treated most effectively when it is detected early through routine screening.

Skyline Urology recommends a PSA blood test for men age 40 along with annual digital rectal exams. Please speak to your physician to discuss your risk factors for prostate cancer and the appropriate screening recommendations for you.

SYMPTOMS:

There are no symptoms for early prostate cancer. This is why it is very important to get a PSA blood test regularly as well as a digital rectal exam.

RISK FACTORS:

  • Family history of prostate cancer
  • African American ethnicity
  • Age
  • Obesity

EVALUATION AND DIAGNOSTIC TESTING:

Once suspected the following tests may be done to evaluate whether cancer is present:

  • Digital rectal exam
  • PSA
  • Biopsy
  • Bone scans to see if it has spread
  • Transrectal ultrasound
  • CT scan
  • MRI

TREATMENT:

Treatment of prostate cancer depends on the stage of the disease, the type of cancer and the patients age and overall health. Treatment options include medications, surgery, chemotherapy and radiation. In some cases, treatments are combined.

  • Watchful Waiting: a period of time monitored by the physician to determine any sudden progression of the disease, to signal the need for more aggressive treatment. This is used only on patients who are elderly, in poor health or with early stage cancer.
  • Hormone Therapy: uses surgical removal of the testicles or hormone injections called LHRH analogs, which block production of testosterone. Common hormone therapy drugs: Viadur®, Vantas®, Eligard®, Lupron®, Trelstar® 

Radiation Therapy

Radiation Therapy uses high-energy x-rays to destroy cancer cells. 

  • Brachytherapy: approximately 80-100 radioactive seeds, each the size of a grain of rice, are permanently implanted directly into the prostate. These seeds emit gamma rays which in turn kill cancerous cells within the prostate. 
  • Intensity Modulated Radiation Therapy (IMRT): the latest form of external beam radiation therapy (EBRT) whereby x-rays are created within a linear accelerator (LINAC) and directed to the prostate gland from multiple angles. IMRT allows for high doses of radiation to be given to the prostate (improving the chance of cure) while minimizing the radiation to the surrounding structures (decreasing the chance of complications) 
  • Image Guided Radiation Treatment (IGRT): because the prostate gland moves, it is important that we know where it is and ensure it is within the target area. Many technologies are able to do locate the prostate prior to treatment but only Calypso can continue to monitor the prostate's position during treatment.

Depending on the stage of the disease, the surgery options are:

  • Cryosurgery: is a minimally invasive surgery, which uses a probe to twice rapidly freezing and thawing the cancerous tissue.
  • Radical Prostatectomy: is the removal of the entire prostate during surgery.
  • DaVinci Radical Prostatectomy uses a state-of-the-art robotic system to make incisions and to remove the cancerous prostate. 
  • Laproscopic Radical Prostatectomy uses conventional laparoscopic instruments to remove the cancerous prostate. 
  • Open Retropubic or Perineal Prostatectomy uses conventional open techniques and instruments to remove the cancerous prostate.
  • Lymphadenectomy: is the surgical removal of the lymph nodes by open and/or laparoscopic due to prostate cancer spreading to the surrounding tissue.