What is Prostate Cancer?
The prostate is a small walnut-shaped gland in males that uses male hormones called androgens, such as testosterone and dihydrotestosterone (DHT), to trigger and maintain male sex characteristics and reproduction. Prostate cancer begins when cells in the prostate gland start to grow out of control.
Other than skin cancer, prostate cancer is the most common cancer in American men. According to the American Cancer Society (ACS), about one man in nine will be diagnosed with prostate cancer during his lifetime.
In many cases, prostate cancer is a slow-growing cancer that does not spread beyond the prostate gland before the time of diagnosis. However, some cases are more aggressive and need more urgent treatment. Prostate cancer that is detected early, when it is still confined to the prostate gland, has the best chance for successful treatment.
Researchers have found several factors that might affect a man’s risk of getting prostate cancer, including:
- Age – Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About six in ten cases of prostate cancer are found in men older than 65.
- Race/ethnicity – Prostate cancer occurs more often in African-American men and Caribbean men of African ancestry than in men of other races. African-American men are also more than twice as likely to die of prostate cancer as white men.
- Family history – Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease.
While there are a lot of risk factors for prostate cancer, there are also good survival statistics associated with the disease. It can be a serious condition, but most men diagnosed with prostate cancer do not die from it. Survival rates for prostate cancer are very high. The ACS estimates that more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.
Early prostate cancer usually causes no symptoms. More advanced prostate cancer can sometimes cause symptoms such as:
- Trouble urinating
- Decreased force in the stream of urine
- Blood in the urine
- Blood in the semen
- Pain in the hips or back
- Erectile dysfunction
- Weight loss
Because these symptoms may overlap with those of other conditions, it is important to get the correct diagnosis to find the right treatment. Make an appointment with your primary care physician or urologist if you are experiencing persistent signs and symptoms that concern you.
As with all cancers, the most important component in the fight against prostate cancer is detecting it as early as possible. The ACS recommends prostate cancer screening times at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65)
- Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age
The first step in screening for prostate cancer is usually a prostate-specific antigen (PSA) test, in which a small amount of blood is drawn from the arm and the level of PSA, a protein made by the prostate, is measured.
If the initial PSA result is abnormal, another option might be to get another type of test(s) to help you and your doctor get a better idea if you might have prostate cancer (and therefore need a biopsy). Some of the tests that might be done include:
- A digital rectal exam (DRE), if it hasn’t been done already
- One or more of the other special types of PSA tests, such as the Prostate Health Index (PHI), 4Kscore test, or percent-free PSA, or other lab tests, such as the ExoDx Prostate (IntelliScore)
- An imaging test of the prostate gland, such as MRI or transrectal ultrasound (TRUS)
If the initial abnormal test was a DRE, the next step is typically to get a PSA blood test (and possibly other tests, such as a TRUS).
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
There are numerous benefits of prostate cancer screening. Finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects and the disease is often curable with early detection. Columbus CyberKnife advocates screening for prostate cancer and encourages patients to discuss PSA testing with their physician to better understand the benefits and risks associated with the screening.
Learn more about the prostate cancer screening guidelines at Mount Carmel, as well as get a phone number for a physician referral, here.
Thanks to advancements in research and treatment methods, men diagnosed with prostate cancer have more options and resources available to them than ever before.
Whether you or a loved one has been newly diagnosed with prostate cancer, talking to your doctor to learn more about the disease and treatments that are right for you is an important first step. You have many treatment choices and learning about the different prostate cancer treatment options will help you make the right decisions for you. Become informed and take control by:
- Asking questions
- Doing your own research
- Seeking a second opinion
- Finding out how different treatments can affect your health and lifestyle
Below is an overview of some current treatment options for prostate cancer. It’s important to learn more about the various risks and benefits of each option.
- Surgery – If prostate cancer hasn’t spread outside the gland, invasive surgery is often used to remove the prostate.
- Brachytherapy – Also known as internal radiation therapy, brachytherapy uses small radioactive pellets, or “seeds,” that are placed directly into the prostate to deliver radiation over a period of several months.
- Stereotactic Body Radiation Therapy (SBRT) – This treatment method uses advanced image guidance software to deliver high-dose radiation to the prostate cancer with sub-millimeter accuracy. Treatment is completed in five or fewer outpatient sessions and results in less radiation exposure to surrounding healthy tissue.
At Columbus CyberKnife, we treat prostate cancer with SBRT using the CyberKnife® Robotic Radiosurgery System. The CyberKnife System painlessly delivers precise beams of radiation to prostate tumors, without requiring incisions, hospitalization, or a long recovery time. It is a prostate cancer treatment technology in which high-dose radiation is delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm. Hundreds of different angles enable the radiation to be contoured to the shape of the prostate, resulting in treatment aimed directly at the prostate gland, avoiding nearby critical anatomy. This precision reduces treatment time to just five outpatient visits, compared to the average 45 visits conventional radiation therapy requires.
CyberKnife is a widely used form of nonsurgical prostate cancer treatment. It serves as an effective treatment for prostate cancer, working within cancer cells to limit their ability to multiply and spread. The American Society for Radiation Oncology (ASTRO) believes that enough clinical evidence exists so that SBRT should be considered an appropriate treatment option for select patients with low- to intermediate-risk prostate cancer. CyberKnife is designed to avoid healthy tissue and critical anatomy, therefore reducing side effects such as erectile dysfunction, urinary, and bowel complications.
- Outpatient procedure, no anesthesia or hospitalization required
- Shorter and more convenient course of radiation – only 5 treatments vs. 45 with conventional radiation
- Noninvasive, no incisions needed
- Typically pain-free treatment
- Reaches prostate tumors from virtually unlimited directions with robotic mobility
- Targets individual prostate tumors with pinpoint accuracy
- Enables clinicians to maximize and conform the dose to the prostate tumor
- Constantly corrects for patient/tumor movement throughout treatment, ensuring radiation beams are always locked on tumor during treatment
- Minimal radiation exposure to healthy tissue surrounding the prostate tumor
- Little to no recovery time and almost immediate return to your normal daily activities
- Minimal, if any, side effects due to pinpoint precision of high-dose radiation delivery
- Patients treated with the CyberKnife System may be candidates for re-treatment or re-irradiation with the CyberKnife System, in the event of a recurrence.