Next to skin cancer, prostate cancer is the most common cancer affecting American men. More than 2 million men in the United States – 1 in every 6 – have been diagnosed with the disease.
New Tools and Techniques Cut Treatment Time in Half for Some Patients
But the good news is that prostate cancer is highly treatable when caught early. In addition, new techniques are shortening the treatment time and minimizing side effects.
But it remains important to know your risks, know the symptoms, get regular screenings, and understand your treatment options.
Know Your Risks for Prostate Cancer
Found only in males, the prostate gland is located below the bladder and in front of the rectum. It makes some of the fluid that is part of semen. The size of the prostate changes with age. In younger men, it is about the size of a walnut, but it can be much larger in older men.
These factors can increase your risk for prostate cancer:
- African American ancestry.
- Having either a father or brother diagnosed with prostate cancer.
- Having at least 2 uncles or an uncle and grandfather on the same side of the family diagnosed with prostate cancer.
If you have any of these risk factors, talk to your family doctor. They may increase the scope and frequency of your screenings.
Know the Symptoms of Prostate Cancer
Prostate cancer symptoms typically do not appear until the cancer has advanced, but here are some things to watch for:
- Painful or burning urination.
- Inability or difficulty urinating.
- Difficulty trying to hold back urination.
- Weak or interrupted urine flow.
- Frequent or urgent need to urinate.
- Trouble emptying the bladder completely.
- Blood in the urine or semen.
- Continual pain in the lower back, pelvis, hips or thighs.
- Difficulty having an erection.
Having these symptoms does not mean you have prostate cancer. Some of the same symptoms can occur with other health problems. If you have one or more of these symptoms for more than 2 weeks, see your doctor.
Get Regular Prostate Cancer Screenings
Screenings can help find prostate cancer at an early stage when it is easier to treat. Prostate cancer can often be found early using one or both of the following tests.
- Prostate-specific antigen (PSA) test. Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. It is found mostly in semen, but a small amount is in the blood as well. A blood test measures the level of PSA circulating in the blood. A higher PSA level usually means a higher chance of having prostate cancer. Men over age 50 with very low PSA levels may need to be tested every 2 years. If your PSA is higher, the doctor may recommend more frequent testing.
- Digital rectal exam (DRE). During a DRE, your health care provider gently inserts a gloved forefinger into the rectum to feel the prostate gland for enlargement or other abnormalities, such as a lump.
For those with a higher risk, UPMC offers a Family Risk Assessment Program. A certified oncology nurse will evaluate your risk of having a hereditary cancer. They will then help you determine preventive steps and how frequently you should be monitored. The genetic testing, cancer gene testing, preventive treatments, and suggested screening schedule are shared with your family doctor.
If the result of a PSA or DRE test is abnormal, your doctor will perform a biopsy. This is the only way to confirm that you have prostate cancer. Biopsies are done as an outpatient procedure in a doctor’s office or other facility.
Your Medical Team
Today men have a number of ways to treat prostate cancer. To get the best treatment, you’ll want a cross-functional team of medical experts collaboratively working together to create an individualized treatment plan. Your team may include:
- Surgeons who use advanced tools to surgically diagnose and treat your condition.
- Radiation oncologists to provide radiation treatments.
- Medical oncologists to plan the most effective chemical and hormonal therapies.
- Nurse navigator to help coordinate all of your care needs.
- Diagnostic and interventional radiologists to help diagnose and treat your condition.
- Nutritionists to answer questions about diet and nutrition during treatment.
The Latest Prostate Cancer Treatments
Today there are many treatments for localized prostate cancer. The type of treatment you receive will depend on your risk level, your age, and any other health problems. Your doctor will take time to clearly explain your cancer, your options for treatment, and possible side effects.
Active surveillance
Because prostate cancer usually grows slowly, some men, especially those who are older or have other health problems, may never be treated for it. Instead, their doctors may recommend active surveillance, otherwise known as “watchful waiting.” If the tumor grows or changes, your doctor may recommend treatment.
Radiation treatment
Radiation is one of the most common forms of treatment, along with surgery, to ensure no cancer cells remain or spread throughout the body. During radiation, high energy beams are used to kill the cancer cells.
The newest radiation therapy techniques allow us to target tumors more precisely than ever before. Using sophisticated image-guided techniques, radiation oncologists can deliver a maximum dose to a precise location, while minimizing the impact on healthy tissue.
Standard radiation treatment for prostate cancer typically involves about 8 weeks of daily 15- to 20-minute treatments. At UPMC, we use the Cyberknife® M6™ radiosurgery platform to deliver stereotactic body radio therapy for our patients.
The machine uses a robotic arm and an x-ray tracking system. Together, they can account for and correct tiny movements by the patient, or small changes in the location of the tumor during treatment. Changes of just one millimeter can be detected and corrected. With this level of precision, very high doses of radiation can be delivered safely and treatment time can be reduced to about 5 appointments over 2 weeks for many patients.
Nerve-sparing prostatectomy
The most frequent surgical procedure to treat prostate cancer is radical prostatectomy, an operation to remove the prostate gland and some tissue around it. The surgeons who treat prostate cancer are experts at using minimally invasive robotic surgery to remove the cancer, while safeguarding the surrounding nerves that govern urinary and sexual function.
Hormone therapy
This works by blocking testosterone production or stopping testosterone from interacting with the tumor cells. This reduces the tumor size or slows its growth. While hormone therapy may help control prostate cancer, it does not cure it.
Immunotherapy
These cutting-edge treatments are designed to help a patient’s own immune system to fight the cancer.
Clinical trials
Research and clinical trials lead to better care for cancer patients. At any time, UPMC Hillman Cancer Centers statewide are involved in more than 440 clinical trials offering the latest, most innovative treatments. These studies examine new treatments, devices, and medicines for a variety of cancer types and conditions.
Different treatments have different side effects. Your doctor will talk to you about your options based on the level of disease and your overall health.
New Treatments Offer Good Odds for Recovery and Cure
Most men with prostate cancer have an excellent prognosis. And with the development of new tools and protocols, they have options for treatment that are faster and have fewer side effects.
So, take some time to talk to your doctor about your prostate health. Get your recommended screenings. And if you have any symptoms as described above, seek care right away. It could save your life.
To get a routine prostate cancer screening, contact your primary care doctor. For questions about prostate cancer treatment, contact the UPMC Hillman Cancer Center closest to you.