Prostate Cancer

Prostate Cancer Evaluation at Southland Urology

Prostate cancer is one of the most common cancers among men, developing in the prostate gland, which is located below the bladder. The disease often grows slowly and may not cause symptoms in its early stages, which is why regular screenings are crucial for early detection. When caught early, prostate cancer is highly treatable, and a variety of treatment options are available depending on the stage and aggressiveness of the cancer.

Understanding Prostate Cancer

What is Prostate Cancer?

Prostate cancer is a malignant tumor that forms in the cells of the prostate gland. The prostate is a small, walnut-shaped gland that produces seminal fluid, which nourishes and transports sperm. Most prostate cancers are adenocarcinomas, which means they develop from the gland cells. While it can be a serious disease, most cases are slow-growing and remain confined to the prostate gland, where treatment is very effective. However, some types are more aggressive and can spread to other parts of the body, a process called metastasis.

Risk Factors and Early Detection

The exact cause of prostate cancer is not fully understood, but several factors are known to increase a man’s risk. The primary risk factors are age, as the risk increases significantly after age 50, and family history. Men with a father or brother who had prostate cancer are at a higher risk. Race also plays a role, with African-American men having a higher incidence and mortality rate. Because the disease often presents with no symptoms in its early stages, early detection is critical. The two primary screening tools are the Prostate-Specific Antigen (PSA) blood test and the Digital Rectal Exam (DRE).

Common Symptoms

While early-stage prostate cancer may be asymptomatic, symptoms can appear as the cancer progresses. These symptoms are often related to the tumor pressing on the urethra or spreading to nearby areas. Common signs include frequent urination (especially at night), a weak or interrupted urinary stream, blood in the urine or semen, and pain or burning during urination. Advanced prostate cancer can cause bone pain (in the back, hips, or pelvis) if the cancer has spread to the bones. It’s important to note that many of these symptoms can also be caused by non-cancerous conditions like benign prostatic hyperplasia (BPH).

Diagnosis

If a PSA test or DRE suggests an abnormality, further diagnostic tests will be performed. A prostate biopsy is the definitive way to diagnose prostate cancer. During a biopsy, a urologist uses a needle to take small tissue samples from the prostate, which are then analyzed by a pathologist for the presence of cancer cells. If cancer is found, the pathologist will assign a Gleason score, which helps determine how aggressive the cancer is. Imaging tests like an MRI, CT scan, or bone scan may be used to determine the stage of the cancer and if it has spread.

Non-Surgical Treatment Options

For low-risk, early-stage prostate cancer, many men opt for active surveillance, which involves closely monitoring the cancer with regular PSA tests, DREs, and biopsies. This approach avoids the potential side effects of treatment while ensuring the cancer is caught if it becomes more aggressive. Other non-surgical options include radiation therapy, which uses high-energy rays to kill cancer cells, and hormone therapy, which aims to lower the level of male hormones that fuel cancer growth. For advanced or metastatic cancer, chemotherapy and targeted therapy may be used.

Surgical Treatment Options

Surgery is a common and effective treatment for prostate cancer, particularly for cancers that are contained within the gland. The most common surgical procedure is a radical prostatectomy, which involves the complete removal of the prostate gland and some surrounding tissue. This procedure can be performed as an open surgery or, more commonly, as a minimally invasive robotic-assisted laparoscopic prostatectomy. Robotic surgery offers benefits like a shorter hospital stay, less pain, and a quicker recovery time. For men with locally advanced prostate cancer, surgery may be combined with other treatments, such as radiation therapy.