- Wednesday, July 19, 2017
Treating Prostate Cancer
By: Dr. Brian Wade
Cancer is a term that will get everyone’s attention. Physicians at Urology Centers of Alabama (UCA) see and treat cancer every day, but we understand that for the patient this can be shocking, as well as a life altering piece of information to process. In this series, I will cover three of the most common types of cancer that we see and treat at UCA – prostate, bladder and kidney.
Prostate cancer is the most common type of cancer (other than skin) diagnosed in the United States, and the third leading cause of death. In fact, 1 in 7 men will be diagnosed with prostate cancer.The prostate is a small, walnut sized gland in the male reproductive system.As with most cancers, the key is early detection and treatment if indicated. Currently, the best method for early detection is with a yearly screening blood test called PSA and a yearly digital prostate exam. Since prostate cancer has very few early symptoms, screening continues to be the best method. The risk of prostate cancer increases with age, family history, and is frequently seen in African Americans. Most urologists recommend the first PSA test around age 40 to establish a baseline. Depending on risk factors, PSA levels can then be checked at varying time points until age 50-55, at which point yearly PSA levels should be checked.
So, what to expect if your PSA is elevated. The only way to accurately determine if you have prostate cancer is with a prostate biopsy. This is a test done in the office under light sedation. A small ultrasound probe is placed just inside the rectum and a numbing block is placed around the prostate. Once this is done, several biopsies are then taken from each side of the prostate and sent to a pathologist to look for cancer. If this test is negative, then your PSA will continue to be monitored for further elevation. One of the newer methods we now use at UCA is an MRI X-ray test if your PSA continues to rise. If this MRI shows any abnormal areas, those areas are marked for a future “targeted” biopsy. If no abnormal areas are seen, then those patients can avoid another biopsy at that time and continue to be monitored conservatively.
If your biopsy is positive for prostate cancer, your doctor will sit down with you and your family to review all of your information and to then go over your treatment options. The good news is that there are many treatment options for all stages of prostate cancer, and with the current volume of research, many more options are emerging. The advances in treatments for prostate cancer have come a long way over the last 10-15 years. We are now performing state of the art:
● Robotic prostatectomy (removal)
● Image guided radiation therapy
● Prostate seed brachytherapy
● Hormone therapy
● Advanced immunotherapy, chemotherapy, and bone health therapy
● Genetic testing to better determine risk status/possible further treatment
The key message with prostate cancer is early detection will lead to better results and chance for cure. Not all patients diagnosed with prostate cancer will need immediate therapy, but knowing that cancer is present allows you and your doctor to make an informed decision.
Another cancer that we frequently treat at Urology Centers of Alabama is Bladder Cancer. I will go into more detail in my next blog.