Aside from skin cancer, prostate cancer is the most commonly diagnosed type of malignancy in American males. Prostate cancer is especially prevalent in males over the age of 50.
The prostate is a gland that produces seminal fluid. It is approximately the size of a walnut. Prostate cancer occurs when cells within or around the gland undergo unusual changes that cause them to divide and grow in an uncontrolled manner. These excess cells cling together and create a tumor.
What is prostate cancer?
Prostate cancer involves uncontrolled cell growth in and around the prostate gland. These cells merge together to form a tumor.
Most of the time, prostate cancer is slow growing, which means that it can take years to become large enough to show up during a screening. It can take even longer to spread outside of the prostate gland. For this reason, prostate cancer is highly treatable.
Much like many other forms of cancer, the exact cause of prostate cancer is not completely understood. A variety of lifestyle and genetic factors may contribute to the development of prostate cancer.
The most prevalent risk factor for prostate cancer is age, followed closely by family history of certain types of cancers.
Symptoms of prostate cancer
In its earliest stages, prostate cancer presents few or no symptoms. This is why regular prostate exams are essential for men over the age of 40.
Once prostate cancer has progressed, it can manifest in the form of several common symptoms. These symptoms include the following:
- Frequent urination
- Painful ejaculation
- Problems stopping or starting a stream of urine
- Painful urination (burning sensation)
As prostate cancer continues to progress, it can cause even more distinct symptoms. These include blood in the urine, weakened urine flow, difficulty getting an erection, and bone pain that does not go away.
While the symptoms outlined above may be a sign of prostate cancer, they are also linked to several other conditions. If you are experiencing these symptoms, your physician will need to order several diagnostic tests to rule out other conditions and determine the underlying cause.
How is prostate cancer diagnosed?
Since prostate cancer presents few symptoms in its early stages, regular screening is essential. During your screening, a physician will be able to determine whether there is a problem with your prostate. Additional testing will be ordered to detect cancer.
Prostate Cancer Screening
Physicians use two prostate cancer screening tests. Your doctor may order either test or both of them. The prostate screening tests are:
PSA blood test
The first screening method is known as a prostate-specific antigen (PSA) blood test. Your physician will use this test to measure the levels of PSA in your blood.
If your PSA levels are elevated, then there may be an issue with your prostate. However, additional testing is often necessary to determine the exact cause of the elevated PSA levels.
Digital rectal examination
A DRE, or digital rectal examination, allows your physician to manually assess your prostate. During the DRE, they will check for any abnormal growth or enlargement in the prostate.
If your prostate is enlarged, they will likely recommend a biopsy to determine whether the abnormal cells are cancerous or benign.
Just because your physician detects an abnormality with your prostate does not mean that you have cancer. They will need to perform additional testing, which includes the following:
An ultrasound is often used to detect prostate cancer in its early stages.
During a biopsy, your physician will harvest a small portion of the abnormal cells on your prostate and send them to a lab for additional testing. The lab will determine if the cells are cancerous or not.
MRI ultrasound fusion
An MRI/ultrasound fusion combines both magnetic resonance imaging and ultrasound waves to pinpoint the exact location of your prostate so that it can be biopsied. This method ensures that your urologist harvests the abnormal cells and not a healthy portion of your prostate.
X-rays are sometimes used to check for prostate cancer. However, ultrasounds and MRIs are much more effective when prostate cancer is in the early stages.
CT scans are often only used if your urologist believes that the prostate cancer has spread to other organs. It is not as effective at viewing the prostate gland itself.
PET scans are also only used to check for cancer that has metastasized (spread outside of the prostate). It is not used to detect early-stage prostate cancer.
Stages of prostate cancer and risk assessment
Prostate cancer, like every other form of cancer, is classified in stages. It is also closely linked to several risk factors.
If you receive a positive prostate cancer diagnosis, it is important that you understand both the staging system and your personal risk factors. Both of these will impact the treatments that our team recommends.
AJCC TNM staging system
AnMed Health uses the American Joint Committee on Cancer’s TNM system. This standardized system allows us to describe how far your prostate cancer has spread. The TNM method for prostate cancer focuses on five essential criteria, which includes the following:
- The extent of the primary tumor
- Whether cancer has spread to lymph nodes
- Whether cancer has metastasized
- PSA level when diagnosed
- Grade group (Gleason score)
The grade group accounts for genetic risk factors. It will measure the chances that your cancer will spread quickly.
Using the above information, your physician will assign your cancer a stage, which ranges from one to four.
Stage 1 prostate cancer is isolated to the gland itself. This means that it has not spread to lymph nodes or other areas of the body. Patients with stage 1 prostate cancer have a PSA level of nine or less and a Gleason score of less than 7.
Prostate cancer receives this designation if it is still limited to the gland. However, stage 2 means that the patient has a PSA level of more than 10 but less than 20. Stage 2 patients also have a Gleason score of seven or more.
During stage 3, prostate cancer may or may not have spread outside of the prostate gland. If the PSA level is at 20 or higher and cancer has not left the gland, then it is classified as stage 3.
Prostate cancer that has spread beyond the outer layer of the gland but has not reached the lymph nodes will also be listed as stage 3.
Stage 4 prostate cancer has reached nearby lymph nodes or further areas of the body. This may include distant organs or bones. The PSA levels and Gleason scores do not influence grading once the prostate cancer has metastasized.
There are several established risk factors that show a strong connection to prostate cancer. These include the following:
- Being over 65 years old
- Having a brother, son, or father that has been diagnosed with prostate cancer
- Eating a diet lacking in fruits and vegetables but high in red meat
There are additional genetic risk factors, as well. For instance, if you have a close blood relative that developed breast or ovarian cancer before the age of 50, then you have an elevated risk of contracting prostate cancer.
Additionally, if you have two relatives that have developed breast, ovarian, or prostate cancer at any age, then your risk may be elevated.
AnMed Health offers genetic counseling to patients that have genetic risk factors for prostate cancer. This counseling is designed to help you and your family adapt to the physical and psychological implications of this genetic risk.
Prostate cancer treatments
There are a wide array of prostate cancer treatments available through AnMed Health. Our physicians design custom treatment plans for every patient based on their personal risk factors and their cancer stage.
Our treatment options include the following:
If your prostate cancer is unlikely to spread and slow-growing, then your physician may recommend watchful waiting. Your urologist will closely monitor your prostate cancer through regular screenings and blood tests but will not take immediate action unless it begins to grow.
The goal is to avoid exposing you to unnecessary surgery or radiation therapy.
Hormonal therapy is designed to counteract the natural cancer-promoting effects of androgens (male hormones). This may include anti-androgen therapy or androgen deprivation therapy.
Hormonal therapy is generally recommended if prostate cancer is aggressive or has already spread.
Chemotherapy may be recommended if hormonal therapy is ineffective. It can be used to kill rapidly growing cancer cells outside of the prostate gland.
Immunotherapy is a unique treatment approach that leverages your body’s immune system to combat cancer. Sipuleucel-T is a specific type of cellular immunotherapy that has produced promising results for many patients.
Surgical intervention is used to remove cancerous growths and nearby tissue or lymph nodes. Urologists often supplement surgical intervention with another treatment, such as hormonal or chemotherapy.
Radiation uses targeted radioactive energy beams to destroy prostate cancer cells. It is usually paired with another treatment option to ensure that no cancer cells are left behind.
This minimally invasive procedure removes the entire prostate using a robotic-assisted surgery system. This robotic system gives surgeons greater control and precision.
AnMed Health is one of the first hospitals using SpaceOAR®, a hydrogel that protects organs near the prostate from radiation aimed at a prostate tumor. Hydrogel creates a space between the prostate and the rectum (the organ at risk – OAR) to reduce potential side effects.
Until recently, the treatment of prostate cancer included a small risk of potential collateral damage; the rectum is very close to the prostate and is therefore very close to the firing line during radiation treatments. The hydrogel creates a space of about a centimeter between the prostate and the rectum, and acts as a barrier during treatments. The procedure takes less than 30 minutes, and patients report no discomfort with the hydrogel. After about 90 days, the hydrogel begins to break down and the body is completely rid of it in about six months.
AnMed Health provides our patients with a variety of support services. We want to give you the best chance of making a full recovery. Our compassionate team understands that cancer attacks your physical health and peace of mind. We want to heal your physical ailments and give you the tools needed to overcome the stress of a positive cancer diagnosis.
AnMed Health’s support services include the following:
Our oncology dietician can help you overcome changes in taste and appetite that commonly occur during cancer treatment.
Patient resource coordinator
Our patient resource coordinator will work with patients to connect them to resources that enhance the overall treatment experience.
Your nurse navigator is your go-to resource throughout the course of your prostate cancer treatment. The nurse navigator will walk with you during your journey and provide resources to aid in your fight against prostate cancer.
AnMed Health also provides male patients with genetic counseling. Genetic counseling gives you vital information about how genetic conditions may impact you or your family members.
The Gleason grading system is used to provide you with a prognosis based on samples from your prostate biopsy. This system is scored on a scale of 2-10.
The National Comprehensive Cancer Network recommends genetic counseling and testing for men with a Gleason score of 7 or higher if additional risk factors are present. The additional factors include a close relative with breast or ovarian cancer at age 50 or younger or at least two family members with breast, ovarian or prostate cancers at any age.
Why AnMed Health?
AnMed Health is a world-class care center that focuses on providing positive patient outcomes. We use the latest treatments and techniques to help our patients in their time of need.
AnMed Health’s services go far beyond the treatment room. We also offer a variety of resources to our patients and their family members. We understand that a positive prostate cancer diagnosis is a trying time for any person.
AnMed Health strives to support our patients before, during, and in the years following prostate cancer treatment.
If you would like to learn more about our prostate cancer screening and treatments, contact AnMed Health. Our compassionate care team will be happy to assist you or schedule an appointment as soon as possible.
AnMed Health is also a member of the NCI Community Oncology Research Program (NCORP). This program is a national network of cancer care providers, investigators and medical institutions. AnMed is proud to work with NCORP through our affiliation with Upstate Carolina Consortium to improve cancer diagnoses and treatment practices. The Upstate Carolina Consortium (NCORP) integrates three affiliates who together have a well-established history of NCI research participation: AnMed Health, Bon Secours St. Francis and Spartanburg Regional. Together, we bring cancer research to larger and more diverse patient populations to improve the quality of life and survival in cancer patients. Learn more about the Clinical Trials that AnMed Health has access to.
Prostate cancer FAQs
What kind of doctor do you see for a prostate exam?
Urologists typically perform prostate exams and other types of screening procedures to detect prostate cancer.
Is prostate cancer treatment covered by insurance?
Most health insurance providers will cover any standardized prostate cancer treatment. However, emerging or experimental treatments are not often covered.
How long can you wait to treat prostate cancer?
Men with low-risk prostate cancer are able to wait for approximately six months without risking serious progression. If a man is high-risk, treatment should not be delayed at all.
How curable is prostate cancer?
Prostate cancer is highly treatable. It is a 5-year and 10-year survival rate of 98%. As with all forms of cancer, early detection is vital.