Have you been diagnosed with prostate cancer recently?
As with any health condition, it’s important to get comprehensive, in-depth information about your disease and all your available treatment options. And if, like many men, your prostate cancer is slow growing, you should have time to thoroughly look into all your options and make an informed choice.
Here is an overview of what you or your family member should know to help you feel prepared when you talk with your doctor. Knowing your options can help give you and your family peace of mind.
Prostate Cancer Symptoms
Many men who have prostate cancer have no symptoms. Prostate cancer typically develops unnoticed in the early stages—men who have it likely won’t notice anything unusual. Signs and symptoms only occur at later stages. Those can include:
- Trouble urinating and emptying the bladder completely
- A sudden, urgent need to urinate, especially at night
- A burning sensation or pain while urinating
- The presence of seminal fluid or blood in the urine
- A continuous pain in the back, hip, or pelvic area
- Signs of anemia, such as fatigue, weakness, or shortness of breath
- Pain during ejaculation and a weak or interrupted flow of sperm
- Erectile dysfunction
- Unexplained weight loss
Prostate Cancer
Diagnosis
Doctors use various diagnostic tests and procedures to determine if a patient has prostate cancer. These tests aim to find out how aggressive the cancer is, how large it is, whether it has spread into surrounding tissue, and to assess a patient’s overall condition.
These examinations may need to be carried out several times to get the most-detailed picture possible.
PSA Test
Prostate Specific Antigen (PSA) is a protein made by prostate tissue. The amount of PSA measured in your
blood normally increases with age and prostate size, but abnormally high levels may indicate the need for
additional testing.
DRE Exam
The digital rectal exam (DRE) is performed by a doctor who uses their gloved index finger to feel your prostate
through the rectal wall to assess the size, shape, and stiffness of your prostate.
MRI Scan
A magnetic resonance imaging (MRI) machine uses a magnetic field and radio waves to generate an image of
your prostate and its surroundings. This image may allow your doctor to find regions suspicious for cancer.1
Prostate Biopsy
Using imaging guidance (typically ultrasound), a small needle is used to collect a small amount of tissue from
the prostate for further examination.
The Gleason score
When pathologists look at samples from prostate biopsies under a microscope, they may find groups of abnormal cells that can indicate cancer called “Gleason groups.” A Gleason score is calculated by combining the numbers for the Gleason patterns of the two largest groups of abnormal cells, creating a score ranging from 6 to 10. So, for example, if the two largest areas of abnormal cells have Gleason pattern numbers of 3 and 4, it would create a Gleason score of 7.
You can get a lot more information on Gleason patterns, Gleason scores and more here.
Common interventions for patients with prostate cancer
Understanding the advantages and risks of your available treatment options is essential in helping you make the best decision possible.
It’s also important to remember that while it’s vital that you talk with your doctor about your treatment
options, ultimately the decision is yours. It’s also too important a decision to be rushed unless absolutely
necessary. After all, it’s your prostate, and your life.
What are the most-commonly used treatments?
Active Surveillance
May be recommended for men with slow-growing prostate cancer. Includes close monitoring such as repeat PSA and biopsy tests.
TULSA Procedure
A minimally invasive treatment performed in an MRI suite that enables ablation of a precisely defined region of the prostate using thermal ultrasound.
Radical Prostatectomy
A surgical procedure that removes the entire prostate gland and, if cancer has spread to surrounding lymph nodes, those structures as well.
Radiation Therapy
External beam radiation therapy (EBRT) uses x-ray beams from outside the body to ablate cancer cells. In brachytherapy, radioactive material is placed inside or beside the cancer.
Focal/Local Therapies
These include cryotherapy, which destroys cancer cells by freezing them, high-intensity focused ultrasound (HIFU), which uses high-energy ultrasound waves, and electroporation, featuring quick zaps of high-voltage.
ADT Hormone Therapy
Androgen Deprivation Therapy (ADT) reduces levels of testosterone and dihydrotestosterone that can fuel tumor growth.
Looking for more information
Both the National Comprehensive Cancer Network (NCCN) and NIH’s National Cancer Institute have a wide range of helpful information on prostate cancer treatment, testing, and more.
Learn more about prostate conditions
Benign Prostatic Hyperplasia (BPH)
With BPH, there’s an overgrowth of tissue that pushes against the urethra and the bladder, restricting the flow of urine.
Radio-Recurrent Prostate Cancer
When radiation therapy fails to eliminate prostate cancer completely, it’s called recurrent prostate cancer. This is a serious health risk for approximately 20%-30% of radiation-treated patients.