Prostate Cancer

Condition

Around one in nine men will develop prostate cancer at some point during his lifetime. Despite these alarming statistics, there’s some good news. Not only is prostate cancer slow to develop, but it can also be detected early and treated with screening exams. We understand that a prostate cancer diagnosis can difficult to face. Mercy’s gastrointestinal cancer experts are dedicated to addressing your cancer needs all the way from diagnosis to treatment.

What’s Prostate Cancer?

Prostate cancer is one of the most common forms of cancer among American men, second only to skin cancer. Prostate cancer develops in your prostate, a gland found only in men. When prostate cancer occurs, it can sometimes spread to the nearby seminal vesicles. If prostate cancer is found early, when it’s still only in the prostate gland, treatment has a greater chance of succeeding. 

Types of Prostate Cancer

Adenocarcinoma is the most common type of prostate cancer that forms in glandular cells. These types of cells are found in the tissue of certain internal organs, including the prostate, which makes substances vital to the body. 

The American Urological Association estimates that small-cell carcinoma makes up approximately 1% of all prostate cancer diagnoses. However, it can spread to other parts of the body quicker than adenocarcinoma, making it more difficult to treat if not caught early. 

When prostate cancer has returned following initial treatment, it’s known as recurrent prostate cancer. However, not all forms of recurrence are the same. You’ll want to talk with your Mercy doctor to determine if your recurrent prostate cancer is considered low-risk or high-risk.

Prostate Cancer Causes & Risk Factors

Although the exact causes of prostate cancer are unknown, the disease may be related to pre-cancerous changes in the cells of the prostate. Other than your diet, most prostate cancer risk factors are out of your control. Prostate cancer risk factors include:

Your risk rises rapidly after age 50. Around 60% of prostate cancer cases are found in men older than 65.

Your race may be a risk factor for developing prostate cancer. For instance, prostate cancer is more common among African American men than men of other races.

About 5 to 10% of prostate cancers are hereditary, meaning the cancer is caused by an inherited gene. Men with immediate family members who have had prostate cancer have twice as high a risk of developing it. If several of your relatives have had prostate cancer, especially if they were diagnosed at a young age, your risk is much higher.

Men whose diet is high in red meat and/or high-fat dairy products appear to have a slightly higher risk of developing prostate cancer. However, being overweight doesn’t appear to be a significant risk factor for prostate cancer.

An increase in testosterone levels stimulates the growth of the prostate gland, making some men more susceptible to prostate cancer. 

Risk Factors to Watch Out For

Mercy’s Dr. Gautum Agarwal discusses risk factors and prostate cancer screening options.

Signs & Symptoms of Prostate Cancer

Signs and symptoms don’t often show up until prostate cancer is already at an advanced stage. As the cancer becomes more advanced, prostate cancer signs may include:

  • Difficulty urinating, including a slow or weak stream
  • Frequent urination, especially during the night
  • Bloody urine or semen
  • Trouble getting or maintaining an erection
  • Pain or discomfort in your pelvic area

If prostate cancer has spread, symptoms may include:

  • Pain in the hips, spine and ribs
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control due to cancer pressing on the spinal cord 

Prostate Cancer Prevention & Screening

Prostate cancer screening can detect cancer before symptoms start. If you have certain risk factors that make you more susceptible to prostate cancer, it's important to have regular prostate screening exams. Genetic testing can identity gene mutations that may increase your risk of prostate cancer if you have any family history of prostate cancer. 

How is Prostate Cancer Diagnosed & Detected?

If a prostate screening exam indicates you may have prostate cancer or you have symptoms, further tests will be recommended. Mercy cancer specialists use several types of tests for diagnosing prostate cancer. Diagnostic imaging can help Mercy physicians determine the stage of prostate cancer as well as develop a prognosis and treatment plan.

Imaging tests use a combination of X-rays and radioactive substances to create a picture of the inside of your body. Diagnostic imaging tests may be used to help your Mercy doctor look for prostate cancer, observe the prostate during certain procedures (such as a prostate biopsy) and determine if your cancer has already spread to other areas of the body.  Imaging tests used in the diagnosis of prostate cancer are:

Designed to help pinpoint any DNA alterations that may be contributing to the growth of a tumor, advanced genomic testing allows your Mercy doctor to identify treatments for specific mutations.

Prostate Cancer Treatment

Our team of cancer specialists has experience treating prostate cancer in all of its stages, including advanced and recurrent prostate cancer. When treatment is needed, the most effective prostate cancer treatment plan will depend on several factors including age, overall health, stage of your prostate cancer, whether or not cancer has spread as well as potential side effects of the treatment(s). Prostate cancer treatment options may include the following.

If prostate cancer is only in the prostate gland and has not spread to other parts of the body, a radical prostatectomy may be recommended. Prostate cancer surgery often performed using minimally invasive robotic technology.


Radical Prostatectomy

The most common procedure to remove the prostate is known as radical prostatectomy. In this procedure, your Mercy surgeon will remove your entire prostate along with surrounding tissue and your seminal vesicles. A surgeon will review common risks and side effects ahead of your surgery. These may potentially include erectile dysfunction and urinary incontinence. 

Mercy offers the most advanced therapies for prostate cancer. Our radiation oncologists offer several types of radiation therapy for prostate cancer treatment, including external beam radiation and internal radiation therapy.


External Beam Radiation Therapy

External beam radiation therapy (EBRT) is the most common type of radiation therapy. A special x-ray machine is used to aim powerful radiation directly at tumors in your prostate. EBRT is most often used in earlier stages of pancreatic cancer as well as used to help relieve symptoms.

  • Stereotactic body radiation therapy (SBRT) - High doses of radiation beams are usually delivered straight to the prostate in SBRT. It is a less common option for patients who have early-stage prostate cancer. SBRT uses a form of radiation therapy known as CyberKnife treatment.

Hormone Therapy

Also referred to as androgen deprivation therapy (ADT) or androgen suppression therapy (AST), hormone therapy is typically used as a treatment for localized prostate cancer. Hormone therapy may be recommended as a treatment option for prostate cancer if:

  • You’re not a candidate for surgery or radiation.
  • Your cancer remains or returns following prostate cancer surgery or radiation.
  • You’re considered to be at high risk of cancer returning.
  • You’re also receiving radiation therapy, aimed to shrink cancer.


Immunotherapy

Also known as biologic response modifier (BRM) therapybiologic therapy or biotherapy, immunotherapy can be used to activate your immune system to battle cancer cells more effectively.


Chemotherapy

If you’re not responding to hormonal therapy or if your cancer has spread beyond the prostate, chemotherapy may be recommended. Chemo uses drugs delivered directly into your veins or given by mouth to reach and fight cancer cells throughout the body. 


Bone-Directed Therapy

Osteoclasts are cells responsible for breaking down the hard mineral of our bones, which keeps them healthy. If prostate cancer spreads to the bones, these cells can become overactive. Drugs known as bisphosphonates work to slow down osteoclasts. Bisphosphonates also help to relieve pain, slow cancer growth and strengthen bones in men who undergo hormone therapy.

Also referred to as cryotherapy or cryosurgerycryoablation is a minimally invasive surgical treatment used to freeze the prostate gland and destroy cancer cells. It’s sometimes used if a patient’s cancer has returned or as an alternative to the surgical removal of the prostate gland.
 

Cryotherapy typically requires epidural anesthesia (where the lower half of your body is numbed) or general anesthesia (where you’re asleep). Since cryoablation is minimally invasive, recovery times are usually quicker and hospital stays are shorter than with radiation therapy or surgery.

Active surveillance (AS) is also known as watchful waiting. This is an option for some men who are at low-risk or have slow-growing prostate cancer. Instead of starting immediate treatment, which may cause unwanted side effects, your Mercy doctor will closely monitor your prostate.
 

Active surveillance may include a PSA test and/or a DRE every three to six months. In addition, regularly scheduled imaging tests of the prostate and/or a yearly prostate biopsy may be recommended.

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