Aspirus Wausau Hospital

Prostate Cancer

Other than skin cancer, prostate cancer is the most common cancer among men. Roughly 86 percent of all prostate cancers are discovered while they are either localized (confined to the prostate) or regional (nearby).

Prostate cancer is rare in men younger than 50, but by the time they are 80, more than half of all men will have some cancerous growth. Because prostate cancer is usually slow-growing, it often goes unnoticed and rarely is the cause of death, the older a man gets.

Some common risk factors for prostate cancer include:

• Age – More than 60 percent of all prostate cancers are diagnosed in men over the age of 65.
• Race – Prostate cancer is nearly 70 percent more common among African-American men than it is among Caucasian-American men.
• Diet – Data suggests men who eat diets with large amounts of fat have a greater chance of developing prostate cancer.
• Obesity
• Family history – Having a father or brother with prostate cancer doubles or triples a man’s risk of developing the disease. The risk is even higher for men with several affected relatives, particularly if the relatives were young at the time of diagnosis.
• Genetic factors – Some men have a genetic makeup that puts them at a higher risk for developing prostate cancer.

Screening

An annual physical exam, prostate-specific antigen (PSA) blood test and digital rectal exams (DRE) provide the best chance of identifying prostate cancer in its earliest stages. You should consult your physician prior to undergoing any prostate screenings.

If it is determined that a prostate screening is appropriate for you, you will likely undergo a PSA or a DRE. To learn more about these tests, please click below:

DRE (digital rectal examinations)

As recommended by your physician, DREs are usually conducted annually for men over the age of 50. Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age.

PSA (prostate-specific antigen) and PAP (prostatic acid phosphatase)

As recommended by your physician, PSA and PAP tests are usually conducted annually for men over the age of 50.

Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should consult their physicians about being tested at a younger age.

Men in high-risk groups, such as African-Americans, or those with a strong family history of prostate cancer, should talk with their physicians about being tested at a younger age.

If the DRE or PSA are unusual, your physician may repeat the tests or request an ultrasound and other procedures. These evaluation tools may include:

Classtransrectal ultrasound (TRUS)

This is a test using sound wave echoes to create an image of the prostate gland to visually inspect for abnormal conditions such as gland enlargement, nodules, penetration of tumor through capsule of the gland, and/or invasion of seminal vesicles; may also be used for guidance of needle biopsies of the prostate gland and/or guiding the nitrogen probes in cryosurgery.

Computed tomography scan (also called a CT or CAT scan)

This diagnostic imaging procedure uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

Magnetic resonance imaging (MRI)

This diagnostic procedure uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Radionuclide bone scan

This is a  nuclear imaging method that helps to show whether the cancer has spread from the prostate gland to the bones. The procedure involves an injection of radioactive material that helps to locate diseased bone cells throughout the entire body, suggesting possible metastatic cancer.

(Lymph node and/or prostate) biopsy

During this procedure, tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.

Symptoms

There are usually no specific symptoms of early prostate cancer. If symptoms are present, individuals experience them differently. They also can resemble other conditions or medical problems, so you should always consult your physician for a diagnosis if you experience any of the following symptoms:

Weak or interrupted flow of urine. Urinating often (especially at night). Difficulty urinating or holding back urine. Inability to urinate.

Pain or burning when urinating. Blood in the urine or semen. Nagging pain in the back, hips or pelvis. Difficulty having an erection.

Treatment

If you have prostate cancer, you need to consider your age and general health before making a decision about treatment. You also need to think about which side effects you can live with. Some men, for example, cannot imagine living with side effects such as incontinence or impotence. Other men are less concerned about these and more concerned about survival.

Treatment decisions are often hard to make by yourself. No written information can take the place of talking directly with your health care professionals. Primary care doctors can help you choose the treatment that is best for you. You might find that speaking with others who have faced or are currently facing the same issues is useful.

Overviews of treatment options:

Observation

Observation therapy is to "watch and wait" while carefully observing and monitoring the prostate cancer. This may be recommended by your physician if the prostate cancer is in a very early stage, especially in the cases of older men with small tumors that are:

• Expected to grow very slowly.
• Confined to one area of the prostate.
• Not causing any symptoms or other medical problems.

Because prostate cancer cells often spread very slowly, many older men who have the disease may not need more extensive treatment. However, observation therapy usually includes routine physician examinations, including digital rectal examinations (DRE) and prostate-specific antigen (PSA) tests.

da Vinci prostatectomy surgery

Also known as robotic surgery for prostate cancer, or robotic prostatectomy, da Vinci prostatectomy is a robot-assisted, minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that da Vinci Prostatectomy might be the most effective, least invasive prostate surgery performed today. Learn more about da Vinci prostatectomy.

Other surgeries

Surgery has increasingly become a viable treatment option for prostate cancer. The growth of the popularity of surgery has corresponded with the advent of minimally invasive surgical options, like da Vinci prostatectomy,  that reduce side effects and promote faster recovery times.

In addition to da Vinci prostatectomy, some different surgical options used to treat prostate cancer include:

• Radical prostatectomy - an open-surgery procedure in which the entire prostate gland and some tissue around it are removed. This surgery involves an incision in either the abdomen or the scrotum area.
• Laparoscopic radical prostatectomy - a less-invasive type of radical prostatectomy in which the prostate gland is removed using a laparoscope (a long, flexible lighted tube with a video camera attached). .
• Cryosurgery - a procedure that involves killing the cancer by freezing the cells with a small, metal tool placed in the tumor.

Radiation therapy

Radiation therapy uses high-energy rays to kill or shrink cancer cells and decrease their ability to divide. To learn more about this treatment, please visit our section on radiation therapy.

Hormonal therapy

Produced mainly in the testicles, the male hormone testosterone causes prostate cancer cells to grow. Reducing testosterone levels can make the prostate cancer shrink and become less active.

The goal of hormone therapy is to lower the level of male hormones in the body, particularly testosterone. Hormone therapy does not cure the cancer, and is often used to treat persons whose cancer has spread or recurred after treatment. Most studies show that hormone therapy works better if it is started early.

Chemotherapy

Chemotherapy is the use of medicines to treat cancer. When cancer occurs, normal cells in the body divide without any control. Chemotherapy fights cancer by stopping these cells from growing and dividing. To learn more about this treatment, please visit our section on chemotherapy.

Angiogenesis inhibitors

A chemical that interferes with the signals to form new blood vessels is referred to as an angiogenesis inhibitor. Sometimes called antiangiogenic therapy, this treatment may prevent the growth of cancer by blocking the formation of new blood vessels. In some animal case studies, angiogenesis inhibitors have caused cancer to shrink and resolve completely.

Clinical trials (research studies)

Clinical trials are studies, managed by government agencies, educational institutions, private not-for-profit organizations, or commercial businesses, to develop, produce, and evaluate the effectiveness of new treatments and therapies for diseases. Go to online listing of trials available at the Aspirus Regional Cancer Center.