OVERVIEW
Prostate cancer is the most common non-cutaneous malignancy and the second leading cause of cancer death in men. The function of the prostate is to produce fluid to facilitate sperm survival. Prostate cancer is often detected using a blood screening test called prostate-specific antigen (PSA). If the test returns elevated or if the prostate exam is abnormal, your doctor may recommend a biopsy of the prostate.
Symptoms
Most prostate cancers are asymptomatic. However, some advanced cancers may cause the following symptoms:
- Trouble with urination or bowel movements
- Blood in urine or semen
- Back or bone pain
- Weight loss
Causes/Risk Factors
Like most cancers, the cause of prostate cancer is not known. However, the following factors that increase the risk of developing prostate cancer:
- Age. Men who are 50 or older have a higher risk for prostate cancer.
- Race. African-American men have the highest risk for prostate cancer—the disease tends to start at younger ages and grows faster than in men of other races.
- Family History. Men whose fathers or brothers have had prostate cancer have a higher risk than men who do not have a family history of the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. Risk may be higher for men who eat high-fat diets.
Diagnosis/Evaluation
- What to know before your visit:
- During your visit, your doctor will ask you questions regarding your medical, surgical, and family history, and perform an exam.
- Other tests that may be performed during or after your visit:
- Lab tests will often be performed including PSA, Testosterone, and urine studies
- Imaging studies after often performed after the diagnosis of prostate cancer: CT, MRI, bone scan
- Prostate biopsy
- Prostate needle biopsy:
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Transperineal prostate biopsy: This involves placement of an ultrasound probe in the rectum. However, instead of taking biopsies through the rectum, biopsies are taken through the skin located between the scrotum and the rectum (typically 12 biopsies are taken, but occasionally more). The procedure lasts approximately 10-15 minutes. This has been associated with lower infection rates and higher cancer detection rates.
- Transrectal prostate biopsy: This involves placement of an ultrasound probe into the rectum. We then measure the size of the prostate, provide local anesthetic, and perform biopsies of the prostate (typically 12 biopsies, but occasionally more). The procedure lasts approximately five minutes.
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Treatment
A variety of treatment options exist for prostate cancer and an individual approach is developed depending on the grade and stage of the cancer, as well as the age and overall health status of the patient. Treatment options include active surveillance, robotic surgery, radiation, hormonal therapy, and chemotherapy. Occasionally, a combination of treatments is recommended.
Clinical Research
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