The prostate is a small gland (walnut sized) located in the male pelvis beneath the bladder and surrounding the urethra (the tube through which urine passes from the bladder out of the body). The prostate plays an important role in reproduction as it produces fluid that mixes with and protects sperm.
As men age, the prostate increases in size (enlarged prostate or BPH) and often causes urinary symptoms (slow urine stream, frequent urination, awakening during the night to urinate, etc.). The risk for prostate cancer also increases as a man gets older.
How We Check for Prostate Cancer
The “check” for prostate cancer involves a PSA (prostate-specific antigen) blood test and a digital rectal exam (DRE). If screening for prostate cancer reveals an elevated PSA or a nodule during a digital rectal exam, then the next step is a discussion between the urologist and patient about the options.
Typically, a transrectal ultrasound (TRUS) is performed to take pictures of the prostate and to provide guidance for biopsies of the prostate. Usually a biopsy sampling is done throughout the prostate with 12 biopsies taken. This is the test most commonly performed for initial evaluation of patients with an elevated PSA or a prostate nodule felt on exam.
Patients who have had prior TRUS prostate biopsies and have a PSA that is continuing to increase as well as those men with prostate cancer on active surveillance are candidates for a relatively newer technique using 3D MRI/ultrasound fusion biopsy technology.
What Happens When a Patient is Diagnosed with Prostate Cancer
If a patient is diagnosed with prostate cancer, he and his urologist will discuss treatment options. Much will depend upon the stage of the cancer (confined to the prostate or cancer that has spread).
For most patients with localized (confined) prostate cancer, the options are (in no particular order):
- Active surveillance, which includes understanding molecular markers, such as the OncotypeDX Prostate Cancer Test (you can read patient stories regarding the OncotypeDX test here)
- Surgery or radical prostatectomy, which involves removing the prostate and reconnecting the bladder to the urethra
- Radiation, which may be external radiation or internal radiation (brachytherapy also known as “seeds”)
- HIFU, which involves usinghigh intensity focused ultrasound energy to treat the cancer
- Cryotherapy, which is a technique of freezing the prostate and cancer cells
At Greater Boston Urology, our board-certified urologists and top-rated specialists are ready to listen, answer your questions, and work with you on a prostate cancer treatment plan that makes sense for you and your life.