Prostate cancer symptoms & treatment

Prostate cancer is one of the most common forms of cancer among American men, with approximately 230,000 new cases diagnosed each year in the U.S.. In fact, one in every seven men will be diagnosed with prostate cancer during his lifetime.

When found in its earliest stage, prostate cancer is very treatable. The American Cancer Society recommends that men consider screening for prostate cancer once they turn 50. Those at higher risk for developing prostate cancer – including African American men and those with an immediate family history – may be encouraged to start screening at a younger age.

Symptoms of prostate cancer

It’s common to have no symptoms of prostate cancer, especially in the early stages, emphasizing the importance of regular screenings. As prostate cancer progresses, symptoms may include:

• A need to urinate frequently, especially at night
• Difficulty urinating
• Painful urination or ejaculation
• Blood in urine or semen

Prostate cancer screening & diagnosis

Starting at age 50 (or 40 if you have a significant family history of the disease or are at higher risk), it’s important to discuss prostate cancer screening with your doctor. Screening methods include:

• PSA (prostate specific antigen) test: This is a blood test that measures PSA, high levels of which can indicate prostate cancer.
• Digital rectal exam (DRE): Your doctor will insert a gloved finger into your rectum and feel your prostate for abnormalities. Although it may be uncomfortable, the exam takes just a few seconds.

If your doctor suspects you have prostate cancer, they may order additional tests to confirm a diagnosis, such as:

• Prostate MRI: Imaging of the prostate is performed to evaluate for suspicious areas and to assess the size and potential spread of prostate cancer.
• Transrectal ultrasound-guided biopsy: A probe is inserted into your rectum up to your prostate, and then several small samples of tissue are removed for evaluation. The samples provide important details that can be useful for treatment planning.

Treatment options for prostate cancer

If cancerous cells are found during testing, your doctor will use the Gleason grading system to indicate your prostate cancer’s aggressiveness, which helps determine the best treatment plan for you.

Prostate cancer treatment options may include:

Active surveillance: Sometimes, a “watch and wait” approach may be an option for you. In that case, your doctor will perform a PSA test and a digital rectal exam every 3-6 months. You may also need an annual prostate biopsy. If the disease begins to progress, you’ll require further treatment./p>

Chemotherapy: Chemo may be used after removal of your prostate to reduce the chance of cancer coming back. It's also used if you have advanced prostate cancer that isn’t responding to other types of treatment, like hormonal therapy.

Focal therapy: The goal of focal therapy is to target the identified cancer cells in your prostate without harming your urinary and sexual function. This treatment has minimal side effects and is an alternate method to radiation or surgery that treats the entire prostate. However, focal therapy isn't suitable for all cases of prostate cancer.

There are three types of focal therapy available:

• Cryotherapy: With cryotherapy, an area of your prostate is treated with freezing or near-freezing temperatures. This allows select cancer cells to be destroyed. Cryotherapy is performed as an outpatient procedure and you’ll return home the same day.
• High-intensity focused ultrasounds (HIFU): HIFU uses high-energy ultrasound waves to destroy cancerous prostate tissues. The procedure is performed under general anesthetic and typically lasts two to three hours. You can expect to go home the same day with a catheter in place with minimal disruption to your daily routine.
• Irreversible electroporation (IRE): IRE uses a focused electrical current to destroy cancerous cells. This outpatient procedure is an emerging therapy that has demonstrated good outcomes while minimizing side effects.

Cryotherapy, HIFU and IRE therapy treatments are offered at Aurora St. Luke’s Medical Center.

Hormone therapy: Although hormone therapy won’t cure prostate cancer, it can slow cancer growth by blocking the release of testosterone to stop hormones from connecting with cancerous cells. Hormone therapy and radiation therapy are commonly used to treat prostate cancer.

Immunotherapy: This treatment stimulates your immune system to identify and destroy cancer cells without affecting healthy tissue. Cancer vaccines use your own cells to trigger your immune system to attack prostate cancer cells.

Laparoscopic surgery: Micro-surgical instruments are inserted through small incisions in your abdomen and then used to remove your prostate.

Prostatectomy: Traditional surgery involves removing your prostate entirely. It’s only a viable choice if the cancer is confined to your prostate area and hasn’t spread.

Robotic surgery: These precise procedures require smaller incisions, which can help speed the recovery process. Since acquiring the state-of-the-art daVinci® Surgical System in 2003, Aurora St. Luke's has performed thousands of operations using robotic surgery – more than any other hospital in Wisconsin.

Radiation therapy: This common therapy either destroys or controls the growth of cancerous cells. Two forms of radiation therapy include:

• External beam radiation: Sends beams of high-energy X-rays through your skin to target and kill cancer cells. There are several different methods, including 3D conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), Calypso 4D System and CyberKnife®.
• Brachytherapy: Involves implanting radioactive seeds in your prostate to kill cancer cells. This method of treatment may have fewer side effects than external beam radiation. On May 21, 2014, Aurora St. Luke's performed its 1,000th radioactive seed implantation.

Side effects of treatment for prostate cancer

Some treatments for prostate cancer include side effects such as urinary incontinence or impotence, though they may lessen over time. The older you are, the greater your risk of complications. Talk to your doctor about any concerns.