By: Gaudencio Olgin, MD
DHR Health Urology Institute
Prostate cancer is the second most common cancer among men, affecting 1 in 9 men in their lifetime, and the second leading cause of cancer death in men after lung cancer. As a man ages, his chances of being diagnosed with prostate cancer increases. Men at an increased risk are African-American or have a first degree relative (father, brother, son) who has been diagnosed with this malignancy.
The prostate is a golf ball sized gland found only in men that is located underneath the bladder and in front of the rectum. It surrounds the urine tube that carries urine from the bladder to and through the penis. Since prostate growth is a natural process of aging, men may experience urinary symptoms such as weakened urinary flow and more frequent trips to the bathroom. These types of symptoms may also be seen in prostate cancer. In general, there are NO signs specific to localized disease. Metastatic cancer can have effects based on the extent of the disease, including fatigue, anemia, loss of strength in legs, and pain from cancer that has spread to bones, which can result in an increased fracture risk. Some prostate cancers grow fast, but most grow slowly over years.
The majority of newly found prostate cancers are localized, meaning they have not moved out of the prostate gland. If the cancer is undetected or left untreated, localized tumors can grow and move to other parts of the body (metastasize). At this point, treatment options decrease and the chance of dying from the cancer increases.
Due to its silent presentation, we rely on screening tests to detect prostate cancer risk. These include a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE), which is a manual exam to feel for abnormalities on the surface of the prostate. If there is a hard or uneven spot, this could be a sign of cancer even with a “normal” PSA.
The only way to confirm prostate cancer is with a prostate biopsy, which is guided by ultrasound and performed under local anesthesia. It is important to discuss your options with a health care provider. A urologist who is a surgeon that specializes in the management and treatment of conditions involving the genito-urinary tract, including prostate health, can help in the early diagnosis and treatment of prostate cancer.
The most advanced techniques for surgical options such as robotic assisted surgery through a robust multidisciplinary robotics program as well as technology that includes an MRI guided fusion biopsy for better detection is available. Options after diagnosis depend on a risk stratification, but include active surveillance, hormone treatment, radiation treatment and surgery.
DHR Health Urology Institute can help guide you through the decision process, including risks, screening, diagnosis and treatment of prostate cancer. If you are interested in learning more about prostate cancer or about the treatment options available, please call (956) 362-8767.