A diagnosis of prostate cancer can send your world into a tailspin. Fortunately, in many cases and when caught in its early stages, prostate cancer is highly treatable. And, having a skilled microsurgeon and expert urologist like Dr. Brad Lerner in your corner is important in the process of diagnosis and treatment.
Prostate cancer is second only to skin cancer as the most common male cancer in the United States. Each year more than 200,000 men are affected by this disease. Men aged 50 and older, African American men and men with a family history of prostate cancer are at higher risk. Fortunately, most prostate cancers are slow growing and can be detected at an early stage, when most can be cured.
Risk Factors for Prostate Cancer
Factors that may increase your risk of prostate cancer include:
- Family history - having a brother, father, grandfather, son or cousin with prostate cancer
- Age - 90% of prostate cancers are diagnosed in men 50 and older
- Race - African Americans are at greater risk
- Diet and lifestyle - obesity and/or a diet high in saturated fats, sugar and red meat may increase risk, while eating fruits and vegetables, especially broccoli and cauliflower, may decrease risk. Lycopene, found in tomato products, and selenium, soy and Vitamins D and E, also may be beneficial.
It's important to know that an enlarged prostate ( benign prostatic hyperplasia or BPH) does not increase your risk of prostate cancer.
Symptoms and Screening - Early Detection is Critical
Early stage prostate cancer often has no warning signs, which is why Dr. Lerner stresses the importance making regular screening tests such as the prostate-specific antigen (PSA) blood test and digital rectal exams (DRE) critically important to all of his patients.
During the DRE, Dr. Lerner will check the texture of your prostate to make sure there are no abnormalities present. The PSA test determines the level of PSA in a blood sample; high levels may indicate prostate cancer, an enlarged prostate or prostate infection. Men with normal levels of PSA also may have prostate cancer.
Dr. Lerner recommends that these tests be performed for all men starting at age 40.
Diagnosis and Staging
If Dr. Lerner finds any of the results of the DRE or PSA tests abnormal or suspect, he may recommend further evaluation after the screening tests, specifically prostate biopsies. In this test, using a local anesthetic and ultrasound guidance, Dr. Lerner will insert a tiny needle into the prostate and withdraw small amounts of tissue to be examined in a laboratory.
If prostate cancer is found during the biopsy, Dr. Lerner may recommend additional testing such as a bone scan or a CT scan.
In its early stages (T1 and T2), prostate cancer is usually confined to the prostate itself. As the cancer advances, it may move outside the prostate to surrounding tissues, lymph nodes, bones or other parts of the body (Stage T3 or T4). Your prostate biopsies will be assigned a Gleason score that may help Dr. Lerner in determining your prognosis.
Many effective treatments for prostate cancer exist today. And, with early detection and screenings, many patients can be cured. The most appropriate treatment for you will depend on factors such as your age, health, lifestyle and the characteristics of your cancer and Dr. Lerner will sit with you, and your family, to thoroughly discuss a course of treatment that will be most effective. Understanding the disease, how it progresses and how to successfully battle it is important and Dr. Lerner will make sure you are educated about and comfortable with the course of treatment. The treatment options Dr. Lerner may discuss with you include:
- Watchful waiting (active surveillance) - men with slow growing, early stage cancers or those with serious health problems or advanced age may be advised to monitor the cancer rather than actively treating it. Many men will "outlive" their prostate cancer.
- Surgery - a surgical procedure called a radical prostatectomy removes the cancerous prostate gland. These techniques include the da Vinci robotic prostatectomy, a state-of-the-art robotic-assisted laparoscopic removal of the prostate.
- Radiation therapy - Chesapeake Urology's Prostate Center offers state-of-the-art Image-Guided Intensity Modulated Radiation Therapy (IG-IMRT), a highly targeted radiation that maximizes tumor shrinkage while minimizing damage to surrounding tissues.
- Brachytherapy - tiny radioactive "seeds" are placed into the prostate to release radiation over the course of several months, providing targeted treatment to the cancer.
- Hormone therapy - in some cases, your physician will inject a medicine called LHRH to block the release of testosterone, the male hormone that fuels the growth of prostate cancer.
- Cryotherapy - is an outpatient procedure, where several small needles are inserted into the prostate to freeze and destroy the cancer cells it contains. It can be used as primary therapy or as an alternative if other treatment is not successful (also known as salvage cryotherapy).
- Chemotherapy - chemotherapy is sometimes recommended for men who have progressive prostate cancer or cancer that is not responding to other therapy.