Prostate Cancer

About 1 in 8 men will be diagnosed with prostate cancer during their lifetime. Other than skin cancer, prostate cancer is the most common cancer in men and is the second leading cause of cancer death in men behind lung cancer.

Prostate cancer is more likely to develop in older men and non-Hispanic Black men. The average age of men at diagnosis is about 66.

Early Detection is Key

Prostate cancer can be a serious disease, but if caught early, through regular health screenings such as a (PSA) blood test, it can be curable.

Who Should Be Screened for Prostate Cancer?

The American Cancer Society recommends patients speak with their doctors about getting screened for prostate cancer:

• Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
• Age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer at an early age (younger than age 65).
• Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

What is Prostate Cancer?

Prostate cancer is a malignant (cancerous) tumor of the prostate, a gland found only in men. The prostate’s function is to create some of the fluid that insulates sperm cells found in semen. In the United States, prostate cancer is among the most common cancers found in men.

Symptoms of Prostate Cancer

Though early warning signs of prostate cancer are rare, sometimes men experience symptoms before they are diagnosed. The severity of symptoms may depend on where the cancer is located in the prostate and how advanced it has become. However, having any of these symptoms does not necessarily mean that you have prostate cancer or that the disease has progressed beyond its early stages.

Urinary Symptoms

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• A weak or interrupted flow of urine
• Painful or burning urination
• Hematuria (blood in the urine)

Erectile and Ejaculatory Symptoms

• Difficulty achieving or maintaining an erection
• Painful ejaculation
• Blood in the semen
• Decreased volume of ejaculation (though hydration, diet, and frequency of ejaculation are more likely than prostate cancer to impact the volume of fluid)

Lower Extremity Symptoms

• Frequent pain or stiffness in the lower back, hips, or upper thighs
• Swelling in the lower extremities
• If a patient experiences bone pain and swelling in the lower extremities—especially when accompanied by urinary, erectile, or ejaculation dysfunction—these could be symptoms of advanced prostate cancer.

These symptoms can also indicate the presence of many other diseases or disorders. Therefore, having a thorough exam will help diagnose the proper condition.

Types of Prostate Cancer

No two cases of prostate cancer are alike, and an accurate diagnosis is critical to developing the best treatment plan.

Urologists and Oncologists at Singing River Health System can make the difficult process of deciding on a treatment plan easier. With award-winning expertise in cancer care, technology, multidisciplinary specialists, and the latest data, you will have an entire team to help guide you in making the most informed decisions about managing your prostate cancer.

Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen).

Prostate Cancer Treatment

A combination of several treatments, including surgery, radiation therapy, or hormone therapy, may be used to treat prostate cancer. The medical team will provide a comprehensive assessment of available treatments as well as expected outcomes. The treatment decision will be based on several clinical and psychological factors, including the patient’s cancer stage, need for therapy, level of risk, anticipated life expectancy, overall health, and personal preference.

When it comes to prostate cancer treatment, timing is often just as important as the type of treatment chosen. Some patients select active surveillance or watchful waiting to delay treatment and avoid the associated risks and side effects.

Who treats prostate cancer?

The main types of doctors who treat prostate cancer include:

• Urologist – a doctor and/or surgeon who treat diseases of the urinary system and male reproductive system (including the prostate).
• Radiation Oncologist – a doctor who treats cancer with radiation therapy.
• Medical Oncologist – a doctor who treats cancer with medicines such as chemotherapy, hormone therapy, and immunotherapy.

Many other specialists may be involved in your care as well, including nurse practitioners, nurses, nutritionists, social workers, rehabilitation specialists, and other health professionals.

Treatment Options

If you’ve been diagnosed with prostate cancer, your cancer care team will discuss your treatment options with you. It’s important to think about the benefits of each treatment option compared to the possible risks and side effects. Depending on each case, treatment options for men with prostate cancer might include:

Observation or Active Surveillance for Prostate Cancer

Patients with localized, slow-growing, low-risk tumors may opt to delay treatment and have more periodic tests to monitor for disease progression. 

Radiation Treatment for Prostate Cancer

Radiation can be used alone or in conjunction with other treatments. It is used to slow tumor growth or destroy tumors in both localized and advanced (metastatic) cancer that has spread to other areas of the body. The four most common types of Radiation Treatment:

External radiation (or external beam radiation therapy – EBRT) uses a machine that directs high-energy rays (or photons) from outside of the body into the tumor. Most patients get external radiation therapy over many weeks, during outpatient visits to a hospital or treatment center.

Internal radiation also called brachytherapy, involves putting a radioactive source inside the body into or near the tumor.

Stereotactic body radiation therapy (SBRT) uses advanced imaging techniques to deliver extremely precise, very intense doses of radiation to the prostate (usually in up to five treatments over a period of days).

Discover SpaceOAR Hydrogel – a new tool to help protect patient’s healthy organs and minimize side effects of radiation treatment for prostate cancer.

Surgery

The goal of surgery is to remove all of the cancerous cells from the body and is usually paired with other cancer treatments such as chemotherapy or radiation, to be most effective.

Our urologic surgeons have extensive experience performing robotic-assisted radical laparoscopic prostatectomies (surgical removal of the prostate), including nerve-sparing techniques. These procedures provide patients with less pain, a shorter hospital stay, and an earlier return to daily activities.  

Singing River is a designated Center of Excellence in Robotic Surgery – offering many different minimally invasive robotic procedures, which lower the risk of complications and side effects.

Chemotherapy

Chemotherapy drugs can be used to improve outcomes following surgery or to help relieve symptoms of advanced disease. 

Hormone Therapy

This approach deprives cancer cells of the hormones they need to thrive. Though commonly used in metastatic prostate cancer, it is increasingly used in early-stage disease to help shrink the tumor before other treatments.

Can Prostate Cancer Be Prevented?

There is no sure way to prevent prostate cancer. Many risk factors such as age, race, and family history can’t be controlled. But there are some things you can do that might lower your risk of prostate cancer.

Bodyweight, physical activity, and diet.

The effects of body weight, physical activity, and diet on prostate cancer risk aren’t completely clear, but there are things you can do that might lower your risk.

Some studies have found that men who are overweight or obese have a higher risk of developing advanced prostate cancer or prostate cancer that is more likely to be fatal. Although not all studies agree, several have found a higher risk of prostate cancer in men whose diets are high in dairy products and calcium.

The best advice about diet and activity to possibly reduce the risk of prostate cancer is to:

• Get to and stay at a healthy weight.
• Keep physically active.
• Follow a healthy eating pattern, which includes a variety of colorful fruits and vegetables and whole grains, and avoids or limits red and processed meats, sugar-sweetened beverages, and highly processed foods.