The prostate gland is part of the male reproductive system. The gland is located below the bladder. The function of the prostate is to produce fluid. This fluid mixes with the fluid from the seminal vesicles and sperm from the testicles to form semen. The prostate is normally about the size and shape of a walnut. With age, the prostate changes in size. It may become enlarged, a condition called BPH, which is not cancer or form cancerous cells as the prostate changes. Prostate cancer is the most common type of cancer in men, other than skin cancer.

Symptoms

The symptoms for prostate cancer depend upon the stage of the cancer. The most common symptoms are:

• Blood in the urine or semen
• frequent urination
• inability to urinate
• pain or stiffness in lower back
• pain or burning during urination
• weak or interrupted urinary flow

Once symptoms occur the following diagnostic tests may be performed to evaluate whether or not cancer is present in the prostate:

• Digital rectal exam: is a physical exam in which the physician inserts a lubricated gloved finger into the rectum to feel the surface of the prostate gland.
• Prostate specific antigen (PSA) level: is a blood test to evaluate the amount of PSA in the blood; a high or rising PSA level may mean an increased cancer risk.
• Biopsy: the removal of tissue to be examined under a microscope.
• Bone scans: is a nuclear imaging procedure used to detect metastasis to bones.
• Transrectal ultrasound (TRUS): in which a probe, emits ultrasonic impulses, is inserted into the rectum and used to project images on a monitor to examine the gland and surrounding tissue for tumors.
• CT scan or CT urogram: is an x-ray procedure that produces three-dimensional images of internal organs and glands with particular attention to the prostate gland.

Treatment

Treatment of prostate cancer depends on the stage of the disease, the type of cancer and the patient’s age and overall health. Treatment options include medications, surgery, chemotherapy and radiation. In some cases, treatments are combined.

• Watchful waiting: is a period of time monitored by the physician to determine any sudden progression of the disease, to signal the need for more aggressive treatment. This is used only on patients who are elderly, in poor health or with early stage cancer.
• Hormone Therapy: uses surgical removal of the testicles or hormone injections called LHRH analogs, which block production of testosterone. Common hormone therapy drugs: Viadur®, Vantas®, Eligard®, Lupron®, Trelstar®
• Radiation Therapy: uses high-energy x-rays to destroy cancer cells.
  • Brachytherapy: approximately 80-100 radioactive seeds, each the size of a grain of rice, are permanently implanted directly into the prostate. These seeds emit gamma rays which in turn kill cancerous cells within the prostate.
  • Intensity Modulated Radiation Therapy (IMRT):the latest form of external beam radiation therapy (EBRT) whereby x-rays are created within a linear accelerator (LINAC) and directed to the prostate gland from multiple angles. IMRT allows for high doses of radiation to be given to the prostate (improving the chance of cure) while minimizing the radiation to the surrounding structures (decreasing the chance of complications)
  • Image Guided Radiation Treatment (IGRT): because the prostate gland moves, it is important that we know where it is and ensure it is within the target area. Many technologies are able to do locate the prostate prior to treatment but only Calypso can continue to monitor the prostate’s position during treatment.

  For more information about radiation therapy for prostate cancer, please visit the

  Center for Radiation Oncology

• Surgery: depending on the stage of the disease, the surgery options are:
  • Cryosurgery: is a minimally invasive surgery, which uses a probe to twice rapidly freezing and thawing the cancerous tissue.
  • Radical Prostatectomy: is the removal of the entire prostate during surgery.
    • daVinci™ Radical Prostatectomy uses a state-of-the-art robotic system to make incisions and to remove the cancerous prostate.
    • Laproscopic Radical Prostatectomy uses conventional laparoscopic instruments to remove the cancerous prostate.
    • Open Retropubic or Perineal Prostatectomy uses conventional open techniques and instruments to remove the cancerous prostate.
  • Lymphadenectomy: is the surgical removal of the lymph nodes by open and/or laparoscopic due to prostate cancer spreading to the surrounding tissue.