Prostate Cancer

Studies link the following with increased risk of prostate cancer:

• Above the age of 50
• Occurs more often in African-American men and in Caribbean men of African ancestry
• Family history – having a father or brother with prostate cancer more than doubles your risk; it is higher for those with a brother with prostate cancer than a father with prostate cancer
• Inherited gene changes
• A diet high in red meat or high-fat dairy products
• Obesity

Most prostate cancers are first found during screening with a prostate-specific antigen (PSA) blood test and or a digital rectal exam (DRE). Early prostate cancers usually don’t cause symptoms, but more advanced cancers are sometimes found because of symptoms they cause, such as bone pain.

Prostate Specific Antigen (PSA) blood test

Most healthy men have PSA levels under four nanograms per milliliter (ng/mL) of blood. The chance of having prostate cancer goes up as the PSA level goes up.

Transrectal Ultrasound (TRUS)

A small probe is inserted into your rectum to show images of the prostate. It is also used to guide the needles into the prostate during a biopsy.

Core Needle Biopsy

A small, hollow needle is inserted through the wall of the rectum into the prostate to obtain tissue samples. This is repeated eight to 12 times in various parts of the prostate. The transrectal ultrasound may be used to guide the needle.

The following tests may be ordered to detect the spread of prostate cancer:

• Bone scan
• CT scan
• MRI scan

With an accurate diagnosis and knowing the stage of your prostate cancer, you and your doctor will discuss treatment options and choose a treatment plan that is right for you.

The treatment you choose for prostate cancer should take into account:

• Your age
• Any other serious health conditions you have
• The stage and grade of your cancer
• Your feelings (and your doctor’s opinion) about the need to treat the cancer right away
• The likelihood that each type of treatment will cure your cancer or help in some other way
• Your thoughts about the possible side effects from each treatment, which will be explained by your doctor

Your Treatment Options

• Active surveillance
  Because prostate cancer often grows very slowly, some men, especially those who are older or have other serious health problems might never need treatment for their prostate cancer.
  
  Active surveillance involves monitoring the cancer closely with prostate-specific antigen (PSA) blood tests, digital rectal exams (DREs) and ultrasounds over regular time periods to see if the cancer is growing. Prostate biopsies may be done to see if the cancer is becoming more aggressive. If your test results show cancer growth, your doctor will talk to you about treatment options.
  
  
• Hormone Therapy

  Hormone therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to stop them from making prostate cancer cells grow.
  
  The main androgen in the body is testosterone. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. Hormone therapy is used in combination with other treatments and therapies.

• Core Needle Biopsy
  

  Prostate cancer is rarely only in one area of the prostate so your doctor will take an average of 12 samples from different parts of your prostate. Your doctor may take more samples of tissue if necessary. The lab report will tell your doctor if cancer is present in each sample, how much of the tissue sample contains cancer and your Gleason score.
  
  The Gleason score is a number based on the results of your biopsy. It's the sum of the most common and second-most common cancer cell patterns in your biopsy. The Gleason scores range from two to 10 and most prostate cancer will score six or higher. A higher score (eight to 10) means the type of cancer has a higher risk of growing and spreading.
  
  Your doctor will use your score along with the results of your prostate-specific antigen (PSA) blood test and digital rectal exam to recommend treatment.

• Surgery
• Radiation Therapy
• Chemotherapy
• Immunotherapy
• Cancer Biomarkers