Prostate Cancer

Cancer of the prostate is the most common cancer in men. The risk of prostate cancer increases with age, a family history of prostate cancer, and diets high in animal fat/red meat or calcium, and/or low in fruits and vegetables. Prostate cancer tends to grow quite slowly. Therefore, when it occurs at advanced age it may not require treatment. However, prostate cancer is the second most common cause of cancer death in men, so generally treatment is needed...more

Symptoms of Prostate Cancer:

Early detection is important, because cure is often possible only when the cancer is confined to the prostate gland itself. The prostate lies just below the bladder in men and adds nutrients and hormones to sperm. The prostate continues to grow in adult life, and often restricts the flow of urine, causing a slow stream, incomplete emptying, and increased urinary frequency both day and night. These symptoms are so common they are often considered to be normal aging. These symptoms can also be caused by prostate cancer, and early prostate cancer typically causes no symptoms. Routine screening after the age of 40 is therefore required to detect prostate cancer that is confined to the gland and curable. Screening consists of a digital rectal examination (DRE or "finger wave") and a blood test for PSA. Between ages 50 and 70 these tests are generally done annually...more

Diagnosis of Prostate Cancer:

If the DRE or PSA are abnormal, a needle biopsy can be done to see if prostate cancer is present. After numbing medicine is given an ultrasound image is used to guide the needle biopsies. The risks of biopsy are bleeding and infection, so you will be asked to hold aspirin and other blood thinners for a week before the procedure and you will be given an antibiotic. If prostate cancer is present, the grade and stage are used to select the best treatment for you.

Grade and Stage: Gleason grade 2-10 describes the microscopic appearance of prostate cancer cells. Near normal appearing cells, grade 2, have near normal behavior, while increasingly abnormal appearing cells have increasingly aggressive behavior. Stage is the extent of disease, its size and location.

Stage I is confined to the prostate and cannot be felt on DRE. Stage II is also confined, but can be felt. Stage III disease is beyond the capsule or lining of the prostate, but not in lymph nodes, while stage IV disease is in lymph nodes or other parts of the body such as bone. Stage is determined by DRE, biopsy, PSA, and if the PSA is above 20 bone scan and other tests such as CT or MRI scan.

Treatment:

Long term cure of prostate cancer can be achieved if cancer cells are confined to the gland. Best results currently are with complete removal of the gland- radical prostatectomy. Risks of this surgery include loss of erections, leakage of urine, and the risks of major surgery. Generally 2 days of hospitalization are required.

Prostatectomy can also be done laparoscopically, with removal of the gland through a small incision. Radiation therapy may also be curative and is often preferred in men over the age of 70 or with a life expectancy of 10 years or less. Complications also include loss of erections and incontinence, as well as bowel and bladder irritation and bleeding. For advanced disease the primary treatment is hormone therapy.

Hormone Treatment: Prostate cancer cells need the male hormone testosterone to grow. Removal of testosterone by removing the testes surgically (castration) or, more commonly, by suppressing testosterone production by medication, causes the cancer to shrink. Studies now show that intermittent hormone therapy reduces the side effects such as muscle and bone loss and may actually be superior to continuous hormone therapy. The PSA is used to determine when hormone treatment is needed again....more

More About Prostate Cancer and Robotic Surgery

> About da Vinci
...... Video
...... Glossary

> Prostate Cancer
...... About Prostate Cancer
...... Causes
...... Screening & Testing
...... Prevention

> Treatment Options
...... Observation
...... da Vinci® Prostatectomy
...... Other Surgery Options
...... Hormonal Therapy
...... Radiation Therapy

More information is available from the National Cancer Institute:
www.cancer.gov/cancertopics/types/prostate (link opens a new browser window)

Created: 3/15/2005 | Updated: 5/21/2006