Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder).
The symptoms listed below may occur with prostate cancer:
- Delayed or slowed start of urinary stream
- Dribbling or leakage of urine, most often after urinating
- Slow urinary stream
- Straining when urinating, or not being able to empty out all of the urine
- Blood in the urine or semen
- Bone pain or tenderness, most often in the lower back and pelvic bones (only when the cancer has spread)
The Prostate Specific Antigen or PSA blood test is suggested to screen men for prostate cancer.
A prostate biopsy is the only test that can confirm the diagnosis. Tissue from the prostate is viewed underneath a microscope. Biopsy results are reported using the Gleason grade and a Gleason score.
|Gleason Score||Gleason Grade|
|2 - 4||Low-grade cancer|
|5 - 7||Intermediate- (or in the middle-) grade cancer. Most prostate cancers fall into this category.|
|8 - 10||High-grade cancer (poorly-differentiated cells)|
There are two reasons a physician may perform a prostate biopsy:
- Your PSA blood test is high.
- A rectal exam may show a large prostate or a hard, irregular surface. Because of PSA testing, prostate cancer is diagnosed during a rectal exam much less often.
The following tests may be done to determine whether the cancer has spread:
- CT scan
- Bone scan
Surgery is usually only recommended after a thorough evaluation and discussion with a physician in regard to the benefits and risks of the procedure.
- Surgery to remove the prostate and some of the tissue around it is an option when the cancer has not spread beyond the prostate gland. This surgery is called radical prostatectomy. A radical prostectomy may be performed using robotic surgery.
Radiation therapy works best to treat prostate cancer that has not spread outside of the prostate. It may also be used after surgery, if there is a risk that prostate cancer cells may still be present. Radiation is sometimes used for pain relief when cancer has spread to the bone.
Radiation treatment options may include but are not limited to:
- Prostate brachytherapy (placing radioactive seeds inside the prostate gland)
Before choosing a treatment option, it is important to discuss all options with a physician.