Prostate cancer is a common cancer in men that is often symptomless initially. Early detection is vital for successful treatment.
What is prostate cancer?
Prostate cancer is one of the most common cancers among men over the age of 60. It’s also one of the most successfully treated. In fact, more than 3.3 million men in the U.S. are prostate cancer survivors.
The AHN Cancer Institute is home to a dedicated Prostate Cancer Center. Specialists from our Prostate Center and Urologic Oncology Center of Excellence collaborate to tailor a treatment plan to suit your needs. We’re skilled at detecting prostate cancer at its earliest stages and developing an effective treatment plan. Together, we help you live a healthy life.
AHN Urologic Oncology Center of Excellence
Our prostate experts at the Urologic Oncology Center of Excellence and the Prostate Cancer Center focus exclusively on prostate cancer. This intensive approach gives us the expertise to quickly and precisely diagnose and treat prostate cancer. We see you and your unique needs and can deliver extensive, personalized care. Our approach to care includes robust support services to help you feel your best during treatment.
We designed our comprehensive center to maximize your convenience. Shortly after diagnosis, you meet with several specialists, like a urologist and a radiation oncologist. We reduce your travel and wait time so you can get answers as quickly as possible.
Prostate cancer care at AHN: Why choose us?
Specialists at the Cancer Institute and the Prostate Center use the latest techniques and technology to provide a comprehensive treatment plan. Our treatment plans use:
- Minimally invasive procedures: Many of our patients receive treatment without a surgical incision. These types of procedures often result in a quicker, more comfortable recovery.
- Advanced technology: Our surgeons use robotic surgical technology to perform intricate procedures with more precision and control than traditional techniques.
- Team approach: We work closely with urologists, radiation oncologists, and other specialists to quickly and comprehensively treat prostate cancer.
- Collaborative: You see the specialists you need in one place, at one time. This approach ensures the quickest possible diagnosis. You also have access to our robust support services, such as support groups and palliative care.
- Expert: Our prostate cancer specialists use the latest research, so you receive the most precise diagnosis. A specific diagnosis helps us create an effective treatment plan, tailored to your needs.
Prostate cancer symptoms and signs
Prostate symptoms and signs can vary widely, depending on underlying conditions and overall health. They can be broadly categorized into urinary symptoms, sexual symptoms, and systemic symptoms. It's crucial to remember that these symptoms can also be caused by other conditions, so a proper diagnosis from a doctor is essential.
Urinary symptoms of prostate cancer
Urinary symptoms are the most common signs of prostate cancer and can vary for each person, but if you notice changes in urination, it’s important to talk to your doctor. Some common urinary symptoms include:
- Frequency: Urinating more often than usual, especially at night (nocturia).
- Urgency: A sudden, strong urge to urinate that's difficult to delay.
- Hesitancy: Difficulty starting the urine stream.
- Weak stream: A slow or weak urine stream.
- Intermittency: Stopping and starting while urinating.
- Straining: Having to strain or push to urinate.
- Incomplete emptying: Feeling like the bladder isn't completely empty after urinating.
- Dribbling: Leakage of urine after urination.
- Urinary retention: Inability to urinate.
Sexual symptoms of prostate cancer
Changes in sexual activity can change as we age and are quite normal. However, if you are experiencing significant changes that are affecting your overall health or well-being, talking with your doctor can help to identify if these changes are related to prostate cancer. Some things to look out for include:
- Erectile dysfunction
- Decreased libido
- Painful ejaculation
- Retrograde ejaculation
Other symptoms of prostate cancer
These symptoms are known as systemic prostate cancer symptoms. They are less common than urinary and sexual symptoms and often present when the cancer is more advanced. Talk to your doctor if you are experiencing:
- Blood in the urine (hematuria)
- Blood in the semen (hematospermia)
- Pain in the lower back, hips, or pelvis
- Weight loss
- Fatigue
- Bone pain
Causes and risk factors
The exact cause of prostate cancer remains unknown, but age is the strongest risk factor; the risk increases significantly after age 50. Family history of prostate cancer, particularly in a first-degree relative, substantially elevates risk. Genetic factors play a role, with certain gene mutations increasing susceptibility. Racial disparities exist, with African American men having a higher incidence and mortality rate. Lifestyle factors, such as diet and physical activity, may also contribute, though the extent of their influence is still under investigation.
Prostate cancer screening and diagnosis
Prostate cancer screenings, and any subsequent diagnosis, will vary for each person. Your AHN urologist will work with you, taking into account your risk factors and family history to determine what tests and screenings are appropriate.
Initial tests for prostate cancer include:
- Digital rectal exam (DRE): Your physician will insert a gloved, lubricated finger into your rectum to feel for bumps or hard areas on both sides of the prostate.
- Prostate-specific antigen (PSA) blood test: This test predicts the likelihood of prostate cancer. If you have high PSA levels, that may indicate prostate cancer. However, this test is not definitive.
- Prostate needle biopsy: This highly targeted procedure allows your physician to sample a select amount of tissue for examination, with as little effect on the surrounding area as possible.
If your physician suspects prostate cancer after these exams, further diagnostic procedures might include:
- Bone scan: In this test, we inject a small amount of fluid into the bloodstream, which gets absorbed by the bones to detect if the cancer has spread. The fluid accumulates in areas where cancer is present.
- Computed tomography (CT) scan: We use a combination of X-rays and computer technology to get detailed images of the prostate to pinpoint the cancer's location.
- Magnetic resonance imaging (MRI): Powerful magnets and radio waves provide a detailed picture of the prostate.
Learn more about prostate cancer screening.
Types and stages of prostate cancer
Imagine your prostate is like a small walnut-shaped gland. Prostate cancer starts when some cells in this gland grow abnormally and uncontrollably. Doctors categorize this cancer in different ways to understand how serious it is and how best to treat it. These categories include a Gleason Score and Grade Group. From there, your doctor will most likely be able to determine the prostate cancer staging.
Gleason Score and Grade Group
Think of this like a rating system for how the cancer cells look under a microscope. A low score (like a Gleason Score of 6 or Grade Group 1) means the cells look fairly normal and are likely to grow slowly. A high score (like a Gleason Score of 8 or higher, or Grade Group 4 or 5) means the cells look very abnormal and are more likely to grow quickly and spread. This is a crucial factor in determining treatment.
Prostate cancer staging
The prostate cancer stage depends on how the cancer has spread in the body.
- Early Stages (Stage I & II): The cancer is still contained within the prostate gland. This is the best-case scenario.
- Locally Advanced (Stage III): The cancer has grown beyond the prostate but hasn't spread to distant parts of the body.
- Metastatic (Stage IV): This is the most advanced stage. The cancer has spread to other parts of the body, like the bones or lymph nodes. This is more serious and harder to treat.
Your AHN urologist and care team will discuss with you, in detail, everything related to your type and stage of prostate cancer while answering any questions and listening to your concerns.
Prostate cancer treatment
Treatment for prostate cancer varies based on each individual case. Your AHN urologist and care team will work with you to determine what’s best for your unique situation. AHN uses advanced treatment options such as minimally invasive techniques and therapies. Treatments are tailored to the type and stage of prostate cancer.
Localized prostate cancer treatments
Treatment options for prostate cancer that hasn't spread beyond the prostate include:
- Active surveillance (watchful waiting): Regular monitoring with PSA tests, digital rectal exams, and biopsies to track the cancer's progression. Treatment is only initiated if the cancer grows or becomes more aggressive. Suitable for low-risk cancers and older men with a shorter life expectancy.
- Radiation therapy: Uses high-energy radiation to kill cancer cells. This can be delivered externally (external beam radiation therapy — EBRT) or internally (brachytherapy, where radioactive seeds are implanted directly into the prostate).
- Surgery (radical prostatectomy): Surgical removal of the prostate gland. This is a major surgery with potential side effects like incontinence and erectile dysfunction. Robotic-assisted surgery is often used to minimize these risks.
- High-intensity focused ultrasound (HIFU): Uses focused ultrasound waves to destroy cancer cells. A less invasive option than surgery, but not as widely used.
- Cryotherapy: Uses extreme cold to freeze and destroy cancer cells. Another less invasive option, but not as widely used as radiation or surgery.
Advanced or metastatic prostate cancer treatments
When the cancer has spread beyond the prostate, treatment options may include:
- Hormone therapy: Androgen deprivation therapy (ADT) reduces the levels of testosterone in the body, slowing or stopping the growth of prostate cancer cells. This can be achieved through medication (e.g., GnRH agonists, antiandrogens) or surgery (orchiectomy, removal of the testicles).
- Chemotherapy: Uses drugs to kill cancer cells. Typically used when hormone therapy stops working.
- Radiation therapy: May be used to treat specific areas where cancer has spread.
- Targeted therapy: Drugs that target specific molecules involved in cancer growth.
- Immunotherapy: Helps the body's immune system fight cancer cells. Several immunotherapy drugs are now approved for metastatic prostate cancer.
Focal therapy
Focal therapy is a specialized prostate cancer treatment option that is used most effective for patients who have localized prostate cancer, confined to a specific area, and low-to-intermediate risk prostate cancer. AHN is the only provider in Western Pennsylvania to offer focal therapy for our patients. Focal therapy offers potential benefits, including:
- Preserving prostate function: By treating only the affected portion, focal therapy aims to minimize damage to healthy prostate tissue and surrounding nerves, potentially reducing the risk of side effects like erectile dysfunction and urinary incontinence.
- Lower risk of side effects: Compared to whole-gland treatments, focal therapy may reduce the risk of urinary, bowel, and sexual side effects.
- Outpatient procedure: Many focal therapy techniques are minimally invasive and can be performed on an outpatient basis, meaning a shorter hospital stay.
- Faster recovery: Recovery time is generally shorter than with traditional treatments.
The primary goal is to eliminate cancer cells within the targeted area of the prostate. Focal therapy for prostate cancer is a newer approach to treatment that focuses on treating only the area of the prostate where the cancer is located, rather than the whole prostate. Your AHN doctor will review factors like PSA level, Gleason Score, and clinical stage to determine if you are a good candidate for focal therapy.
After prostate cancer treatment
After undergoing treatment for prostate cancer, some patients may experience changes that have long-lasting effects. AHN offers support and resources to help aid in rehabilitation and getting you back to a life that is fulfilling. Our Prostate Cancer Survivorship Care and Guidelines offer resources and options.
Prostate cancer FAQs
Questions are common with any cancer diagnosis. Your AHN urologist and care team are here to answer any of your questions and help talk through your concerns. Know you’re not alone in a prostate cancer diagnosis. If you’re feeling overwhelmed, we’ve included some frequently asked questions to get you started.
How do you know if you have prostate cancer?
Prostate cancer often has no noticeable symptoms in its early stages. Doctors typically detect it through a prostate-specific antigen (PSA) blood test and a digital rectal exam. If these tests suggest a problem, further tests like a biopsy will be needed for a definitive diagnosis.
Is prostate cancer curable?
Yes, prostate cancer is often curable, especially if detected early. The cure rate depends on several factors, including the stage of the cancer and the individual's overall health. Treatment options aim to remove or destroy the cancerous cells.
What is the prostate cancer survival rate?
The survival rate for prostate cancer is high, especially for those diagnosed at an early stage. The five-year survival rate is over 99% for localized prostate cancer and remains significant even in later stages. Survival rates are constantly improving with advances in treatment.
Contact us
Call (412) DOCTORS (412) 362-8677 or request an appointment to learn more about prostate cancer screening.
Learn more about AHN cancer screening dates and locations for each screen offered.