Prostate Cancer 101

Below is important information to consider about prostate cancer. If you’ve been diagnosed, learn about YOUR individual risk and treatment options by taking the My Prostate Cancer Coach Risk Tool.

What is Prostate Cancer?

The prostate is a small, walnut-sized organ that surrounds the urethra just in front of the bladder just above the rectum. The prostate is not essential for life, but it’s important for reproduction. It supplies fluids that are necessary for sperm transit and survival for fertilization.

Prostate cancer occurs when cells in the prostate grow in an uncontrolled, abnormal manner. This growth can invade nearby healthy prostate tissue over time, and potentially spread to other areas of the body.

Most prostate cancers are caused by a mistake in your genetic makeup, which usually occurs as a result of natural “wear and tear” and the normal aging process. About 9 percent of the time, prostate cancer is caused by a genetic abnormality inherited from your parents.

 To Treat or Not to Treat?

Prostate cancer grows at different rates in different individuals. In fact, research suggests that the majority of newly diagnosed prostate cancers are biologically insignificant and may not require treatment; many men live with prostate cancer and never undergo therapy. Instead, such cancers can be managed with what is called active surveillance, which consists of strict, regular monitoring of the cancer by a doctor, allowing men to avoid potentially life-altering side effects of treatment but at the same time not losing the ability to treat cancers whose behavior may change at a later time.

However, aggressive prostate cancers that have a high risk of growing and spreading should be treated in a timely manner. Treatment might include surgery (Radical prostatectomy), Radiation therapy, Cryosurgery, Hormonal therapy, Chemotherapy, and emerging new drugs or investigational agents.

For each man, the potential benefits versus risks and side effects of treatment should be considered. If you are diagnosed with prostate cancer, it is important to determine the risk of your cancer growing and spreading, because this will shape your course of care. This can be achieved through the use of recently introduced genomic diagnostic tests along with other considerations.

Detecting Prostate Cancer

Most men are not diagnosed based on prostate cancer symptoms. Instead, prostate cancer is often detected through the use of two types of screening tests:

  • PSA test – this is a blood test that checks your levels of Prostate specific antigen (PSA), a protein that is normally made by the prostate gland. Increased PSA readings may suggest prostate cancer or other prostate health problems.
  • Digital Rectal Examination (DRE) – this test allows your doctor to feel the prostate for abnormalities by inserting a gloved finger through the rectum.

Men should see their healthcare provider if they experience any of the following signs or symptoms:

  • Persistent hip or back pain.
  • Difficulty urinating.
  • Painful or burning urination.
  • Blood in the urine.

If one of the screening tests described above suggests that you might have prostate cancer, the following diagnostic tests may be conducted:

  • Needle biopsy and pathologic analysis – your urologist will remove small amounts of tissue from the suspected prostate tumor and send it to the lab for microscopic analysis.
  • Imaging – tests such as MRI, CT scan or bone scan will allow your doctor to determine whether the cancer has spread.

Factors that Determine Course of Care

Men diagnosed with prostate cancer have many different options available. Depending on certain factors - such as your PSA readings, Gleason score, and age - you and your urologist will discuss whether active surveillance, surgery (radical prostatectomy), radiation therapy, androgen deprivation therapy (ADT) or chemotherapy is the best course of care for you.

Each prostate cancer diagnosis and course of care is unique. Empowering yourself with information and understanding the implications of each treatment is vital to selecting the course of care that is right for you. Take a few minutes to complete the My Prostate Cancer Coach Risk Tool to better understand your risk level, options for care and what questions you should be asking your healthcare team.

New, biopsy-based genomic tests, used in conjunction with the Gleason Score and other considerations, can aid in more accurately assessing whether a patient has the likelihood of less aggressive or indolent prostate cancer, which can be appropriately managed with active surveillance, and those who are likely to have more aggressive prostate cancer and should be treated immediately.

Defining your healthcare team

Your healthcare team is there to be your advocate and answer any questions you may have. Below is a list of some of the medical professionals you may encounter during your treatment.

  • Primary care physician – Often serves as your first point of contact for medical issues and continues to track your overall health throughout your treatment.
  • Urologist – Oversees your healthcare team during diagnosis and treatment, conducts active surveillance, performs surgery and manages your hormonal therapy regimens. Some urologists may also manage chemotherapy, although this is more commonly done by a medical oncologist.
  • Radiation oncologist – Specializes in treating your cancer through radiation.
  • Medical oncologist – Manages your potential chemotherapy regimens.
  • Radiologist – Identifies and monitors your cancer through medical imaging.
  • Pathologist – Studies cells to determine the specifics of your cancer stage and grade.
  • Physician assistant – With physician supervision, supports your basic care as well as performs more comprehensive medical duties and procedures.
  • Nurse practitioner/Nurse – Provides personalized care and quality of life education during your treatment.
  • Psychiatrist/Psychologist – Can help navigate emotional issues and challenges during your diagnosis and treatment.
  • Family members/Loved ones – Your spouse, partner, family and friends play an important role in your treatment serving as support, advocates and companions.

Remember, YOU are one of the most important members of your healthcare team, so start getting to know these people and ask questions to ensure you're comfortable with the course of care proposed by your healthcare team.