Prostate cancer is the 2nd leading cause of cancer death in men, and 1 in 7 men are diagnosed in their lifetime. Patient diagnosis is based upon an abnormal PSA level (a blood test) or an abnormal digital rectal exam. When indicated, a prostate needle biopsy is performed to detect the presence of cancerous prostate cells, and when present the aggressiveness of those cells. Further testing can help determine if the cancer is organ confined (local cancer only) or advanced (metastatic cancer). We also utilize new advanced molecular and genomic based testing to further risk stratify some patients. This allows us to consult with each patient individually to determine their own personalized treatment plan, as no single regimen is perfect for all patients.
Active Surveillance. Some very early, low grade prostate cancers may never clinically progress, and therefore can be followed with regular close observation. Protocols using routine PSA blood tests, digital rectal exam, and screening biopsies are performed.
Surgery/ Robotic Radical Prostatectomy. Definitive surgery for organ-confined prostate cancer may involve removal of the prostate gland. Surgical removal has the best long term data in terms of cancer control and cure rates. We utilize the da Vinci Robot to remove the prostate, with excellent post-operative erectile and continence rates.
Radiation. Radiation can be given in a variety of methods, either via internal radiation seed placement, external beam radiation, or proton therapy. This treatment is indicated for men with organ-confined disease or localized prostate cancer.
Hormone Therapy. Hormone therapy reduces your body’s production of testosterone, which is a stimulant for the growth and progression of prostate cancer. This treatment can be used in combination with radiation for intermediate localized prostate cancer, or alone for advanced/metastatic stages. This treatment is not curative alone, but slows the progression of prostate cancer. Typical injections are given at 1-3 month intervals.
Advanced Cancer. Metastatic or advanced prostate cancer has been traditionally treated with chemotherapy via a medical oncologist. Extensive research in prostate cancer has recently produced multiple new agents that may delay the time until chemotherapy is required. These include oral medications and injections that can help slow prostate cancer growth, even after hormone therapy has failed or become resistant.