Diagnosing Prostate Cancer
Prostate cancer is diagnosed with an exam that includes family and medical history and a PSA blood test.
Although the U.S. Preventative Services Task Force in 2015 downplayed the need for an annual PSA test, a 2020 study in the Journal of the National Cancer Institute said the recommendation actually triggered an increase in advanced disease in men over 50. PSA is the only screening test to detect prostate cancer. Our experts recommend regular screening for any man with a life expectancy of 10 or more years.
If PSA levels are elevated, our experts use specialized MRI and ultrasound equipment to biopsy the suspicious area and determine if cancer is present.
Treating Prostate Cancer
Treatment depends on the aggressiveness of your cancer and your general health. Nonaggressive prostate cancer can be monitored twice each year, an approach called “watch and wait.” For more aggressive cases, treatment may include surgery, radiation therapy, hormonal therapy and chemotherapy.
- Chemotherapy: Administered intravenously or by mouth. It circulates through the bloodstream to kill cancer cells.
- High-Intensity Focused Ultrasound (HIFU): HIFU technology ablates prostate tissue by focusing high-intensity ultrasound waves on the affected area, causing localized heating that destroys the cells in the gland without damaging the healthy surrounding tissue. The real-time imaging allows for precise local ablation in one session under general anesthesia, repeatable, if necessary, with a low risk of side effects. At the end of the procedure, a temporary urinary catheter will be placed in order to limit the risk of urinary retention due to the temporary swelling. You will be discharged and can return home rapidly after the end of the procedure. The catheter will be removed at the first follow-up visit just a few days later. Typical follow-up will include prostate-specific antigen (PSA) testing at three months, six months and one year, as well as an MRI image and potential follow-up biopsies at one year to evaluate the result.
- Hormonal therapy: Reduces production of the testosterone that stimulates prostate cancer cell growth. This does not cure prostate cancer, shrinks it before radiation therapy or if it returns after surgery or radiation.
- Surgery: Prostate removal is often required. Our surgeons pioneered the use of robotic prostatectomies with the remarkably precise da Vinci Surgical System. The robot gives surgeons a 3D view of even the smallest surgical field for precision that can preserve sexual function and continence. Patients also benefit from less blood loss and faster recovery times.
- Radiation therapy: High-energy particles or waves of radiation, similar to X-rays, destroy cancer cells.
- External beam radiation: A machine outside the body aims radiation at the cancer location. We use Intensity Modulated Radiation Therapy, an advanced 3D technique that minimizes damage to nearby healthy tissue.
- Internal radiation or brachytherapy: Seeds containing radioactive substance are placed in or near the cancer. We can use permanent seeds containing a low dose rate implant or temporary seeds with a high dose rate implant removed a day after placement.
To make accessing care easier, we created virtual visits for you and your family to connect from home or the urologist’s office with other members of your care team, including medical oncologists and radiation oncologists. These appointments are set up by our nurse navigators.
Learn more