Prostate cancer is the most common cancer to effect men and the second leading cause of death from cancer in men behind lung cancer. Prostate cancer usually occurs silently with no immediate signs until it manages to extend out of the prostate (metastasis). Prostate cancer metastasis occurs primarily in the lymph nodes and bones as well as other soft tissue (visceral) organs such as lung, liver, and brain. Symptoms of metastatic prostate cancer include bone pain and weight loss.
Prostate cancer screening with PSA blood testing and Digital Rectal Exam (DRE) is critically important in the early detection (catching prostate cancer contained in the prostate) to allow care with locally directed therapy.
It’s not clear what causes prostate cancer.
Doctors know that prostate cancer begins when some cells in your prostate become abnormal. Mutations in the abnormal cells’ DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread to other parts of the body.
Prostate biopsy is a procedure performed to evaluate for the presence of prostate cancer in someone who has been found to have an abnormality such as an elevated PSA blood test or a prostate nodule on examination. Prostate biopsy is undertaken not only to diagnose the presence of prostate cancer but also performed to evaluate the extent or aggressiveness of the disease.
Prostate biopsies can be performed in the office setting or in outpatient surgery. In the office setting local anesthesia is injected into the nerve bundles around the prostate by penetrating the rectal wall under the direction of an ultrasound probe in the rectum. In this manner the prostate can be numbed like the numbing of a tooth by a dentist prior to dental work. If the biopsy is performed in outpatient surgery, anesthesia will be used under the direction of an anesthesia specialist.
An ultrasound probe is used to perform an ultrasound (sound wave) examination of the prostate tissue and is also used to visualize and direct the biopsy locations. Typically, biopsies are taken in multiple standardized areas throughout the prostate thoroughly sampling the prostate gland. Additional abnormal areas are targeted for biopsy as well.
After the biopsy, the patient might experience a small amount of blood in the urine or bowel movement for a day or two. Usual recommendations include only mild activity the day of and the day after the biopsy. Results typically take several days to a week or more to return.
Prostate cancer is initially diagnosed by performing a biopsy, usually as a result of a PSA blood test elevation or abnormality noted on digital rectal examination. Prostate biopsies can be performed in our office using local anesthesia, or in an outpatient surgery setting using sedation or general anesthesia. Staging tests are coordinated through our office and area hospitals when needed.
At Urologic, we offer comprehensive prostate cancer care using all the clinical information available concerning the patient. We can facilitate genetic testing of prostate cancer tissue when appropriate to aid in providing an individual patient centered treatment plan. We help guide patients through the planning process concerning their prostate cancer.
We also offer treatment for those who fail local therapies or develop cancer outside of the prostate (metastatic disease):
Using Da Vinci Si or Xi surgical platforms at our local hospital, we remove the prostate with cancer through 5-6 tiny incisions. Robotic surgery has maintained cancer control rates while dramatically lowering blood loss, decreasing hospital length of stay, and improving patient recovery. Nerves are still often able to be spared (when appropriate) that run past the prostate and thus help to preserve erectile function. Techniques are also used to help maintain urinary control and prevent urinary leakage.
Testosterone is the principal stimulator of prostate cancer growth. The vast majority of Testosterone is produced by the testicles with a smaller amount coming from the adrenal glands. Traditional Hormone Ablative Therapies center around removing the testicles or turning off testicular production of testosterone. This can deliver durable remission rates for years in most individuals.
Immunotherapy is an approved treatment for patients with prostate cancer who fail primary treatment, and have been diagnosed with metastatic prostate cancer to only the lymph nodes and bone. Immunotherapy is accomplished by washing the patients blood through a filter and harvesting the STEM CELLS. These STEM CELLS are sent to a special regional lab to train them how to recognize and destroy prostate cancer. The newly trained cells are then placed back into the patient by 3 separate infusions weeks apart. This therapy has been proven to extend the lives of patients with advanced prostate cancer.
Radiation Therapy is currently performed in Tupelo MS, often with the aid of gold seed marker placement. The gold seed makers allow the radiation oncologist to deliver radiation energy to the prostate more accurately sparing adjacent structures and limiting side effects. The gold seeds are typically placed in our office using ultrasound guidance.