Prostate cancer is the No. 2 leading cause of cancer death in American men, second only to lung cancer. An estimated 333,830 men will be diagnosed with prostate cancer in the United States in 2026, and about 1 in 44 of all men will die from it, according to the American Cancer Society.
The prostate is a male reproductive gland located between the bladder and the penis. Fluid from the prostate is discharged into the urethra at the time of ejaculation, to nourish and stabilize sperm for procreation.
Prevention
Experts recommend that men age 50 or older be screened during their annual physical exam, beginning with a discussion about prostate cancer risk. A prostate-specific antigen (PSA) blood test can identify a man’s risk of prostate cancer, and it’s often combined with a rectal exam and imaging scans. The results of the PSA test, rectal exam, and/or imaging scans can lead doctors to recommend a biopsy (taking a small tissue sample) of the prostate gland. This helps determine whether prostate cancer is present, and if so, how aggressive it is.
Certain men with a higher risk of prostate cancer based on family history, ethnicity, race, or ancestry should have their first discussions about screening tests starting as early as age 40.
Diagnosis
Symptoms of prostate cancer are rare, and many men show no symptoms before being diagnosed, which is why prostate cancer is sometimes called a “silent killer”. In advanced stages, symptoms may affect quality of life and can range from pain in the bones and bloody urine, to blood in the semen, blockages in the urinary tract, and kidney failure.
To learn more about a personalized path toward a cure, men diagnosed with prostate cancer should ask their doctor these questions:
- How will my personal health be affected?
- What grade or level of aggressiveness is my specific cancer at?
- What stage or level of progression is my cancer at?
- Are there any additional tests that should be done?
- What are my treatment options?
- What are the side effects of each treatment option?
Treatment
The patient and physician should look at the options available to treat the prostate cancer and develop a personalized care plan to manage symptoms, preserve quality of life, and hopefully cure the cancer.
In the earliest stages of low-grade prostate cancer, doctors may recommend active surveillance, which means keeping an eye on the cancer without immediate treatment. This surveillance may last for years.
If treatment is needed, options include:
- Surgery, which involves removing the entire prostate gland and sometimes lymph node tissue, too
- Radiation therapy, where beams of radiation are focused on the prostate
- Hormone therapy, which reduces levels of male hormones to stop them from affecting prostate cancer cells
- High-intensity, focused ultrasound therapy (HIFU), where high-energy sound waves are used to destroy cancer cells
- Irreversible electroporation (IRE), which uses electrical energy to cause cancer cells to rupture and die
- Cryosurgery, where extreme cold temperatures are used to freeze and kill cancer cells
If the cancer is diagnosed in later stages and has spread to other parts of the body, it often becomes more aggressive and more difficult to treat in most cases.
To help guide personalized care of patients, the UAB Department of Urology offers magnetic resonance imaging (MRI) scans and ultrasound fusion-guided biopsy. This type of biopsy allows doctors to take a more direct tissue sample of areas that are most concerning.
UAB Medicine is a leader in diagnosing and evaluating the risk various patients face. Our doctors and researchers have participated in clinical trials that led to approval and widespread use of specialized forms of PET scans in developing more personalized treatment plans.
Current research
Researchers currently are searching for prostate cancer biomarkers that could lead to earlier and more accurate diagnoses and greater insight into the cancer itself. Biomarkers are biological signs that can help doctors better understand a patient’s condition and/or disease risk.
At UAB Medicine, prostate cancer research is focused on advanced imaging and biomarker development, new technologies for minimally invasive therapies, and other innovative options. And as a major center for research, our patients may have access to cutting-edge techniques and treatments not widely available at other medical centers.
UAB Medicine Urology has convenient clinic locations at The Kirklin Clinic of UAB Hospital and UAB St. Vincent’s East. To make an appointment, please call 205-934-9999 or visit uabmedicine.org.
SOURCES: UAB Medicine Urology, American Cancer Society