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Prostate Cancer

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Prostate cancer is the second most common type of cancer among men in the U.S. (after skin cancer). It develops in the male prostate gland, a part of the reproductive system located below the bladder and in front of the rectum. An enlarged prostate is a normal part of the aging process for many men, and does not necessarily indicate cancer.

Prostate cancer is mostly diagnosed in men over age 65 and becomes increasingly common with advancing age. It also is more common in African-American men than in Caucasian, Hispanic or Asian-American men. A family history of prostate cancer and a diet high in animal fats may increase a man's risk of developing prostate cancer. Men with pre-cancerous cells ("prostatic intraepithelial neoplasia") also have a higher risk for prostate cancer.

How is it diagnosed?
How is it treated?
How does Advocate Christ Medical Center make a difference?
Frequently Asked Questions
Genetic Cancer Risk Assessment Program

How is it diagnosed?

Screening for prostate cancer is relatively routine in men over age 50, and includes:

  • Digital rectal exam-the physician inserts a gloved finger into the rectum to feel the prostate for any irregularities.
  • PSA test-a blood test for prostate specific antigen (PSA). Elevated PSA level may indicate cancer or a non-cancerous problem called benign prostate hyperplasia.

    If the PSA level is high, additional tests may be recommended such as:
    • Transrectal ultrasound-a test that uses soundwaves to create a picture of the prostate.
    • Transrectal ultrasound-guided biopsy-using images provided by ultrasound, the physician extracts a small amount of tissue to be analyzed in the pathology lab. The tissue biopsy provides important details that can be useful for treatment planning.
    • Cystoscopy-long, thin, lighted tube with a tiny camera on the tip allows the physician to see inside the urethra and bladder and look for abnormalities.

If cancer is confirmed, your doctor may order additional tests to determine the stage of cancer (how far advanced the cancer is). These tests might include:

  • Bone scan-to see if cancer has spread to the bones, which sometimes happens when prostate cancer progresses.
  • Computed tomography (CT or CAT scan)-diagnostic imaging that combines X-rays and computer technology to create many cross-sectional image "slices" of organs and other body structures.
  • MRI (magnetic resonance imaging)-diagnostic imaging that uses a powerful magnet, radiofrequencies and computer technology to create detailed images of organs.

Advocate Christ Medical Center has a genetic cancer risk assessment program that offers counseling and testing for families who are at high risk for prostate cancer.

How is it treated?

Several factors influence the decision of how to treat prostate cancer, including age, stage of disease and personal preference. When prostate cancer is found in a younger man, it usually is treated aggressively (surgery, sometimes supplemented by radiation therapy or hormones). When the patient is much older and the cancer is growing very slowly, he may decide to take a "watchful waiting" approach that involves testing several times per year but no active treatment.

Surgery is the primary treatment for mostly younger men and many older men with early-stage cancer. Surgery is not an option for more advanced prostate cancer. The prostate's close proximity to the urethra and genitals makes surgery complicated, as the surgeon tries to avoid damage to these other organs that can cause incontinence and impotence. Urologists (surgeons who specialize in issues of the genitourinary tract) choose from several techniques to surgically remove the tumor and some of the surrounding tissue. These include:

  • Radical retropubic prostatectomy - removal of the entire prostate and nearby lymph nodes through an incision in the abdomen.
  • Radical perineal prostatectomy - removal of the entire prostate and nearby lymph nodes through an incision between the scrotum and anus. A small incision in the abdomen may be needed to remove lymph nodes.
  • Laparoscopic prostatectomy - removing the prostate and lymph nodes with several small incisions in the abdomen. A thin, lighted scope helps the physician work within the small incisions.
  • Nerve-sparing prostatectomy - removes the prostate, but protects the nerves that control erection.
  • Radiation therapy - uses high-powered X-rays or ionizing radiation to kill cancer cells. It can be helpful to shrink a tumor before surgery, to destroy cancer cells remaining after surgery, or as an alternative to surgery.
  • Robotic prostatectomy - removal of the prostate and lymph nodes that utlize tireless robotic arms and a camera inserted through a few tiny incisions in the abdomen. Patients experience less risk of blood loss and complications, as well as much recovery time than a traditional surgery.
  • External radiation therapy - is delivered by a linear accelerator and often can be done on an outpatient basis. Patients may need therapy up to five days per week for several weeks. Three-dimensional (3-D) conformal radiation therapy and intensity-modulated radiation therapy (IMRT) are more sophisticated methods of external radiation therapy.
  • Internal radiation - also called brachytherapy-involves implanting tiny radioactive seeds close to the tumor site. These seeds remain in place and give off radiation to the tumor site for weeks or months.
  • Radiosurgery - such as CyberKnife®, is a state-of-the-art technique that combines CT imaging, computer-controlled robotics and radiation therapy to deliver powerful radiation precisely targeted to the tumor. This technology minimizes damage to healthy tissue surrounding the tumor.
  • Hormone therapy - works by reducing the body's level of male hormones (such as testosterone), which prostate cancer cells need in order to grow. Hormone therapy may be accomplished with medications that inhibit the body's hormone production, or by surgically removing the testicles.

How does Advocate Christ Medical Center make a difference?

At Advocate Christ Medical Center, our urologists are skilled in all types of prostate surgery-from nerve-sparing prostatectomy that lessens the risk of impotence, to laparoscopic surgery, which offers faster recovery and less pain, to more traditional techniques for radical prostatectomy. And Christ Medical Center is one of few medical centers in Illinois using CyberKnife® radiosurgery, a revolutionary non-invasive treatment to attack cancer cells with pinpoint accuracy.

Prostate cancer and its treatment sometimes cause urinary incontinence or impotence. Our reconstructive urologists utilize a range of surgical and non-surgical methods to restore normal urinary and erectile function.

Urologists (who provide both surgical and medical treatment), radiation oncologists, medical oncologists, reconstructive urologists, pathologists, oncology nurses and other care providers at Christ Medical Center all work collaboratively to meet each man's specific needs. Additionally, we have the experts and resources to address other medical issues that can complicate cancer treatments, such as heart disease or diabetes.

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