The prostate gland is a small firm organ, about the size of a chestnut, located below the bladder and in front of the rectum. The urethra, the channel that carries urine from the bladder and through the penis, runs through the prostate. The primary function of the prostate gland is to produce fluids important for reproduction. As men get older, however, cancers develop in the prostate. Prostate cancer is the most common cancer among American men. Not all prostate cancers behave the same: some are slow growing while others can be very aggressive.
If a prostate cancer is allowed to spread beyond the prostate gland it becomes incurable. Therefore, early diagnosis is important.
Because prostate cancer generally develops without any symptoms, screening with blood tests and digital rectal exams is the best way to catch these cancers at an early and curable state.
For more information on prostate cancer and the University of Arizona Prostate Cancer Program, visit the prostate cancer page at the Center for Urologic Oncology at www.arizonaprostatecancer.com.
The urologic surgeons at the University of Arizona are experienced in the most up-to-date conventional, minimally-invasive and experimental treatments for prostate cancer
Our urologists include some of the only doctors in the state with additional fellowship training in the diagnosis and management of cancer, some of the most experienced robotic surgeons in the state and some of the only urologists in the Southwest comfortable performing salvage prostatectomies
Urologists at the University of Arizona work closely with colleagues in Radiation Oncology and Medical Oncology to offer the most comprehensive and contemporary treatment options in a multi-disciplinary approach
Once a man is diagnosed with prostate cancer, treatment decisions are based on an evaluation of the aggressiveness of the cancer, levels of prostate-specific antigens (PSA) and the feel of the prostate on digital rectal exam.
The least aggressive cancers can be treated effectively in several ways. However, as a prostate cancer becomes more aggressive, the treatment options become more limited. Once a cancer spreads away from the prostate, there are few effective treatment options.
Your urologist at the University of Arizona will discuss the different treatment options with you and will help you determine the most appropriate therapy, from the following selection.
Nerve-sparing Radical Prostatectomy
Often considered the “gold standard” of prostate cancer treatment, a nerve-sparing radical prostatectomy removes the prostate, the adjoining seminal vesicles and the nearby lymph nodes while attempting to preserve nerves associated with sexual function and the muscle for urinary control.
Most radical prostatectomies are performed using a surgical robot (the DaVinci Prostatectomyä) although rarely it is performed in a traditional “open” fashion.
There are two basic techniques of radiation therapy for prostate cancer. I.M.R.T. targets the prostate with radiation beams from the outside-in. It involves short daily sessions over many weeks.
Brachytherapy involves the implantation of radioactive seeds in the prostate in an outpatient surgical procedure.
When cancer recurs after radiation treatment, some patients can benefit from a “salvage” prostatectomy: removal of the prostate after radiation. Because of scarring from radiation, this is a more difficult operation and is almost always performed in open surgery.
Cryotherapy involves freezing the prostate with pressurized Argon gas in a brief outpatient operation. It can be used for both the initial treatment of prostate cancer and recurrences after radiation.
Active Surveillance with Delayed Intervention
Some men with early and non-aggressive prostate cancer can forego initial treatment and, instead, follow their cancer through a regimen known as Active Surveillance. This treatment approach involves monitoring the cancer with PSA blood tests, digital rectal exams and repeat biopsies. When the cancer becomes more aggressive, the patient is treated with surgery, radiation or cryoablation.
Androgen Deprivation Therapy
Androgen deprivation therapy treats prostate cancer by suppressing the production and effects of the male hormone testosterone. It is usually reserved for men with advanced prostate cancer and involves either surgical castration (removal of the testes) or medical castration (shots and pills that suppress the production and effects of testosterone).
Androgen deprivation therapy is sometimes use in conjunction with radiation therapy for men with more aggressive prostate cancer.
The effects of androgen deprivation therapy last five years on average. After that, patients can be treated with chemotherapy or cancer vaccines.