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  • Conditions
    • Kidney and Ureteral Stones
    • Urinary Tract Infections
    • Urinary Incontinence
    • Neurogenic Bladder
    • Benign Prostatic Hyperplasia (BPH)
    • Hematuria
    • Erectile Dysfunction
    • Prostatitis
    • Vasectomy
    • Vasectomy Reversal
    • Interstitial Cystitis
    • Voiding Dysfunction
    • Female Urology
    • Prostate Cancer
    • Kidney Cancer
    • Testicular Cancer
    • Bladder Cancer
    • Low Testosterone
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Prostate Cancer

According to the American Cancer Society, prostate cancer is the second most common type of cancer affecting American men today. It is estimated that 186,320 American men will be diagnosed with prostate cancer in 2008. In Colorado, 3,210 men will be diagnosed with prostate cancer this year. Because of early detection and advanced treatment options, mortality rates associated with prostate cancer are declining. The risk of prostate cancer is highest among African-American men.

Click here for more information on living with prostate cancer.

Common risk factors for prostate cancer include:

• Age. Men over the age of 50 and African-American men over the age of 40 have a higher risk of developing the disease.
• Race/ Ethnicity. The mortality rate of African-American men diagnosed with prostate cancer is twice that of other men.
• Genetics. Men who have family members diagnosed with prostate cancer have a greater risk of developing the disease.
• Diet. A diet rich in red meat and high-fat dairy products and low in fruits and vegetables may increase a patient's risk of developing prostate cancer.

There are often no symptoms of early stage prostate cancer, so early detection and screening are paramount.

The best way to detect early stage prostate cancer involves undergoing annual PSA (prostate specific antigen) tests and digital rectal exams (DRE) begining at age 50. High risk men such as African-Americans or men with a positive family history, should begin these annual tests at age 40.

Tests:

Digital Rectal Exam (DRE)
This exam invloves a physician assessing the patient's prostate gland through the rectal wall to determine it's size, shape and consistency. Cancerous tissue may be firm, hard, asymmetrical or stony. However, digital rectal exams often come back normal in as many as one-third of patients with prostate cancer.

PSA Tests
PSA (prostate specific antigen) is a protein produced by prostate cells, which can be detected in the blood. A simple blood test can indicate if further evaluation for prostate cancer is necessary.

Transrectal Ultrasound and Prostate Biopsy
If a patient's PSA is abnormal or if a firm area is noted on a digital rectal exam, an ultrasound and biopsy are performed to determine if cancer is present. A transrectal ultrasound is performed by inserting a probe into the rectum. The probe emits sound waves which allow the prostate to be visualized. Then, a biospy needle is inserted along the ultrasound probe and small pieces of prostate tissue are removed for diagnosis. This procedure is done under local anesthesia in the office and takes approximately 15 minutes. Patients may drive to and from the procedure without a chaperone.

Staging Tests for Prostate Cancer:

CT Scan
This X-ray procedure produces three-dimensional images of internal organs and glands and is used to detect pelvic lymph node enlargement. CT scans may be performed to help assess the extent of the cancer.

Bone Scan
This procedure detects the spread of cancer to the bones. A bone scan may be ordered if patients have atypical bone pain, a high PSA or an aggressive cancer (Gleason Score of 7 or higher).

Treatments:

Brachytherapy
Brachytherapy is a procedure that places small radioactive seeds directly into the prostate. The seeds cause little discomfort and remain in the prostate permanently. Side effects of this procedure may include impotence, voiding dysfunction, bowel problems and pain in the pelvic area.

External Beam Radiation
This type of radiation therapy is performed on an outpatient basis. A carefully targeted beam of radiation is administered to the prostate. The length of the treatment may vary. Side effects of external beam radiation may include bowel or bladder dysfunction, impotence or mild bleeding from the bladder or rectum.

Intensity Modulated Radiation Therapy
In this procedure, radiation is guided to the prostate through a computer system. By doing so, IMRT is able to maximize the radiation dose delivered to the tumor while minmizing the amount of radiation delivered to surrounding tissues. The precision of IMRT greatly decreases the risk of adverse radiation therapy side effects.

Radical Prostatectomy
Radical prostatectomy is a surgical procedure where the entire prostate gland is removed. The procedure is usually performed in the early stages of the disease to prevent the cancer from spreading throughout the body. Patients undergoing this procedure will be admitted to the hospital and typically have a one to three day hospital stay. A robotic prostatectomy via the DaVinci may also be used in select patients.

For more information about DaVinci procedures, please click here.