The Benefits of Testing and Treatment for Prostate Cancer

Prostate cancer is the most common cancer among men. It is often very slow-growing: studies have shown that 90 percent of men aged 90 and over have microscopic evidence of prostate cancer.

How Do We Test for Prostate Cancer?

Patients should understand the benefits of testing and treatment for prostate cancer. Two initial tests are commonly used to screen: a digital rectal exam and a prostate-specific antigen blood test (PSA). PSA levels can be higher in men who have prostate cancer. Recently, MRIs have been helpful to identify any suspicious areas within the prostate that could be targeted for biopsy (getting a tissue sample). Genomic testing can help guide decisions to proceed with biopsy and even to proceed with treatment.

I've Been Diagnosed With Prostate Cancer. What's Next?

The big question is once you have a diagnosis of prostate cancer, what do you do next? Because prostate cancer is often slow-growing, a treatment decision can be difficult. Which patients do we treat? Which ones do we leave alone? What treatment options are available?

After a biopsy, sometimes, more testing is required to see if the cancer is within the prostate or spread to other parts of the body.

Treatment might be recommended in men with have a life expectancy of at least 10 years, or has a Gleason score of 7 to 10 (the Gleason score evaluates the aggressiveness of cancer).

Treatments for Prostate Cancer Include:

• “Active surveillance” where a digital rectal exam and a PSA test are done every six months. Biopsies are repeated every 1-3 years.
• Observation or “watchful waiting” may be best for older patients or those diagnosed with a very early or intermediate stage of prostate cancer with less than 5 year life expectancy
• Surgery, which is often performed with the DaVinci robot
• Radiation therapy including beam therapy or radiation “seeds”
• Medical therapy including hormonal therapy, chemotherapy, and immunotherapy

Discuss Your Treatment With Your Urologist

Men who are diagnosed with prostate cancer after biopsy, should first speak with their urologist (surgeon) to discuss all possible management options listed above, and what possible side effects are associated with each treatment. Patients should also meet with a radiation oncologist to learn about radiation therapy options. A medical oncologist can also help to guide medical treatment in select patients. Patients should meet with the various specialists to learn as much as they can and they should turn to trusted health care professionals for help in making well-informed decisions.

If you have questions about prostate cancer, contact your primary care provider.