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Prostate Cancer

Prostate cancer is a type of genitourinary cancer that affects people with a prostate, which is a walnut-sized gland located between the bladder and the base of the penis. Behind skin cancer, prostate cancer is the most common cancer among men and people assigned male at birth (AMABs).

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Are you proactive with your prostate health?

Prostate cancer is one of the most curable forms of cancer with early detection. Because prostate cancer doesn't often show symptoms in its earlier stages, it's important to talk with your doctor about how you can stay one step ahead of your prostate health.

We encourage people with an average risk of developing prostate cancer to take their health into their own hands and receive routine cancer screenings starting at age 50 (or earlier, depending on your personal health history). You owe it to yourself and your loved ones to take your prostate health seriously. And we owe it to you to make doing that as convenient of a process as possible.

You can rest assured that your team at Tufts Medicine will be there to help you keep your eye on the prize — the comfort and quality of life you deserve.

Gennaro Carpinito, MD, FACS performing a urology surgery at Tufts Medical Center.
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Conditions

Prostate cancer takes several different forms like:

  • Adenocarcinoma: This is the most common type of prostate cancer. It starts in the gland cells that line the prostate and tends to grow slowly.
  • Sarcoma: This rare type of prostate cancer starts in the connective tissue of the prostate. It tends to be more aggressive and spreads quickly.
  • Small cell carcinoma: This is a rare and aggressive form of prostate cancer. Less than 2% of people living with prostate cancer have small cell carcinoma. 

Prostate cancer symptoms

Prostate cancer may not produce any symptoms in its early stages. However, more advanced cases may show signs such as:

  • Blood in semen
  • Blood in urine
  • Bone pain 
  • Decreased urinary stream
  • Difficulty with erections
  • Discomfort in the pelvic area 
  • Swelling in the legs
  • Trouble urinating
  • Urinary frequency and urgency

If you notice any of these symptoms, talk to your doctor or urologist right away. 

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Testing

Prostate cancer is very treatable when detected early. That's why prostate cancer screening is so important. People with a prostate are screened for this cancer in two ways:

  • A blood test that measures for a prostate-specific antigen (PSA) 
  • A digital rectum exam that feels for irregularities in the prostate

PSAs are present in all people with a prostate. Elevated PSA levels may indicate prostate cancer or other milder conditions like an enlarged prostate gland or a prostate infection.

Prostate cancer screening

The majority of prostate cancers detected by screening are slow-growing and won't threaten a person's life or become symptomatic. Other prostate cancers can behave aggressively and spread to other organs in the body, most commonly the bones or lymph nodes.

Behind skin cancer, prostate cancer is the most common cancer among men and AMABs. It's also preventable and can be treated when detected early on with a digital rectal exam.

Talk with your doctor about your health and family history to learn how often and at what age your prostate cancer screenings should take place.

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Treatments

Your prostate cancer treatment path depends on your condition and how much the tumor has grown. Treatments can range from simple maintenance to surgery, radiation or chemotherapy.

We're all here for you if you ever have questions about your treatment path or just need someone to lend a listening ear.

Hypofractionated radiation treatment

Hypofractionated radiation uses a higher dose of radiation over a shorter period of time. Depending on your prostate health, we can trim treatment time from 9 to only 5 and a half weeks. This approach is just as effective as other radiation treatments with the added benefit of regaining meaningful time.

So, how does hypofractionated radiation treatment work? First, we'll ensure you're comfortable before placing you in a deep sleep with anesthesia. We then inject a special gel into your body that separates the prostate from the rectal wall. The gel offers two main advantages:

  1. It moves the rectal wall outside of the treatment area.
  2. It provides your doctor with a better view of the prostate on an MRI, allowing for more precise treatment. 

As a result, we can reduce irritation of the rectal wall and urethra and limit complications like urgency or frequency of urination or bowel movements.

Localized prostate cancer treatment

Localized prostate cancer means that the cancer cells haven’t spread to other parts of the body. Localized cases are usually easier to treat with the following wellness options.

Active surveillance

If your prostate cancer is considered low risk, we’ll keep a close eye on your progress. This method is called active surveillance, and it usually includes:

  • Monitoring your PSA levels
  • Periodic digital rectal examinations
  • Regular prostate biopsies (usually once a year)
Surgery

The advantage of surgery is that it can completely remove the tumor in most cases of localized prostate cancer. In fact, people with a low risk of prostate cancer have a 95% chance of being cancer-free for 10 years.

Your surgery may be open (invasive surgery with a large incision) or laparoscopic (minimally invasive robotic surgery with a small incision). Your surgeon will discuss the pros and cons of both options with you.

Radiation therapy

Radiation therapy, also known as radiation oncology, is an effective way to treat localized prostate cancer. There are 2 types of radiation therapy for prostate cancer:

  1. External beam radiotherapy (radiation generated by a machine)
  2. Brachytherapy (implanting seeds into the prostate gland)
Cryosurgery

Cryosurgery is a minimally invasive treatment that destroys cancer cells by quickly freezing and thawing cancerous tissue.

Metastatic prostate cancer treatment

Metastatic prostate cancer means the cancerous cells that started in the prostate have spread to other parts of your body. This type of cancer can be more challenging to treat, but we'll do everything we can to slow its spread and help you maintain a comfortable quality of life.

Chemotherapy

Chemotherapy is the most common treatment for metastatic prostate cancer. People receive treatment intravenously (directly within a vein) every 3 weeks, which gives the body time to recover in between sessions.

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FAQs

What does your prostate do?

The prostate is responsible for producing seminal fluid that nourishes sperm.

How common is prostate cancer?

In the United States, prostate cancer is the most common cancer that affects only men and AMABs. While the cause of prostate cancer is unknown, more than 230,000 new cases of prostate cancer are diagnosed each year.

Am I at risk for prostate cancer?

Certain factors can make people more likely to develop prostate cancer. Some of these factors include:

  • Race and ethnicity: African American men are more likely to develop prostate cancer than other ethnicities. 
  • Family history: People with one immediate family member with prostate cancer have twice the increased lifetime risk. 
  • Obesity: People with prostate cancer who are clinically obese are more likely to have an advanced condition that’s more difficult to treat.
  • Age: The incidence of prostate cancer increases with age. Most cancers are diagnosed between the age of 60 and 75.
Urulogy Associate Mariepet	Ask, MD using a laser during an urology DaVinci center at Tufts Medical Center and working alongside Gennaro Carpinito , MD.
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