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Overview

It's important to know that not all men who get prostate cancer will develop an aggressive form of the disease. Advances in detection and treatment have increased the cure rate to 93 percent for patients who catch the disease in its earliest stages.

At Yale Medicine, we know prostate cancer can be treated and potentially cured if it’s diagnosed early enough, which is why being screened regularly is essential for men. We use the most advanced diagnostic imaging technology available in the world to screen our patients for early signs of prostate cancer.

What is prostate cancer?

The prostate is a walnut-sized gland located just below the bladder. The prostate makes semen and helps push sperm through the urethra when a man ejaculates.

When malignant cells start to grow in the prostate, it is cancer.

Prostate cancer tends to be slow-growing and rarely causes symptoms, so in many cases may go undetected without screening. Some forms of prostate cancer, however, can be more aggressive and spread quickly.

About 175,000 men will be diagnosed with prostate cancer in the United States this year. Early detection plays a critical role in treatment and recovery.

What are the risk factors of prostate cancer?

Avoiding general cancer risk factors may help prevent prostate cancer. These include smoking, being overweight and not getting enough exercise.

There are also some specific factors linked to higher rates of diagnosis. These include:

  • Age: The risk of prostate cancer increases dramatically after age 50.
  • Race: African-American men are more likely to be diagnosed with prostate cancer than Caucasian men. African-American men are also more likely to die of the disease.
  • Family history: A patient with a father, brother or other male relative who had the disease is twice as likely to develop it himself.

What are the symptoms of prostate cancer?

Not everyone experiences symptoms of prostate cancer. Men experiencing any urinary symptoms should be evaluated by a physician and discuss being screened for prostate cancer. A few symptoms that may be experienced at advanced stages of the disease are included below:

  • Difficulty urinating, a slower stream of urine or a need to frequently urinate
  • Blood in the urine or semen
  • Erectile dysfunction
  • Discomfort in the pelvic area or pain in the lower pack, hips or thighs

How is prostate cancer diagnosed?

If your doctor is worried about prostate cancer, he or she will perform a DRE or digital rectal exam. A common follow-up to this physical exam is a PSA test, which measures the level of prostate-specific antigens (PSAs) in a patient’s bloodstream.

A healthy patient will have low levels of PSA. However, if PSA levels are high or the prostate exam is abnormal, a prostate biopsy is required to determine if prostate cancer is present. We use advanced 3D MRI imaging and biopsy technology—including multi-parametric MRI and the Artemis device—to provide our doctors a virtual look inside the prostate and allow for targeted prostate biopsies.

How is prostate cancer treated?

There are many different approaches to treating prostate cancer, depending on the level of risk and stage of the disease.

Not all prostate cancer requires treatment. Patients must weigh recovery time, possible outcomes and complications with their urologist. Common approaches include:

Active Surveillance: This is often recommended for patients with low-grade prostate cancer. Prostate cancer can take a long time to grow. Active surveillance uses the latest imaging technologies to watch it and make sure it is not progressing.

Surgical treatment options: Our surgeons continually integrate innovative approaches into their practice to offer patients safer and more effective treatments. Minimally invasive surgical treatments include laparoscopic surgery and robotic-assisted surgery. Patients may also undergo removal of the prostate through more conventional surgery.

Brachytherapy (Radioactive Seed Implantation): In this treatment, radioactive seeds are implanted permanently in the prostate to give off radiation and provide localized treatment to the tumor.

Intensity modulated radiation therapy (IMRT): This is a state-of-the-art radiation delivery system. By targeting intense radiation on prostate tumors, Yale Medicine urologists are able to minimize or even destroy them completely.

Surgery, radiation and hormonal therapy: These approaches can cause erectile dysfunction and other complications related to sexual health. However, within two years most men regain their potency and return to the sex life they had prior to treatment.

Experimental treatments: New therapeutic treatments are being developed and evaluated in select groups of patients at Yale Medicine. One such treatment is focal ablation of prostate tumors in which only the prostate tumor (not the entire prostate) is treated.

What are the recommendations for prostate cancer screening?

Screening for prostate cancer is controversial. Some studies have questioned the benefit of prostate cancer screening in the general population. However, the American Urologic Association and the National Comprehensive Cancer Network both recommend patients discuss prostate cancer screening with asymptomatic men between 45 and 75 years of age, starting even earlier if they have risk factors (listed above) for prostate cancer.

What makes Yale Medicine’s approach to prostate cancer unique?

Yale Medicine's urology department is on the cutting-edge. Our Cancer Center's Prostate & Urologic Cancers Program brings together a team of physicians, surgeons, nurses and support staff who all are dedicated to breaking new ground in the fight against prostate cancer.

Part of that fight is early detection, and we utilize some of the most advanced diagnostic imaging technology available in the world, which helps us more accurately detect prostate cancer.