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Prostate

Cancer of the Prostate

The most common type of cancer in males.

Normal cells reproduce themselves by dividing—facilitating growth and replacing worn-out and injured tissue. Cancer is characterized by the uncontrolled growth of abnormal body cells. Occasionally, cells grow abnormally into a tumor mass. Some tumors are benign (non-cancerous); others are malignant, or cancerous. Cancers invade and destroy nearby tissues and organs or spread to other parts of the body.

If not treated early and effectively, however, prostate tumors can start to grow and spread into other tissues such as lymph nodes and bone. Although only a small proportion of prostate cancers progress to this severe stage, the ones that do can spread relatively quickly and are not easily treated or cured. It is most commonly found in the outer portion of the prostate gland. The cancer can grow without symptoms for years, even decades. Prostate cancer is rare before the age of 40, and the risk increases with age. Its cause is unknown.

The Prostate Gland

Like other cancers, prostate cancer is a disease of the body’s cells. The prostate gland is located at the base of the penis just below the bladder and in front of the rectum. It produces the fluid that transports semen during ejaculation. The size and shape of the prostate gland vary considerably among men, but it is usually about two inches in diameter (roughly the size and shape of a large walnut).

Prostate Cancer Patient Guide

Goals of Prostate Cancer Treatment

Ideally, treatment for any cancer should cure the disease, be easily tolerated, and cause minimal or no problems. This concept is particularly important in prostate cancer for several reasons. Some men have an aggressive form of cancer that can lead to death from this disease. In other men, prostate cancers can grow so slowly that it causes few if any problems during a patient’s natural lifetime. However, there is no absolute way to determine if prostate cancer will be aggressive or slow growing.  Therefore, for most men whose disease is confined to the prostate, treatment is preferable to waiting and watching, especially since, as our life expectancies continue to increase, even slow-growing cancers could in time become life-threatening.

In other words, the ideal treatment for prostate cancer should effectively arrest or cure the disease particularly in men with aggressive cancer–but cause little, if any, problems–especially for men with slow–growing disease. Furthermore, since many men with prostate cancer are older or have other medical problems that make it impossible for them to undergo radical treatment, a treatment that minimizes trauma and complications is essential.

Common questions about Brachytherapy or Radioactive Seed Implantation

What is Brachytherapy?

Brachytherapy involves the implantation of radioactive seeds into the prostate. Iodine-125 and palladium are well suited for prostate implantation. They give off very low energy radiation that does not significantly travel outside the area of the prostate gland. This limits risk of radiation damage to surrounding body organs and poses little or no threat to those in close contact with them.

How is Implantation Done?

Tiny pellets containing radioactive medication, such as Iodine-125 or palladium are used. Seeds are permanently implanted directly in the middle of the prostate where they give off low-level radiation continuously for up to one year. Using TRUS (transrectal ultrasound) guidance, these seeds can be positioned so that  radiation is distributed throughout the entire prostate gland. Since only a small area is irradiated by each seed, relatively little radiation reaches the adjacent normal organs-the colon, which is directly under the prostate gland or the bladder, lying on top of the gland.

Who are poor candidates for implantation?

Patients with very large prostate tumors which have extended beyond the prostate capsule or to other organs (Stages C and D or T3 and T4). Patients with very large benign portions of their prostate (BPH or benign prostatic hyperplasia) or patients who have had prior prostate surgery (TURP or transurethral resection of prostate) may be poor candidates for implantation.

Who are best candidates for implantation?

Patients with small prostate tumors localized to the prostate are the best candidates (Stages A and B or any T1 or T2, depending on the staging system used). That means that about 50-60% of the patients with prostate cancer will fit this criteria. The development of more sensitive tumor detection techniques means that prostate cancer patients are being diagnosed at earlier stages, permitting more patients to become potential candidates for seed implantation.

Enlarged Prostate (BPH)

BPH is a condition of aging. Nearly all men over the age of 50 have an enlarged prostate.

Benign prostate hyperplasia (BPH) is not simply a case of too many prostate cells. Prostate growth involves hormones, occurs in different types of tissue and affects men differently. As a result of these differences, treatment varies in each case. There is no cure for BPH and once prostate growth starts, it often continues, unless medical therapy is started. The cause of benign prostatic hyperplasia is unknown. It is possible that the condition is associated with hormonal changes that occur as men age.

Treatment Options

There are several treatment options for men with benign prostate hyperplasia, depending on the severity of symptoms. Men with mild symptoms may choose to return for annual examinations. This is called “watchful waiting.” The physician will perform an examination that includes a DRE, PSA tests, and a urinary flow rate. The patient will be asked to describe symptoms in order to determine if the condition is worsening.

There are medications available to help treat BPH. These medications include alpha-blockers, which relax the muscles of the bladder neck and prostate, increasing urinary flow and improving symptoms. Alpha-blockers typically are taken orally, once or twice a day.

Common symptoms of benign prostatic hyperplasia include the following:

  • Blood in the urine caused by straining to void
  • Dribbling after voiding
  • Feeling that the bladder has not emptied completely after urination
  • Frequent urination, particularly at night
  • Hesitant, interrupted, or weak urine stream caused by decreased force
  • Leakage of urine
  • Pushing or straining to begin urination
  • Recurrent, sudden, urgent need to urinate

Surgical treatments available for BPH

Treatments we offer at our practice

  • GreenLight™ Laser Therapy

    GreenLight™ Laser Therapy is a procedure performed with a small fiber that is inserted into the urethra through a cytoscope. The fiber delvers high-powered energy which quickly heats up the prostate tissue, causing the tissue to vaporize. This process is continued until all of the enlarged prostate tissue has been removed. Natural urine flow is rapidly restored and urinary symptoms are quickly relieved in most patients.

  • TURP

    Transurethral resection of the prostate (TURP). This procedure is performed under general or regional anesthesia and takes less than 90 minutes.

    The surgeon inserts an instrument called a resectoscope into the penis through the urethra. The resectoscope is about 12 inches long and one-half an inch in diameter. It contains a light, valves for controlling irrigating fluid, and an electrical loop to remove the obstructing tissue and seal blood vessels. The surgeon removes the obstructing tissue and the irrigating fluids carry the tissue to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time.

  • Prostatectomy

    Another surgical procedure is called the Prostatectomy. If the prostate is greatly enlarged, if the bladder has been damaged, or if the patient has complications prohibiting transurethral surgery, prostatectomy (removal of the obstructing prostate) may be necessary. This procedure is sometimes the best and safest approach.

    Prostatectomy is performed under general or regional anesthesia. The surgeon makes an external incision in the lower abdomen or in the perineum (area between the rectum and the scrotum). If the surgeon accesses the prostate from the abdomen, the procedure is called suprapubic or retropubic prostatectomy; surgery through the perineum is called perineal prostatectomy. Once access is gained, the prostate is removed.

  • The Urolift System

    The UroLift®️ System is a minimally invasive procedure to treat an enlarged prostate. It is a proven option for patients looking for an alternative to medications or major surgery. It is the only leading enlarged prostate procedure that does not require heating, cutting or destruction of prostate tissue.

    Downloadable Information for UroLift®️ System:
    Download Patient Information Booklet Download BPH Information
    Informational Videos on UroLift System & BPH:

    Click an image below to watch the video.

    UroLift Animation

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