What is CyberKnife & How Can it Help Treat Prostate Cancer?
Prostate Cancer Symptoms
Video Playlist: Prostate Cancer Symptoms
Learn about common signs and symptoms of prostate cancer including dull, persistent pain in the lower back and pelvic area with expert prostate health tips in this free men’s health care video clip.
In most cases, prostate cancer symptoms are not apparent in the early stages of the disease. The symptoms of prostate cancer may be different for each man and any one of these symptoms may be caused by other conditions. As a result, routine screenings in the form of digital rectal exams (DRE) and prostate specific androgen (PSA) tests are important.
The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer, beginning at age 50. Men with one or more risk factors for prostate cancer should consult with their physician about whether to start routine screening earlier.
Urinary Symptoms of Prostate Cancer
Because of the proximity of the prostate gland in relation to the bladder and urethra, prostate cancer may be accompanied by a variety of urinary symptoms. Depending on the size and location, a tumor may press on and constrict the urethra, inhibiting the flow of urine. Some prostate cancer signs related to urination include:
- Burning or pain during urination
- Difficulty urinating, or trouble starting and stopping while urinating
- More frequent urges to urinate at night
- Loss of bladder control
- Decreased flow or velocity of urine stream
- Blood in urine (hematuria)
Other Prostate Cancer Signs & Symptoms
Prostate cancer may spread (metastasize) to nearby tissues or bones. If the cancer spreads to the spine, it may press on the spinal nerves. Other prostate cancer symptoms include:
- Blood in semen
- Difficulty getting an erection (erectile dysfunction)
- Painful ejaculation
- Swelling in legs or pelvic area
- Numbness or pain in the hips, legs or feet
- Bone pain that doesn’t go away, or leads to fractures
Testing and Screening for Prostate Cancer
Prostate cancer screenings make it possible to detect the cancer in early stages, before symptoms are present.
Current screening methods include a simple blood test for the prostate-specific antigen (PSA) and a digital rectal exam (DRE) of the prostate. The Centers for Disease Control (CDC) and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force, which state that there is insufficient evidence to recommend for or against routine screening for prostate cancer using PSA or DRE.
Most men over 50 are advised to talk with their doctor about the pros and cons of annual prostate cancer screening. If there is a family history of prostate cancer, or other factors that may put an individual at an increased risk for the disease, the conversation should begin earlier (starting at age 40 or 45).
Although screening methods are not 100 percent accurate, these tests are often an effective method for detecting prostate cancer in the early stages, when it is still highly treatable. Talk with your doctor about whether or not prostate cancer screening is right for you.
NOTE: These symptoms may be the result of a number of conditions other than cancer. It is important to consult with a medical professional for an accurate diagnosis.
Prostate Cancer Diagnosis
During your first visit, you’ll undergo a comprehensive exam to precisely diagnose your prostate cancer and determine if it has spread to any other part of your body. This helps your care team make the correct prostate cancer diagnosis and formulate an individualized treatment plan that is best suited to your needs.
Throughout your prostate cancer treatment, we will use diagnostic imaging and laboratory tests to monitor your progress. If the disease is resisting treatment, we will modify your treatment or recommend using a different therapy. Our turnaround goal from the time of imaging scans to results is four hours, so that treatment planning can occur as quickly as possible.
Discover a Treatment Plan Tailored to Your Needs
Prostate cancer often does not cause any symptoms in the early stages. Instead, it may be detected during routine screening, using the following tests:
- Digital Rectal Exam (DRE): This is usually the first step in determining prostate health and is often done as part of routine screening, such as an annual physical. During the exam, your doctor inserts a gloved finger into the rectum. Your doctor will check to see if the prostate is the proper shape, size and texture. If your doctor feels something suspicious, he or she may order diagnostic tests.
- Genetic Tests: These tests can be used to reveal information about your diagnosis, predict your responsiveness to treatment, understand your risk of developing the same cancer again, and other factors.
- ProstaVysion: A panel of three prognostic molecular biomarkers (PTEN, ERG and HOXD3). Studies indicate that patients with PTEN deletions, ERG fusion/translocation and HOXD3 methylation typically have a less favorable prognosis. Testing is performed on prostate tissue sections.
- PCA3 (Prostate Cancer Antigen 3 Gene) Gene Testing: The PCA3 gene is over expressed in prostate cancer cells. This molecular test evaluates the ratio of mRNA transcripts of PCA3 to PSA. It is performed on a urine sample obtained after a digital rectal exam.
- Prostate-specific Antigen (PSA) test: To aid in prostate cancer detection, your doctor may perform a blood test to measure the level of PSA in the blood. High amounts of PSA may indicate prostate cancer or other less serious conditions, such as infection.This test is generally performed in conjunction with a DRE.
- Prostate Biopsy: Similar to a transrectal ultrasound, during a prostate biopsy, your doctor guides a small probe into the rectum and removes a small tissue sample from the prostate for further examination. This tissue allows your doctor to stage the disease and determine an appropriate treatment plan.
- Transrectal Ultrasound: During this exam, a small probe is inserted into the rectum and sound waves provide a picture of the prostate and measure its size. Images will reveal tumors, calcifications and any enlargement of the prostate.
Your Treatment Response is Monitored with Advanced Diagnostics
Once a prostate cancer diagnosis has been made, your Colorado CyberKnife doctor may choose one or a combination of the following imaging tests to monitor the cancerous tissue and determine whether it has spread beyond the prostate:
- Ultrasound – Ultrasound technology may be used to monitor prostate size, tumor response or activity in other tissues.
- CT (Computerized Tomography) Scan – A CT scan is an X-ray technique that produces a detailed, 3D image of the prostate and other structures in the body. A CT scan reveals blood flow and anatomy of tissues in and around the prostate, allowing for the diagnosis and monitoring of tumor growth.
- PET/CT (Positron Emission Tomography/Computerized Tomography) – A PET/CT scan combines the 3D images of a CT scan with a PET scan, which reveals abnormal metabolic activity in the tissues. By blending these two images into one image during a single exam, our physicians can identify abnormal activity and know precisely where this activity is taking place. PET/CT scans may reveal cancerous cells before any tumors or structural changes are present.
- MRI (Magnetic Resonance Imaging) – An MRI uses radiofrequency waves to create a detailed cross-sectional image of the prostate and surrounding tissues. An MRI has much greater soft tissue contrast than a CT scan, making it especially useful in prostate cancer detection, particularly for tumors and metastases.
- ProstaScint Scans – This technique detects if cancer has spread to the lymph nodes, adjacent tissue or bone. Given by intravenous injection, ProstaScint circulates throughout the body and attaches to prostate cancer cells. The injection contains a small amount of radioactive material that is absorbed by cancer cells and shows up as “hot spots” using a special camera.
- Bone Scans – Similar to a ProstaScint Scan this test takes a picture of the skeleton to detect if prostate cancer has spread to the bone (but not to other tissues or lymph nodes).
Prostate Cancer Staging Information
Video Playlist: Gleason Grading System & The Stages of Prostate Cancer
Learn about Gleason grading, including what the scores of this prostate cancer test mean.
Your doctor will assign a Gleason score to the disease based upon its microscopic appearance. Cancer with a higher Gleason score is more aggressive.
- Grade 1 – The cancerous prostate closely resembles normal prostate tissues. The glands are small, well-formed and closely packed.
- Grade 2 – The tissue still has well-formed glands, but they are larger and have more tissue between them.
- Grade 3 – The tissue still has recognizable glands, but the cells are darker. At high magnification, some of the cells have left the glands and are beginning to invade surrounding tissue.
- Grade 4 – The tissue has few recognizable glands. Many cells are invading the surrounding tissue.
- Grade 5 – The tissue does not have recognizable glands. There are often just sheets of cells throughout the surrounding tissue.
Together with other diagnostic tests, the Gleason score is incorporated into a strategy of prostate cancer staging, which helps guide therapy.
Prostate Cancer Staging
Prostate cancer stages are clearly identifiable. At Colorado CyberKnife, your doctor will examine the cancer tissues to determine the stage of the disease.
- Stage I: Cancer is confined to the prostate. It can’t be detected during a DRE. It is usually expected to be slow growing.
- Stage II: Cancer can be detected during a DRE. It’s still confined to the prostate, but the cells may be more abnormal and may grow faster.
- Stage III: Cancer is in tissues near the prostate. It also may have reached the seminal vesicles.
- Stage IV: Cancer has invaded other parts of the body, such as the rectum, nearby lymph nodes or bone.
- Recurrent: Cancer has returned after treatment. It may recur in the prostate area or in other places, such as the bones.
Your care team at Colorado CyberKnife thoroughly reviews your Gleason score and the prostate cancer stage, along with your medical history, family history, PSA score and other factors to develop a customized prostate cancer treatment plan for you.