Prostate cancer is second only to skin cancer as the most common cancer in men living in the United States. Each year more than 200,000 men are diagnosed with prostate cancer and over 30,000 will die from the disease. Men aged 50 and older, African American men and men with a family history of prostate cancer are at higher risk. Fortunately, most prostate cancers are slow-growing and can be detected through an elevated PSA test at an early stage when treatment is most effective.
With over 20 experienced urologist and oncologist office locations in Kansas and Missouri, the doctors at KCUC proudly offer diagnosis and prostate cancer treatment in Kansas City, Overland Park, Emporia, Leavenworth, Clinton, Liberty, Olathe, Lexington, Harrisonville, Lee’s Summit, Independence, MO, and the entire KC metro area.
Elevated PSA & Prostate Cancer Risk Factors
Factors that may increase your risk of prostate cancer include:
- Family history — having a brother, father, grandfather, son or cousin with prostate cancer
- Age — 90% of prostate cancers are diagnosed in men 50 and older
- Race — African Americans are at greater risk
- Diet and lifestyle — obesity and/or a diet high in saturated fats has been associated with more aggressive prostate cancer. Eating fruits and vegetables high in antioxidants such as broccoli and cauliflower may decrease risk.
Please note that an enlarged prostate (benign prostatic hyperplasia or BPH) does not increase your risk of prostate cancer.
Symptoms and Screening of Prostate Cancer
Early-stage prostate cancer often has no warning signs and can only be found through routine testing such as a rectal exam (DRE) and PSA, (prostate-specific antigen) a protein that may be elevated in men with prostate cancer. During the DRE, your physician will insert a gloved finger into your rectum to feel the size, shape, and texture of your prostate. The PSA test determines the level of a protein, PSA, in a blood sample; high levels could indicate prostate cancer and may require further testing. Other benign conditions such as an enlarged prostate or prostate infection may also elevate this test. Despite this lack of specificity, PSA testing remains a useful test to help detect prostate cancer before it spreads outside the gland.
Because many men with prostate cancer are diagnosed at early stages and the fact that prostate cancer often grows slowly, recent publications have highlighted the risks of over-diagnosis and over-treatment, which may cause more harm than good. However, prostate cancer is still a lethal disease for over 30,000 men each year in the United States. A more measured approach to early detection has been published by the American Urological Association (AUA) and is outlined below.
- Screening for prostate cancer before age 40 is not recommended (men with a strong family history or symptoms could be an exception)
- Men age 40 to 54 with high risk (family history, African American men) may benefit from early detection.
- Men age 55 to 69 will have the greatest benefit from early detection. KCUC recommends annual PSA and DRE for men with average risk and every 6 months for men with high risk.
- Men over the age of 70 will have the least amount of benefit from early detection with PSA. Exceptions are men at high risk and those in exceptionally good health. KCUC recommends having a discussion with your doctor (shared decision making) to see if PSA testing in Kansas City is appropriate for you.
Diagnosis and Staging
If further evaluation is needed after the screening tests, a prostate biopsy or prostate MRI (Magnetic Resonance Imaging, similar to CT scanning but without radiation) may be recommended. If the MRI reveals a lesion with a high risk of cancer, then a fusion biopsy may be recommended. During fusion biopsy, the MRI images are overlapped (fused) with real-time ultrasound images and the lesions seen on MRI can be targeted with a great deal of accuracy. Samples of the prostate obtained in this manner are mapped out and sent to pathology for diagnosis. If prostate cancer is found during the biopsy, additional testing such as a bone scan or a CT scan may be recommended.
The biopsy report will determine the cancer grade. This is the “Gleason Score” that estimates the aggressiveness of the cancer based on microscopic features. This grade will also determine the type of prostate cancer treatment recommendations.
Based on the DRE, PSA, grade, and imaging results, a cancer grouping is determined, and the stage of cancer can be predicted.
In its early stages (T1 and T2), prostate cancer is usually confined to the prostate itself. As the cancer advances, it may move outside the prostate to surrounding tissues, lymph nodes, bones, or other parts of the body (Stage T3 or T4). Prostate cancer treatment success reduces as the cancer stage increases.
Prostate Cancer Treatment – What are your options?
Many effective prostate cancer treatments exist today. With early detection, many patients can be cured. The most appropriate treatment for you will depend on factors such as your age, health, lifestyle, and the characteristics of your cancer.
Your Prostate Cancer Treatment Options Include:
- Active Surveillance (watchful waiting) — men with slow-growing, early-stage cancers (usually cancer group 1 or 2) or those with serious health problems or advanced age may be advised to monitor the cancer rather than actively treating it. Many men will “outlive” their prostate cancer.
- Surgery — a surgical procedure called a radical prostatectomy removes the cancerous prostate gland, surrounding tissues, and often lymph node sampling. The surgeons of KCUC, P.A. use the latest techniques to remove cancerous tissue while minimizing side effects. These techniques include the nerve-sparing prostatectomy that can be performed through a traditional “open” prostatectomy or with the aid of the da Vinci robot through a laparoscopic approach.
- Radiation therapy — At our Cancer Center, we offer integrated cancer treatment for prostate cancer patients where urologists, medical oncologists, and radiation oncologists collaborate to offer state-of-the-art prostate cancer radiation therapy. Our radiation treatment center is a high-volume program that uses IMRT (intensity-modulated radiation therapy) to treat only prostate cancer. The side effects and risks of prostate cancer radiation at our center are some of the most favorable in the country due to the vast experience of our radiation team and specialized techniques like image-guided radiation (IG-IMRT) and SpaceOar. IG-IMRT involves placing a small carbon fiber into each side of the prostate to allow the linear accelerator radiation delivery unit to stay focused on the prostate during treatment. SpaceOar is a protective gel that is placed between the rectum and prostate before radiation begins. It is a glycoprotein that protects the rectum during IMRT and is reabsorbed by the body in 3 – 6 months, after the radiation is completed.
- Hormone therapy — in some cases, your physician will prescribe a medicine called LHRH. This is an injection usually dosed every 3-6 months that will block the release of testosterone thus shrinking most prostate cancers. This therapy may be used by itself or in conjunction with other treatments, like radiation therapy to maximize the success of your cancer therapy.
- Chemotherapy — The integrated cancer program at KCUC includes medical oncology to allow offering patients the most up-to-date cancer treatments when prostate cancer has become resistant to all the treatment listed above. This treatment may include anti-androgen testosterone receptor blockade, anti-metabolic medications to further reduce testosterone levels, specialized radioisotopes to treat advanced prostate cancer in the bones and chemotherapy.
About Kansas City Urology Care (KCUC)- KC’s Prostate Cancer Specialists
At KCUC, we specialize in providing supportive care that is knowledgeable, accurate, friendly and courteous. We offer state-of-the-art treatments in a modern facility, including prostate cancer treatments, so you can get in and out quickly in a setting that’s relaxing and less stressful than a hospital. We also have some of the top Kansas City prostate cancer doctors, urologists, and oncologists to help support you with multiple locations in Kansas and Missouri. Our Mission is to strive to provide the highest quality medical care for prostate cancer in a supportive, empathetic and respectful environment.