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Questions to Ask after a Prostate Cancer Diagnosis

Proton Therapy

At KCUC Urology and Oncology, we treat more prostate cancer patients than anyone else in the Kansas City area. The good news is that even though roughly 13% of men will be diagnosed with prostate cancer during their lifetime, only 2-3% will die from it. Prostate cancer tends to progress slowly and less aggressively than many other types of cancer. Detected in the early stages, men with a prostate cancer diagnosis have a very high chance of survival. In the U.S., the 5-year survival rate with prostate cancer is close to 98%

Top Prostate Cancer Patient Questions

If you, or someone you love has received a prostate cancer diagnosis, no doubt, you have questions. We have put together this Q & A to answer the most common questions we hear from our patients. Read on to learn more and come see one of our board-certified urologists or oncologists to answer any questions you still have.

Is Prostate Cancer Genetic?

Most prostate cancer patients have no family history of the disease, however, prostate cancer seems to run in some families which suggests that genes may play a part. In fact, according to the American Cancer Society, risk of prostate cancer more than doubles when a father, son, or brother has been diagnosed. Men who have a close relative with prostate cancer may be twice as likely to develop the disease, while those with two or more relatives may be nearly four times as likely to be diagnosed. While privacy is important to many prostate cancer patients, please consider sharing this information with family members who might be at risk.

How Is Prostate Cancer Treatment Determined?

Your prostate cancer diagnosis is just the first step. Your treatment will be determined by many factors including the stage of the cancer, level of PSA, Gleason score, Grade Group, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body (metastasized).

What Are My Treatment Options for Prostate Cancer?

Every case is unique, and there are many treatment options available. Many factors will influence your treatment choice including stage and grade of your cancer, your health, your lifestyle, and personal preferences. You and your doctor will discuss your options and decide which is right for you. Generally speaking, there are seven prostate cancer treatment options:

  • Active Surveillance – This treatment is for low-risk prostate cancer that appears to be growing slowly, doctors will closely monitor with regular check-ups, blood tests, and biopsies.
  • Radiation Treatment – Radiation treatments include traditional X-ray (photon) radiation and proton radiation. KCUC offers proton therapy at our Kansas City Proton Institute (KCPI) on an outpatient basis.
  • Chemotherapy – Chemotherapy uses powerful drugs to kill fast-growing cells in your body. The drugs can be in pill form, administered intravenously (through your veins), or both.
  • Immunotherapy – Immunotherapy uses substances made by the body or in a laboratory to boost the immune system and help the body find and destroy cancer cells. At KCUC, we offer Provenge cellular immunotherapy.
  • Targeted Therapy – This therapy delivers focused energy, such as high-intensity focused ultrasound (HIFU) or cryotherapy, to destroy cancer cells in specific regions of the prostate.
  • Hormone Therapy – Because cancer cells often depend on hormones like testosterone for growth, hormone therapy reduces the level of testosterone in the body. It can be achieved through medications or surgical removal of the testicles.
  • Surgery – A prostatectomy is surgery to remove the prostate gland. Surgery can accommodate a “nerve-sparing” procedure to reduce the chances of erectile dysfunction and incontinence. Most prostatectomies are done via robotic surgery.

What Is a PSA Test?

A PSA test measures the amount of prostate-specific antigen (PSA) found in the blood. PSA is a protein made by the prostate gland. The amount of PSA may be higher in men who have prostate cancer, infection or inflammation of the prostate, or BPH (benign prostatic hyperplasia) more commonly known as enlarged prostate.

What Is a Biopsy?

Doctors remove a small piece of tissue from the prostate and look at it under a microscope to see if there are cancer cells.

What Is a Fusion Biopsy?

Detecting, diagnosing, and treating urologic cancers, like prostate cancer, can be tricky because the prostate is not in an easily accessible area. A fusion biopsy combines MRI technology with ultrasound technology to create a more detailed image and more accurate biopsy. Using both types of technology, provides a more accurate means to identify prostate cancer and treat it more effectively.

What Is Staging?

After a prostate cancer diagnosis, other tests are done to determine if cancer cells have spread within the prostate or to other parts of the body. The main stages of prostate cancer range from I through IV. The lower the number, the less the cancer has spread. In the first stage, the tumor is only affecting your prostate and hasn’t spread to other tissues. At stage 4, the tumor has spread to tissue beyond the prostate and possibly to distant parts of your body.

What Is a Gleason Score?

While the stage of your cancer looks at where the cancer is in your body, the grade is determined by looking at the cells themselves under a microscope to see what they look like and how they are behaving. Doctors will determine a Gleason Score during the biopsy. A Gleason Score indicates how likely the cancer is to spread. A pathologist will calculate your Gleason score by adding together the number of the most prevalent type of cell in the sample and the second most prevalent type of cell. For example, if the most common cell grade in your sample is 5 and the second most common is 4, you would have a score of 9. The lower the score, the less likely the cancer will spread. Gleason scores will typically range from 6 to 10. A score of 6 is low grade, 7 is intermediate grade, and a score of 8 to 10 is high grade cancer.

What Is a Grade Group Score?

Because the Gleason Score is made by combining two numbers (the two most prevalent types of cells), it can be confusing. In 2014, a new type of scoring system was introduced by The International Society of Urological Pathology which breaks the diagnosis into levels 1-5. Group one is low to very low grade cancer and group 5 is high to very high grade cancer. Because it is newer, not everyone has switched to the Grade Group system. You may receive one or the other or both Grade Group and Gleason scores.

What Is Metastatic Prostate Cancer?

When cancer cells spread to nearby tissue, the cells are said to have metastasized. There are three ways that cancer spreads in the body. Cancer can spread through tissue, the lymph system, and the blood. Lymph nodes are often the first destination. When prostate cancer cells get into the bloodstream, they can spread to other parts of the body including organs like the liver, brain, or lungs, but most commonly the bones. Bone metastases are seen in 85% to 90% of cases where prostate cancer has spread.

What Is the Difference between Traditional X-Ray Therapy Radiation and Proton Therapy Radiation?

Proton therapy is a newer type of radiation treatment for cancer that allows for more precise targeting of the cancer cells. Instead of using traditional X-ray radiation (also known as photon beam therapy), it uses protons to send beams of high energy that can target tumors more precisely than X-ray radiation. Because it is more precise than some other radiation therapy treatments, it is better for treating cancer in hard-to-reach areas of the body like prostate cancer.

Does Outpatient Proton Therapy Cost Less?

Most prostate cancer patients know that an office-based proton therapy center makes cancer care more accessible and convenient, but the biggest advantage for our patients is that the cost of proton therapy in the outpatient setting is actually much less expensive. In fact, our state-of-the-art outpatient proton therapy is less expensive than traditional X-ray therapy in the hospital setting. We are proud to be able to bring cutting-edge technology to the Kansas City community in a much more cost-effective manner. If you need radiation therapy, KCUC’s Kansas City Proton Institute (KCPI) is the only office-based proton therapy facility in the central United States.

From robotic surgery to cutting-edge treatments, we take pride in being the first to bring the forefront of medicine to the Midwest. If you’ve received a prostate cancer diagnosis and have other questions, contact one of the 26 KCUC Urology and Oncology locations throughout Kansas and Missouri and schedule an appointment for a second opinion. At KCUC, you see the best in KC.