Torrance Memorial Prostate Cancer Program
For men, prostate cancer is the second most common form of cancer (skin
cancer is the most common). Torrance Memorial’s Hunt Cancer Institute
is committed to delivering prompt diagnosis and optimal treatment, tailored
to individual needs, as well as providing practical and emotional support
to men with prostate cancer and their families.
Our specialized team of cancer care physicians, nurses and staff provides
expert care for men with prostate cancer. We offer state-of-the-art diagnosis
and treatment technologies, including robotic
prostatectomy using the
da Vinci Surgical System, and a wide range of clinical trials.
What is Prostate Cancer?
Because it affects the male reproductive system, prostate cancer only affects
men. It begins and grows in the prostate gland and usually grows very
slowly. In fact, most patients with prostate cancer die of other causes.
Even aggressive cases of localized prostate cancer can be cured with surgery
or radiation therapy.
Prostate Cancer Types
Almost all prostate cancers originate in the cells of the prostate gland.
Although other types of cancer, including sarcomas and small cell carcinomas,
can develop in the prostate gland, the vast majority of cancers diagnosed
in the prostate belong to a category called adenocarcinoma.
Adenocarcinoma is a type of cancer that forms in mucus-secreting glands
throughout the body. It can occur in many different places in the body.
Stages of Prostate Cancer
The most widely used staging system for prostate cancer is the American
Joint Committee on Cancer (AJCC) TNM system, which uses five pieces of
information:
- T: The extent of the primary tumor
- N: Whether the cancer has spread to nearby lymph nodes
- M: The absence or presence of distant metastasis
- The PSA level: the level of prostate-specific antigen, a protein produced
by prostate. The higher his PSA level is, the more likely that a patient
has prostate cancer.
- The Gleason score
Prostate cancer is assigned a stage from I to III based on the information
listed above. This table illustrates how prostate cancer is staged:
Stage |
T |
N |
M |
PSA |
Gleason |
I |
T1a-c |
N0 |
M0 |
PSA < 10 |
Gleason ≤6 |
T2a |
N0 |
M0 |
PSA < 10 |
Gleason ≤6 |
TI-T2a |
N0 |
M0 |
PSA X |
Gleason X |
IIA |
T1a-c |
N0 |
M0 |
PSA < 20 |
Gleason 7 |
T1a-c |
N0 |
M0 |
PSA ≥10 but < 20 |
Gleason ≤6 |
T2a |
N0 |
M0 |
PSA < 20 |
Gleason ≤7 |
T2b |
N0 |
M0 |
PSA < 20 |
Gleason ≤7 |
T2b |
N0 |
M0 |
PSA X |
Gleason X |
IIB |
T2c |
N0 |
M0 |
PSA X |
Any Gleason |
T1-2 |
N0 |
M0 |
Any PSA |
Any Gleason |
T1-2 |
N0 |
M0 |
PSA ≥20 |
Gleason ≥8 |
III |
T3a-b |
N0 |
M0 |
Any PSA |
Any Gleason |
IV |
T4 |
N0 |
M0 |
Any PSA |
Any Gleason |
Any T |
N1 |
M0 |
Any PSA |
Any Gleason |
Any T |
Any N |
M1 |
Any PSA |
Any Gleason |
Prostate Cancer Risk Factors
Age is the single most important risk factor for prostate cancer, which
ffects mainly older men. Four out of five cases are diagnosed in men over
age 65, but less than 1% in men under 50. Beside age, other risk factors
of prostate cancer are:
- Race/ ethnicity
- Geography
- Family history
- Gene changes
- Diet
- Obesity
- Smoking
- Workplace exposure (for instance, firefighters are at higher risk for prostate cancer)
- Inflammation of the prostate
- Sexually transmitted infections
- Vasectomy
Prostate Cancer Signs and Symptoms
In its early stages, prostate cancer has no symptoms. As prostate cancer
grows, it may bring the following signs and symptoms:
- Problems urinating, including a slow or weak urinary stream or the need
to urinate more often, especially at night.
- Blood in the urine
- Trouble getting an erection (erectile dysfunction)
- Pain in the hips, back (spine), chest (ribs), or other areas from cancer
spread to bones
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel
control from cancer pressing on the spinal cord.
Other conditions can also cause many of these same symptoms. For example,
trouble urinating is much more often caused by benign prostatic hyperplasia
(BPH) than cancer. Still, it’s important to tell your doctor if
you have any of these problems so that the cause can be found and treated,
if needed.
Prostate Cancer Screening
The best way to detect prostate cancer in its early stages is with regular
digital prostate (rectal) exams and prostate specific antigen (PSA) blood tests.
Committed to leading edge cancer diagnostics, Torrance Memorial offers
digital prostate exams and PSA blood test for those concerned about having
prostate cancer or who want to be monitored actively.
Prostate Cancer Diagnosis
Since it frequently has no symptoms, most prostate cancers are first found
during an annual physical exam or screening. A PSA blood test may provide
indicate the possible presence of prostate cancer or a physician may detect
it with a digital rectal exam (DRE). In this test, a gloved, lubricated
finger is inserted into the rectum to feel for any bumps or hard areas
on the prostate, which may be signs of cancer.
A higher than normal PSA test result or abnormalities discovered during
the DRE may lead your doctor to order a prostate biopsy to find out whether
the cancer really exists.
Prostate cancer diagnosis is usually done with a core needle biopsy. In
this test, the doctor quickly inserts a thin, hollow needle through the
wall of the rectum into the prostate. Many patients prefer to have the
area numbed with a local anesthetic prior to the procedure, which takes
approximately 10 minutes.
Prostate Cancer Treatment
Depending on its stage, treatment of prostate cancer may include a single
therapy or some combination of surgery, radiation therapy and hormone therapy.
At the forefront of prostate cancer treatment, Torrance Memorial’s
specialists offer advanced, personalized treatment for each patient. This
may include:
- Expectant management (watchful waiting) or active surveillance
-
Surgery
- Radiation therapy
- Brachytherapy (radioactive seed implants)
- Cryosurgery (cryotherapy)
- Hormone therapy
- Chemotherapy
- Vaccine treatment
- Bone-directed treatment
Radical prostatectomy (removal of the prostate gland, seminal vessels and
sometimes some lymph nodes) is the standard treatment for aggressive prostate
cancer. At Torrance Memorial, radical prostatectomy is typically performed
using the minimally invasive da Vinci Surgical System. This approach works
as well as traditional open surgery, but with less blood loss, lower risk
of complications, faster healing and a quicker recovery.
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