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Prostate Cancer

Prostate cancer is common.
OhioHealth Cancer Care experts will treat you with uncommonly specialized care.

In the United States, prostate cancer is the second most common cancer in men, second only to skin cancer. 

It most often occurs in men older than age 65, but can occur in men much younger, as well. It is also the second leading cause of cancer death in men. Although it can be a serious disease, most prostate cancers are slow growing, and most men with prostate cancer will die from other causes, especially with proper treatment when necessary.

If you or a loved one has just been diagnosed and will soon enter treatment, we’ll be alongside you every step of the way, marrying the clinical with the compassionate, providing you the precise care, and caring, you need.  

Key Statistics About Prostate Cancer 

  • Approximately one man in seven will be diagnosed with prostate cancer during his lifetime.
  • Prostate cancer occurs mainly in older men.
  • Approximately six cases in 10 are diagnosed in men aged 65 or older.
  • The average age at the time of diagnosis is about 66.
  • Prostate cancer is rare before age 40.
Prostate Cancer Basics Treatments and Procedures

Frequently Asked Questions

  • Q: What is prostate cancer and what causes it?

    A: Prostate cancer is a common cancer occurring in a man’s prostate gland, which is a walnut-size gland located in the pelvic region below the urinary bladder. It’s not clear what causes this cancer, which develops from abnormal cells in the prostate. You can find more information on the “What Is Prostate Cancer?” page of The American Cancer Society’s website.
  • Q: Is prostate cancer treatable?

    A: Yes. There are many prostate cancer treatment options. The success of treatment depends on what stage your prostate cancer is in and if it’s contained within your prostate gland or has spread to other areas in your body. Additional factors affecting the types and success of treatment include your age and health. Talk to your doctor about the stage of your cancer and how it will likely respond to various treatment options.
  • Q: What treatment options are available to me, and how will they affect my daily life?


    There are different types of treatment for prostate cancer. The options available to you will depend on several factors, such as:

    • the stage of your prostate cancer 
    • how fast your cancer is growing
    • how much it has spread, and
    • your overall health

    These are things your doctor will discuss with you.

    Common prostate cancer treatments include:

    Active surveillance – For early stage prostate cancer, this involves regular examinations, tests and sometimes biopsies to monitor the cancer

    Radical prostatectomy – A surgical procedure that removes the prostate gland and nearby tissues

    Radiation therapy – Radiation delivered to the prostate gland. Different types of radiation therapy include external beam radiation and brachytherapy (implanting radioactive seeds with needles directly into the prostate gland).

    Hormonal therapy – Interference of hormone production, by either blocking hormone activity or removing hormones, to stop cancer cells from growing

    Chemotherapy – Used for prostate cancer that has spread outside of the prostate gland. Chemotherapy uses drugs to kill cancer cells

    Treatment will change your daily life due to the side effects and the time requirements of routine appointments. One of the best things you can do for yourself and your family is to be prepared – ask your Cancer Care Team for guidance on what to expect and how to make changes in your life during treatment.
  • Q: Does OhioHealth treat prostate cancer?

    A: We offer advanced, comprehensive treatment options for prostate cancer patients, including surgery, radiation therapy, hormone therapy and chemotherapy. Our surgeons perform most prostate cancer surgery using the minimally invasive da Vinci™ robotic surgical system.
  • Q: What are the different stages of prostate cancer?

    A: Staging is the process of determining the extent of the cancer, whether or not it has spread within the prostate and/or outside of the prostate to other organs. Staging is important in determining the type of treatment most appropriate for the cancer.

    The National Cancer Institute defines the stages of prostate cancer as follows:

    Stage I: The cancer can't be felt during a digital rectal exam, and it can't be seen on a sonogram. It’s found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate. The grade is G1, or the Gleason score is no higher than 4.

    Stage II: The tumor is more advanced or a higher grade than Stage I, but the tumor doesn't extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.

    Stage III: The tumor extends beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven't spread to the lymph nodes.

    Stage IV: The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.

    Recurrence: This is cancer that has been treated and has returned after a period of time when the cancer could not be detected. The disease may return in the prostate or in another part of the body.
  • Q: Does OhioHealth offer any clinical trials for prostate cancer?

    A: Talk to your doctor about your interest in participating in a clinical trial for prostate cancer. Your doctor will be able to give you information about any trials for prostate cancer going on at OhioHealth. Also visit the National Cancer Institute’s website for information on clinical trials to help you learn more about clinical trials so that you may have an informed discussion with your doctor.
  • Q: What tests are used to diagnose prostate cancer?


    Two common diagnostic tests include:

    Digital Rectal Exam (DRE)

    This test is done during a physical exam. It requires your healthcare provider to gently insert a gloved lubricated finger into your rectum to feel for any lumps or enlargement of the prostate gland.

    This test is usually used in combination with the Prostate Specific Antigen (PSA) blood test and evaluating any other symptoms you may be having to aid in the diagnostic process.

    Prostate Specific Antigen (PSA) blood test

    When prostate cancer develops, the PSA level usually goes up. However, a low level does not guarantee that a man doesn't have cancer. Talk to your doctor about your level.

    • PSA is a blood test that can be taken from a vein in your arm by a needle.
    • PSA is a protein that is naturally produced by the prostate gland.
    • It is normal for PSA to be in your blood stream within a certain range.

    The PSA level can also be increased by things other than prostate cancer, such as:

    • An enlarged prostate.
    • Age: PSA levels normally go up slowly as you get older.
    • Prostatitis: Many things, including infection, can cause this inflammation of the prostate.
    • Ejaculation (ejection of semen): This can cause the PSA to go up a minimal amount for a short time, and then go down again.
    • Certain medicines: Taking male hormones like testosterone (or other medications that raise testosterone levels) may cause a rise in PSA.
  • Q: What imaging tests are used for prostate cancer?


    Below are some imaging tests used for prostate cancer.

    Transrectal Ultrasound (TRUS)

    • TRUS uses sound waves to place an image of your prostate on a video screen.
    • This test can be used to measure the volume of your prostate but is most commonly done during a prostate biopsy.
    • A small, lubricated probe that gives off sound waves is placed into the rectum and helps create a black-and-white image of the prostate. 
    • Procedure only takes 10 minutes and happens in an outpatient location. You will feel pressure from the probe. Your physician may use a numbing medication to make you more comfortable.
    • This test is not done to diagnose or rule out prostate cancer as the diagnosis can only be made with a biopsy.

    Computerized Tomography (CT) Scan

    A CT scan is not used to diagnose or rule out prostate cancer but rather to determine if someone with prostate cancer has any sign of spread to lymph nodes or other organs. If ordered, you may need a contrast material injected into a vein (IV) in your arm as well as a contrast material that you drink to allow the organs to show up on the scan.

    Magnetic Resonance Imaging (MRI)

    MRI uses radio waves and a magnetic field to take pictures of soft tissues, organs and bones. Some physicians order an MRI scan to determine the extent of cancer within or around the prostate. A rectal probe may be used as part of the MRI scan.

    Some medicine may be ordered to help you relax if you have fear of confined spaces.

    Bone Scan

    • This test is commonly used to detect whether prostate cancer has spread to your bones.
    • A small amount of radioactive tracer material is put into your bloodstream several hours before the test. The tracer material is safe for you and settles into your bones.
    • A normal scan will find tracer material evenly spread throughout your bones. Areas of bone that have more growth or breakdown will have more tracer material detected and appear as "hot spots". Alternatively, areas of bone that do not soak up the tracer material will appear as "cold spots".
    • Abnormal "hot spot" results may be due to several conditions, such as arthritis, chronic bone disease, fracture or infection, but can show characteristic changes consistent with cancer.
  • Q: What is an Open Prostatectomy?


    Radical Retropubic Prostatectomy is a surgical procedure during which the surgeon removes the prostate through an incision below the belly button to the pubic bone. This is done either under general anesthesia or epidural along with sedation medications. Lymph nodes may or may not be removed to check for cancer. The surgeon will try to spare the nerves that assist in erections, if they are unaffected by the cancer. It may take a few months to a year to regain ability to have an erection, but some men may not regain this ability. A urinary catheter will be placed during surgery and after a few days in the hospital, you will go home with the catheter for a couple of weeks. Recovery can take 3-5 weeks.

    During a Radical Perineal Prostatectomy, the surgeon removes the prostate through an incision between the scrotum and anus. This is not used as often, due to the inability to take out lymph nodes to test for cancer. You will go home with a urinary catheter in place for a couple weeks. Recovery takes about 3-5 weeks.

  • Q: What is a Laparoscopic Prostatectomy?


    Laparoscopic Radical Prostatectomy (LPR) is a surgical procedure during which the surgeon removes the prostate with instruments that are inserted through several small incisions. A camera is inserted to allow the surgeon to see the inside of the body while performing the surgery. This surgery requires an overnight stay in the hospital, and you may have less blood loss and pain than with an open prostatectomy. A urinary catheter will be needed for 1-2 weeks after the surgery.  

    The Robotic-Assisted Laparoscopic Prostatectomy (RALPR) is a newer type of laparoscopic surgery using a robot called the Da Vinci system. The difference is a surgeon controls the robotic arms to remove the prostate through several small incisions. The surgeon may have better maneuverability with the robot. The surgery is done under general anesthesia and requires an overnight stay in the hospital. You will go home with a urinary catheter for about a week. Recovery time is typically shorter with laparoscopic and robotic surgery as compared with open surgery. 

  • Q: What is a Transurethral Resection of the Prostate (TURP)?

    A: This operation is not a surgery used to cure prostate cancer, but rather is used to treat advanced prostate cancer in relieving symptoms, such as urination problems. An instrument called a resectoscope is passed through the urethra and either electricity or a laser is used to cut tissue from the prostate. This is done under general anesthesia or spinal anesthesia. The operation takes about an hour and a urinary catheter is in place for a day. Hospital stay is around 2 days and recovery can take a couple of weeks.
  • Q: If I have surgery, will there be side effects?


    Side effects from surgery are often temporary and may include, but are not limited to: 

    • urine leakage (incontinence)
    • difficulty achieving an erection (impotence)
    • blood loss
    • inability to have a child (infertility)
    • dry ejaculation (orgasm)
    • infection

    There are many things to assist with these possible side effects including Kegel exercises (pelvic floor exercises), erectile dysfunction medications, penis pumps, storing your sperm and support groups. Talk to your doctor about these potential side effects and your personal risk.

  • Q: How is Radiation Therapy used for prostate cancer?

    A: Radiation Therapy uses high-energy beams to kill cancer. It can be used to cure the prostate cancer alone or in combination with other therapy. It can also be used for cancer that returns in the area where the prostate was surgically removed, or to simply relieve symptoms in advanced prostate cancer. There are two main types of radiation commonly used, External Beam Radiation Therapy (EBRT) and Brachytherapy / Seed Implantation.
  • Q: How does External Beam Radiation Therapy (EBRT) work?


    External Beam Radiation Therapy uses a machine outside the body to treat prostate cancer. It can either be used to cure prostate cancer or used to relieve symptoms, such as bone pain, if the cancer spreads. State-of-the-art radiation therapy uses intensity modulated radiation therapy (IMRT), which can achieve more uniform radiation dose coverage of the prostate. IMRT is coupled with image-guided radiation therapy (IGRT), which uses daily imaging just prior to the treatment delivery to ensure accurate targeting of the prostate with highly focused beams, thereby limiting any collateral treatment of the surrounding tissues or organs. To make sure that the beam targets only the exact area needed, the radiation oncologist will create a planning session using CT scan images. This is done in order to reduce the potential side effects. 

    Tiny tattoos, the size of a freckle, and markers implanted into the prostate are typically used to line up the body with the beam. The treatment will usually take place 5 days a week in an outpatient radiation center for a series of up to 8 1/2 consecutive weeks. The treatment appointment usually lasts 10-20 minutes each day. You will not be able to feel the beams of radiation, and you will not give off any radiation yourself.

    Temporary side effects may include, but are not limited to: 

    • fatigue
    • bowel  symptoms, such as diarrhea or discomfort with bowel movements
    • bladder irritation, such as urgency and frequency of urination or burning with urination
    • possible erectile dysfunction (impotence) 

    There are many things to assist with these side effects, including exercise programs, medications, kegel exercises (pelvic floor exercises) and support groups. Talk to your doctor about your personal risk for these side effects.

  • Q: How does Brachytherapy or Seed Implantation work?


    The other main type of radiation is Brachytherapy or Seed Implantation. This type of therapy is usually used alone or sometimes in combination with external beam radiation therapy in early stage prostate cancer. The seeds are tiny titanium pellets, the size of a grain of rice, filled with radioactive material. These seeds are inserted into your prostate by thin needles through the area between your scrotum and anus. The seeds deliver high doses of radiation directly into the prostate, while limiting radiation to the normal tissues around the prostate. This is done under general anesthesia and takes about 45 minutes. 

    You will typically be able to go home the same day. Most patients return to work or normal activities within a few days. Although the seeds give off low dose rate radiation for several months, exposure to those around you is considered negligible. The seeds are implanted permanently and slowly become inactive as the radiation wears off, gradually over time. 

    You may be advised against being close to pregnant women and babies for prolonged periods for a month after the seeds are placed. You may also be asked to use a condom during sexual intercourse for a few weeks, as well. Seed implantation requires a planning session using ultrasound imaging to determine the exact location of seed placement and the volume of the prostate. If the prostate volume is too large to treat, a short course of hormonal therapy may be used to shrink the prostate to a treatable size, or alternative treatment programs may be reconsidered. 

  • Q: What are Radiopharmaceuticals?

    A: These are drugs, such as strontium-89, Samarium 153, and Radium-223, that contain radioactive material. They are outpatient IV injections used for prostate cancer that has spread to the bones. It allows all bones affected by the cancer to be treated, as opposed to external beam radiation that only treats one area of the bone. Your blood counts may be monitored while undergoing this type of treatment.
  • Q: What is Hormonal Therapy?


    Hormonal Therapy or Androgen Deprivation Therapy (ADT) is given to reduce male hormones, which promote prostate cancer growth. It is not used alone to cure prostate cancer, but can be used to slow prostate cancer growth. It can also be used to shrink the prostate before implanting radiation seeds, used if surgery or radiation is not an option and the cancer has spread, and if your cancer returns after initial therapy. 

    There are different types of Hormonal Therapy. These include surgical removal of the testicles (surgical castration) and chemical castration, which include medications that are given to decrease hormone production by the testicles. It can also include other types of medications that help lower hormone levels that work in a different way when castration no longer works.

    Hormonal therapy can cause possible side effects, including reduced sex drive, inability to have an erection, hot flashes, thinning of the bones, anemia, breast tenderness, weight gain, fatigue, increased cholesterol and depression. Some of these side effects may decrease or go away with time, and many can be alleviated by other medications and exercise. Please discuss with your physician.

  • Q: Is Chemotherapy a treatment option?


    Chemotherapy is an anti-cancer medication that is given either in the form of a pill or given in an IV through your veins. It is not the main form of treatment for prostate cancer, but can be used when cancer has spread and hormonal therapy is becoming less effective. Side effects depend on the type of drug that you are receiving but can include:

    • temporary hair loss
    • Sores in your mouth
    • Nausea
    • diarrhea
    • getting infections more easily
    • increased risk of bleeding
    • feeling tired (fatigue)

    Many of these can be treated, are short term, and vary depending on the specific medication that you are receiving. Talk to your doctor about your personal risk and ways to manage your side effects. 

  • Q: What are Luteinizing Hormone-Releasing Hormone Agonists?

    A: Luteinizing hormone-releasing hormone (LHRH) agonists are drugs that lower the amount of testosterone made by the testicles. This is known as chemical castration. The drugs are either injected or implanted under the skin and are given periodically, on a schedule determined by your doctor. Some LHRH Agonists drugs are frequently given with anti-androgens in combination. 
  • Q: What are Anti-Androgens used for?


    Anti-androgen pills  are used to block androgens from getting to their receptors. It can be given in addition to the LHRH agonist. Combined therapy is sometimes used with an anti-androgen pill and surgical or chemical castration.

    Side effects include:

    • diarrhea
    • fatigue
    • hot flashes 
  • Q: Is Cryotherapy a treatment option?

    A: Cryotherapy or Cryoablation may be used to treat prostate cancer, but is typically used for cancer that returns after radiation therapy rather than as a first form of treatment, due to side effects. A physician inserts tiny needles through the area between the anus and scrotum to deliver gases to freeze the cancer. This is done using a transurethral ultrasound for guiding the needles. It is done under general anesthesia and you will go home within a day with a urinary catheter for 3 weeks.
  • Q: How are Bisphosphonates used in conjunction with prostate cancer?

    A: This is a group of drugs given to patients to strengthen the bones. This can be used when prostate cancer has spread to the bones and can help prevent fractures. Some symptoms associated with bisphosphonates include flu-like symptoms and bone/joint pain.
  • Q: What are Monocolonal Antibodies?

    A: Monocolonal antibodies are drugs that can help reduce bone loss when prostate cancer has spread to the bone and bisphosphonates are not working. They can help prevent bone fractures. They are given as an injection under the skin every month. It is encouraged to take supplemental calcium and vitamin D during this therapy. 
  • Q: How do Vaccine Treatments work?

    A: Vaccine Treatments  are used to stimulate the immune system to encourage it to attack prostate cancer cells. It can be considered for selected patients if advanced prostate cancer has progressed despite hormone therapy. It might prolong life in certain cases but is not considered curative. Each vaccine is specific to each different person. Vaccines are created using white blood cells from the patient's blood and taken to a lab to expose the cells to prostate cancer. They are then delivered back to the patient through an IV.

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