Prostate

What is prostate cancer?

Prostate cancer arises in the prostate, a gland in men only that is located below the bladder. Prostate cancer is the second most common type of cancer among men in the U.S., and is unique in that most men will develop it, but few will have any related symptoms or problems.

Our role in the Genitourinary Oncology Program is to help distinguish between aggressive and non-aggressive forms of prostate cancer and work with you to create a treatment plan based on your individual biology.

More information about prostate cancer (American Cancer Society)

What prostate cancer is not

There are many factors other than cancer that can raise a PSA level. Prostate cancer is also not the same as an “enlarged prostate” and should not be confused with other genitourinary cancers such as bladder, kidney, testicular, adrenal, penile, or urethral because these cancers can have different symptoms, outlooks, and treatments.

Common types of prostate cancer

Adenocarcinoma is the most common type of prostate cancer, however, within this category are aggressive and non-aggressive forms. Aggressiveness can be determined by biopsy diagnosis.

Tests

It’s possible that you could have one or more of the following tests (but not all of these may apply to your condition):

  • Trans-rectal biopsy - This procedure involves sample tissue removal from the prostate using a thin needle that is inserted through the rectum and into the prostate. Transrectal ultrasound is usually used to guide the needle. The sample is examined under a microscope to see if it contains cancer.
  • Bone scan - A bone scan is procedure to check for abnormal areas or damage in the bones using a small injection of radioactive material that travels through the blood and can be detected by a scanner.
  • Imaging (PET scan or MRI):
    • MRI scan (magnetic resonance imaging) - An MRI test uses magnetic fields and radio waves to capture detailed images of the prostate. During the procedure you will lie flat on a padded platform, which then slides into the center of a tube shaped MRI machine. You will not feel the magnetic fields or radio waves around you, but you will hear a loud thumping sound. You will be asked to lie very still during the procedure, The MRI technicians will work with you to help this procedure be as comfortable as possible.

    • PET scan (positron emission tomography) - A PET scan is an imaging procedure used to locate cancer cells in the body. A PET scan involves injecting a small amount of radioactive glucose (sugar) into a vein and using a scanner to detect and create images of where in the body the glucose collects.

  • Meeting with your surgeon, medical oncologist and radiation oncologist

Treatment

Depending on your unique set of conditions, your treatment could include radiation therapy, surgery or active surveillance. Many individuals with prostate cancer will receive a recommendation to undergo radiation therapy either before or after surgery. Some types prostate cancer are very slow-growing over the course of many years and do not cause symptoms. In certain cases you and your provider may opt for active surveillance, which means careful long-term monitoring without any further invasive treatments. 

Your full team of care providers will work closely together to review your diagnostic tests, identify the best course of treatment particular to you, and help you understand your diagnosis and what to expect with any treatment you have.

Radiation Oncologist, Alan Hartford, MD, with his patient, William Handy.

New Protection for Prostate Cancer Patients Undergoing Radiation Therapy

D-H's NCCC is the only hospital in Northern New England to offer a hydrogel that protects organs adjacent to the prostate, reducing side effects for patients undergoing radiation for prostate cancer.

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