One in six men living in the U.S. today will develop prostate cancer. It is the second leading cause of cancer-related death in men 50 years and older. Yet when caught early, prostate cancer is nearly 100 percent curable.
Boulder Community Health has the most advanced diagnostic and treatment technologies available for prostate cancer. Our inpatient care unit provides the highest quality care for acutely ill cancer patients and their families. We also offer a comprehensive range of cutting-edge outpatient treatment services.
Prostate cancer typically does not produce symptoms in its early stages, so early detection requires men to take advantage of available screening tests.
Two tests are commonly used to initially screen for prostate cancer. One is a digital rectal exam (DRE), in which a doctor feels the prostate through the rectum to look for hard or lumpy areas known as nodules. The other is a blood test used to detect a substance made by the prostate called "prostate-specific antigen" (PSA). A small amount of PSA always circulates in the blood, but high PSA levels, or levels that rise over time, could indicate prostate inflammation, enlargement or cancer. When used together, the DRE and PSA tests can detect abnormalities that suggest prostate cancer.
Many doctors recommend an annual rectal exam, supplemented by a PSA blood test, starting at age 50 for most men.
It is important to note, however, that neither of these tests is perfect. Many men with a mildly elevated PSA do not have prostate cancer, and men with prostate cancer may have normal levels of PSA. Also, the digital rectal exam does not detect all prostate cancers.
However, if you have an abnormal DRE or a high PSA, your doctor may suggest additional tests. He may recommend a prostate ultrasound and biopsy. During a biopsy, small tissue samples from several different areas of the prostate are removed and examined under a microscope for the presence of cancerous cells. A prostate ultrasound is generally performed in conjunction with biopsy. The images produced from the ultrasound can help your doctor detect any abnormal growths. Boulder Community has board-certified urologists with expertise in diagnosing prostate cancer.
If cancer cells are found, additional blood or imaging tests may be necessary to determine the extent of the cancer. Boulder Community Health offers the latest laboratory and imaging technology to help determine how quickly the cancer is growing and whether it has spread beyond the prostate.
Computed Tomography (CT) scans may be used to detect abnormal lymph nodes in the pelvis and abdomen where prostate cancer tends to spread. Generally, a CT scan is only used if the cancer is large, looks aggressive or is associated with a very high PSA level.
Magnetic Resonance Imaging (MRI) may be used to examine the prostate and nearby lymph nodes to distinguish between noncancerous and cancerous areas. MRI scans are better suited for detecting cancer in soft tissues.
Other imaging technologies such as bone scans also are available through BCH.
Full Range of Treatments
Boulder Community Health offers a wide range of treatment options for prostate cancer. The appropriate treatment choice largely depends on factors such as how fast the cancer is growing, how much it has spread, your age and overall health.
There are three basic options for patients with early-stage prostate cancer. “Early-stage” refers to cancer that is contained entirely within the prostate gland and has not spread. The two active treatment alternatives--surgery and radiation therapy (described below in more detail)--often lead to a cure. In certain cases, patients choose a wait-and-see approach, often referred to as “watchful waiting.” In this instance, no treatment is pursued unless the tumor gets bigger.
Radical prostatectomy, the surgical removal of the entire prostate gland and surrounding tissue, is the most widely used treatment for prostate cancer in the U.S. At BCH, our urologists perform both traditional open prostatectomy as well as minimally invasive prostatectomy with the advanced da Vinci robotic surgery system.
In open surgery, the surgeon makes a 6-8” incision to reach the prostate gland. Depending on the case, the incision is made either in the lower belly (retropubic approach) or in the groin between the anus and the scrotum (perineal approach.).
During robotic-assisted surgery, five small 1-2 cm incisions are made in the belly. The surgeon then inserts high-tech robotic arms that translate the surgeon's hand motions into precise actions within the body. This type of minimally-invasive surgery requires specially trained doctors. Click here for more information on robot-assisted prostatectomy.
Consult your physician to determine which surgical option is right for you.
You may have the option of using radiation to treat your prostate cancer. The two forms of treatment are external beam radiation and internal radiation (also known as brachytherapy). When prostate cancer is localized, radiation therapy serves as an alternative to surgery. In men with advanced disease, radiation therapy can help to shrink tumors and relieve pain.
Boulder Community Health patients can take advantage of an advanced technology for external radiation called intensity modulated radiotherapy (IMRT). Our new linear accelerator with IMRT delivers high doses of cancer-killing radiation to tumors with laser-like precision, decreasing the exposure of the surrounding healthy tissues and organs.
We also offer Image-Guided Radiation Therapy (IGRT) to improve the targeting and delivery of radiation treatment. Often used in concert with IMRT, IGRT is a remarkable advance that marks the exact location of a cancerous tumor, making it easier to track over time. A surgeon implants gold markers into the tumor to act as a reference system for ongoing radiation treatment. This lets the radiation oncologist compensate for moving organs by accurately retargeting the tumor at each treatment session. Best of all, IGRT’s ultra-precise targeting means less radiation exposure for healthy tissue surrounding the tumor, significantly reducing side effects.
Brachytherapy, or internal radiation therapy, involves implanting dozens of tiny radioactive “seeds” in the diseased tissue. Needles are used to insert the seeds through your skin into your prostate. The seeds release radiation for weeks or months, after which they are no longer radioactive. The radiation in the seeds can't be aimed as accurately as external beams, but is less likely to damage normal tissue. Once the seeds have lost their radioactivity, they become harmless and can stay in place indefinitely.
Hormone therapy may be used in conjunction with other treatments or alone as a primary treatment. Hormone therapy may act to halt or slow the growth of prostate cancer, and it is often used in men with advanced disease.
Cryosurgery (also called cryotherapy) is a minimally invasive procedure that uses extreme cold to destroy cancerous cells. Cryosurgery can be used to treat men who have early-stage prostate cancer that is confined to the prostate gland. It is not as well established as prostatectomy and radiation therapy.
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