Meet The Prostate Care Team
Prostate cancer used to be solely the domain of the urologist, a doctor who specializes in the urinary tract system and treats conditions such as bladder and prostate cancer. In the past, prostate cancer was almost always treated with surgery to remove the diseased prostate, a procedure called prostatectomy. Today, the urologist remains integral in a patients prostate cancer care. They help patients determine if screening is the right thing to do, make the diagnosis of cancer, and help walk patients through options for treatment. The urologist helps the patient access other specialists in cancer care, which may include a medical oncologist and radiation oncologist. In some parts of the United States, especially in areas that are far from major medical centers, the local urologist may still be the only expert available to treat prostate cancer.
Prostate cancer therapy may include one treatment or a combination of surgery, radiation, drugs, and regular monitoring.
Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will recommend a specific treatment plan for you based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
Examination Of Your Prostate
When your doctor examines you it might include feeling your prostate gland. To do this your doctor puts a gloved finger into your back passage to check for abnormal signs, such as a lumpy, hard prostate. Doctors call this test a digital rectal examination .
It’s normal to feel a bit anxious about this test and it might be uncomfortable. But it usually only takes a few minutes.
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Further Tests For An Enlarged Prostate
Depending on your test results, you may have further tests to find out what is causing your symptoms.
Bladder pressure test
This shows how well your bladder is working. The doctor passes thin tubes up your penis and fills your bladder with a clear liquid. Thin tubes are also placed in your back passage . The tubes measure the pressure in your bladder, back passage and urethra. You will then be asked to empty your bladder, and the pressures will be measured again while you urinate. You may have this test if youre thinking about having surgery to treat an enlarged prostate, or if youve had surgery but your symptoms havent improved or are getting worse.
This shows whether you have a blockage or any abnormal tissue in your urethra or bladder. A doctor or specialist nurse will pass a thin tube up your penis into your bladder. Youll be able to feel the tube moving, but anaesthetic gel will be used to make the test more comfortable. The tube has a light and camera on the end so the doctor or nurse can see the inside of your urethra and bladder on a screen. You may have this test if you have severe urinary symptoms, blood in your urine or pain, or if you often get urine infections. You may also have this test if your doctor thinks your urethra or the opening of your bladder may be too narrow this is called a stricture.
Understanding The Anatomy Of The Prostate
Despite its importance, the prostate gland in an adult man is only about the size and shape of a walnut and weighs less than 1 ounce .
It is located below the bladder, above the pelvic floor muscles, and in front of the rectum.
The prostate reaches its mature size during puberty and will keep its walnut size until the man is in his late forties or early fifties. After this age, it slowly begins to enlarge.
The prostate, which surrounds the urethra, is made up of glandular, stromal tissue, and smooth muscles fused within a capsule.
Though the prostate gland is often referenced as a singular entity, it is actually made up of a number of tubular or saclike glands that secrete fluids into the urethra through the ejaculatory ducts.
The prostate is divided into three histologically and anatomically separate glandular areas: The transition zone, the central zone, and the peripheral zone.
Transition Zone This surrounds the part of the urethra that passes through the prostate . This zone only represents about 5 percent of the gland, but is the primary origination of benign prostatic hyperplasia, or enlarged prostate. That is, the transition zone is the region of the prostate that grows as men age.
Central Zone Making up quarter of the prostate, this area surrounds the transition zone, as well as the ejaculatory ducts that stretch from the seminal vesicles which produces the majority of the fluid of semen to the prostatic region of the urethra.
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Routine Tests For Men
When it comes to cars, you know when to change the oil, rotate the tires, and have the front end aligned. But you may not be as diligent about caring for your body as you are about your car.
The body needs routine maintenance, no matter how many miles you have on it. Some men never get that care, and end up breaking down on the road, so to speak. For many that’s because they have no dealership to remind them when they’re due for service.
“People bounce around from doctor to doctor and no one is really working with them on an ongoing basis,” says Rick Kellerman, MD, president-elect of the American Family Physicians, who practices in Wichita, Kan.
“I think the No. 1 thing is probably establishing a relationship with a physician that you know, and that you trust, and that you can communicate with,” he tells WebMD.
In addition to having a primary doctor, wouldn’t it be nice to have a basic maintenance schedule for your health? Well, here you go.
Keep in mind that the following schedule is meant for generally healthy men. Recommendations may differ for men who have — or once had — significant medical problems, or have other factors that might increase risks.
Deciding If You Need A Prostate Screening
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What Happens Before The Examination
Its normal to feel a bit anxious about this test and it might be uncomfortable. But it usually only takes a few minutes and you shouldnt feel any pain. Tell your doctor if you do.
You can ask for a man or woman doctor if youd prefer. Or you can have someone else in the room, such as a family member.
Why Is A Prostate
A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.
When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.
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See A Prostate Doctor In Mint Hill And Concord North Carolina
Dr. Richard Natale, who is an expert in mens health and a broad range of urological conditions, leads our team in giving you treatment tailored to your needs. Your prostate health is our top priority. If you happen to feel any of these symptoms, do not hesitate to have yourself checked.
If you have any questions, you may call us at 786-5131. We also have a secure online form you may fill out to schedule an appointment. We look forward to helping you soon.
How Does The Prostate Play A Role In Male Fertility
The prostate gland is essential for reproduction and male fertility due to the prostatic fluid it produces.
The components of the prostatic fluid ensure that sperm is healthy and is able to fertilize eggs. Prominent components of prostatic fluid include:
- The enzyme prostate-specific antigen , which thins or loosens up semen so that sperm can travel more freely
- Prostatic acid phosphatase, an enzyme that catalyzes the breakdown of energy-rich compounds present in seminal fluid and may also increase sperm’s motility
- Citric acid, which may help maintain osmotic-electrolytic equilibrium in semen
- Zinc, which is important for semen coagulation
- Spermine, which is ultimately responsible for semen’s unique odor and may play a role in sperm motility and helping sperm fertilize eggs, according to an article published in Endocrine Reviews.
- Prostatic inhibin, or prostatic secretory protein, a protein that plays a role in regulating cell growth
Additionally, prostatic fluid is alkaline , and research published in July 2015 in the journal PLoS One suggested that the pH level of sperm can play a role in reproduction, helping maintain the viability of sperm and successful fertilization.
Infertility may develop if there are changes to the composition or secretion of the prostatic fluid.
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How Soon Will Prostate Test Results Be Available
Results for simple medical tests such as some urodynamic tests, cystoscopy, and abdominal ultrasound are often available soon after the test. The results of other medical tests such as PSA blood test and prostate tissue biopsy may take several days to come back. A health care provider will talk with the patient about the results and possible treatments for the problem.
What Are Additional Tests For Detecting Prostate Problems
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.
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What Is A Urologist
Urologists diagnose and treat diseases of the urinary tract in both men and women. They also diagnose and treat anything involving the reproductive tract in men.
In some cases, they may perform surgery. For example, they may remove cancer or open up a blockage in the urinary tract. Urologists work in a variety of settings, including hospitals, private clinics, and urology centers.
The urinary tract is the system that creates, stores, and removes urine from the body. Urologists can treat any part of this system. This includes the:
- kidneys, which are the organs that filter waste out of the blood to produce urine
- ureters, which are the tubes through which urine flows from the kidneys to the bladder
- bladder, which is the hollow sac that stores urine
- urethra, which is the tube through which urine travels from the bladder out of the body
- adrenal glands, which are the glands located on top of each kidney that release hormones
Urologists also treat all parts of the male reproductive system. This system is made up of the:
- penis, which is the organ that releases urine and carries sperm out of the body
- prostate, which is the gland underneath the bladder that adds fluid to sperm to produce semen
- testicles, which are the two oval organs inside the scrotum that make the hormone testosterone and produce sperm
Genetic Testing For Prostate Cancer
You may hear a lot about genetics or genomics. Both terms are related to genes and cell DNA, but they are different. These tests are being used to learn more about the DNA of cancer cells, and link DNA mutations with treatments. In the future, genetic testing may be the first step doctors take when diagnosing prostate cancer.
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Is A Cystoscopy Painful
You may feel discomfort when the cystoscope goes into the urethra and bladder. Youâll probably feel a strong need to pee when your bladder gets full. You may feel a slight pinch if the doctor takes a biopsy.
After the procedure, your urethra may be sore and it might burn when you pee for a day or two.
Resources To Find And Evaluate Doctors
Administrators in Medicine DocFinderInformation on licensing and disciplinary actions taken against doctors in 18 states links to state medical boards of remaining states.
American Board of Medical Specialties Includes a database to find doctors who are ABMS Member Board Certified Specialists, a designation achieved through additional training and education.
American College of SurgeonsInformation about finding surgeons who are Board Certified as well as information about surgical specialties. Includes database of member surgeons.
American Medical Association DoctorFinderEducation, board certification, and hospital admitting privileges for doctors who belong to the AMA.
American Society for Radiation Oncology RT AnswersIncludes searchable database of radiation oncologists.
American Society of Clinical Oncology Cancer.NetOncologist-approved cancer information from the American Society of Clinical Oncology can be found on the site Cancer.Net. This site includes a Find an Oncologist tool with tips on choosing a doctor and a database of oncologists.
Urology Care FoundationSearchable database of member urologists all of whom have been certified by the American Board of Urology.
Medicare Physician and Other Healthcare Professional DirectoryProvider profiles including specialties, practicing locations, and phone numbers. Other information may also include education, gender, residency, foreign languages spoken, and hospital affiliation.
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What Happens After The Prostate Tests
Urodynamic tests and cystoscopy may cause mild discomfort for a few hours after the procedures. Drinking an 8-ounce glass of water every half-hour for 2 hours may help reduce discomfort. The health care provider may recommend taking a warm bath or holding a warm, damp washcloth over the urethral opening to relieve discomfort. A prostate biopsy may produce pain in the area of the rectum and the perineum, which is between the rectum and the scrotum. A prostate biopsy may also produce blood in urine and semen.
An antibiotic may be prescribed for 1 or 2 days to prevent infection.
Patients with signs of infectionincluding pain, chills, or fevershould call their health care provider immediately.
Nurse Counselors And Coordinators
A team of experts assists doctors on the care team. Those experts include oncology nurses, who will administer chemotherapy and other medicines, perform the tests used for monitoring the disease, and help patients cope with side effects. Case managers and patient coordinators are also part of the care team. These experts will help patients coordinate care across the team. They will also help patients make connections with experts, such as nutritionists, who can help with dietary concerns, or endocrinologists, who can help patients who are taking hormone therapy. Social workers with expertise in oncology may also help patients get help with personal challenges such as coping with the emotional burden of prostate cancer as well as helping patients navigate financial concerns, including questions about insurance coverage and family medical leave.
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