Advanced Prostate Cancer Care
Our multidisciplinary team of medical oncologists, radiation oncologists, urologic oncologists, pathologists, radiologists, nurses, nurse navigators, and social workers work together to provide patients with the most advanced treatment options for prostate cancer. Through our partnership withRutgers Cancer Institute of New Jersey, the states onlyNational Cancer Institute-designated Comprehensive Cancer Center, patients have access to complex surgical techniques including minimally invasive surgery and robotic prostatectomies,clinical trials, precision medicine, immunotherapy, and innovative radiation therapy procedures, including proton therapy.
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What Is The Psa Test
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a mans blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.
The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the US Food and Drug Administration in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem.
In addition to prostate cancer, a number of benign conditions can cause a mans PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis and benign prostatic hyperplasia . There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.
Moffitt Cancer Centers Urologic Oncology Program
Men who are experiencing prostate cancer symptoms can feel confident turning to Moffitt Cancer Center for a diagnosis and treatment. In addition to urologists, uropathologists and uroradiologists, our team of skilled prostate cancer doctors includes radiation oncologists, interventional radiologists and medical oncologists. Requesting an appointment is easysimply call us at or complete our new patient registration form online.
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What Research Has Been Done To Study Prostate Cancer Screening
Several randomized clinical trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and DRE were evaluated for their ability to decrease a mans chances of dying from prostate cancer.
The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.
A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .
Prostate Cancer And Your Sex Life: What You Should Know
While sex might not be the first thing in your mind when you are diagnosed with prostate cancer, it is something that you need to know about especially if you lead a sexually active life. You might feel awkward talking about your sex life with your doctor but it is important to do so.
When you get treated for prostate cancer, it can affect your sex life in various ways. You might lose interest in sex or you might just feel discomfort when you think of sex. Some men feel pain during ejaculation as well. All of these can hinder your ability to enjoy sex and this can affect your self-image and self-confidence.
You need to ask your doctor about the treatment that you will be receiving and how it will affect your sex life. You can ask questions such as the safety measures that you can take, which sex positions you should avoid, whether you can have sex with your partner daily, etc.
Whatever questions you have, just ask your doctor to be on the safe side. If you are unable to do that then you might want to speak to your counsellor first and then to your doctor so you dont feel awkward.
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How To Prepare For The Prostate Exam
The best way to prepare for an annual prostate exam is by making sure you are hydrated, so your bladder isnt full when you go in for the appointment! You should also make sure theres enough time between urination before going in to get checked out. Finally, empty your bowels before the prostate exam!
If you have hemorrhoids, anal tears, or other problems with your anus before a PSA test, it will be easier to relax and breathe normally. Speak to your doctor about any medications/supplements that may affect the results of this exam, as well as recent ejaculation, beforehand so they can provide advice on how best to prepare for the procedure.
How Is Prostate Disease Treated
Treatment depends on the diagnosis, and the type of disease that is present.
Diseases associated with excessive hormone levels are typically treated by neutering the dog. Because testosterone and estrogen are both formed in the testicles, neutering is generally an effective treatment. The prostate will return to its normal size within one month after surgery. Certain medications or hormone replacements, such as finasteride, megestrol acetate, and GnRH, may be used to treat specific prostatic conditions.
Paraprostatic cysts and prostatic abscesses require surgery to drain and remove them.
Diseases involving primary or secondary bacterial infections are treated with aggressive and prolonged antibiotic therapy. Because it is difficult for antibiotics to penetrate into the prostate gland, treatment for several weeks to months is usually necessary. Antibiotics that can penetrate the prostate include enrofloxacin, erythromycin, ciprofloxacin, chlorhamphenicol, doxycycline, and trimethoprim-sulfonamides each having varying pros and cons. Since the prostatic infections are typically secondary to another disease, treating the prostatic infection is only part of the overall treatment.
“Because it is difficult for antibiotics to penetrate into the prostate gland, treatment for several weeks to months is usually necessary.”
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The Different Types Of Prostate Surgery
The term prostatectomy is used to describe a number of different surgical procedures to remove either part or all of the prostate gland. This may be required to treat prostate cancer or BPH.
When only a part of the prostate is removed, this is called a simple prostatectomy. This process involves enucleating it from its capsule to trim away excess tissue, but where the sphincter muscle and nerves remain intact. It is usually used to treat BPH, which is a benign condition, meaning there is no risk of malignant cells having moved on to surrounding tissue.
When the entire prostate gland, capsule , the surrounding lymph nodes and neighbouring tissue is removed, this is known as a radical prostatectomy. This is usually a treatment for men with localised prostate cancer and there a number of techniques used:
Open Surgery This is where the prostate is removed via a large single incision in the lower abdomen, or the perineum .
Laparoscopic Radical Prostatectomy This is where the prostate is removed via several small incisions in the lower abdomen using small surgical instruments. This process is much less invasive than open surgery.
Robotic-assisted radical prostatectomy Much like laparoscopic radical prostatectomy, the prostate is removed via small incisions in the lower abdomen. Robotic-assisted instruments are inserted through the incisions and controlled by a surgeon.
Holmium Laser Enucleation of the Prostate
Transurethral Resection of the Prostate
What Is Prostate Enlargement
Enlargement of the prostate occurs when the prostate gland cells begin to multiply and cause the prostate gland to swell. This swelling tends to compress the urethra, limiting urine flow and causing symptoms known as lower urinary tract symptoms . BPH is a condition that many men encounter with aging.
Most of the symptoms of BPH are associated with urinary function. They are:
- Frequent need to urinate
- Urinary retention inability to empty the bladder
- An intense urge to urinate, even shortly after urinating
- A weak urine stream or an interrupted urine stream
- Difficulty starting or stopping urination
While BPH itself is not a directly linked cause of sexual problems, most men that suffer from it do indeed find it affects sexual performance. Some common sexual side effects of BPH are:
- Inability to maintain an erection
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Reasons Why Men Should See A Urologist
Lets face it, men are usually not as good as women at going to the doctor for health screenings. They often wont even go to the doctor when there is something wrong. In fact, it takes the average man who feels a mass or tumor on his testicle six months to see a doctor, according to urologic surgeon Dr. Jonathan Bingham. But ignoring it doesnt mean the problem will disappear, no matter how much you wish it would.
Urologists are doctors who see men and women. For men, they are the doctors who deal with urinary issues, prostate issues, and any problems of the male reproductive organs. Here are seven common reasons for men to see a urologist.
What Treatments Can A Urologist Offer
Urologists can prescribe medicines and offer whatÃ¢â¬â¢s called “behavior training.” For instance, you can manage some problems with holding in your urine by doing exercises that strengthen your pelvic muscles.
Urologists can also do a range of procedures. Some of these they’ll do in their office. Others are major surgeries done in a hospital.
A few common procedures include:
Cystoscopy. This is a close-up look at your bladder and urethra with a special telescope-like tool called a cystoscope.
Ureteroscopy. Similar to cystoscopy, it’s a look inside your ureters and kidneys.
Prostate biopsy. The urologist removes a tiny tissue sample from your prostate to test for cancer in a lab.
Nephrectomy. This is surgery to remove a kidney to treat cancer.
Vasectomy. The urologist cuts the tubes that carry sperm to prevent pregnancy.
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How Will My Veterinarian Get These Samples
A free-flow urine sample iscollected . Samples of prostatic fluid are obtained by passing a urethral catheter to the level of the prostate and massaging the prostate to milk fluid out of it.
Samples of prostatic cells are obtained by fine needle aspiration or biopsy. If the prostate is greatly enlarged, it may be sampled by through the body wall by FNA or biopsied. FNA involves taking a small needle with a syringe and suctioning a sample of cells directly from the prostate and placing them on a microscope slide. A veterinary pathologist then examines the slide under a microscope. In some cases, results from FNA may not be entirely clear and biopsy may be necessary.
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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What Is Cryotherapy
There are several treatment options for localized prostate cancer. These options include active surveillance, surgery, radiotherapy, and cryotherapy. Cryotherapy is one of the newer forms of treatment, so patients with prostate cancer usually have lots of questions about what this treatment is an how it works. If you are considering cryotherapy as a treatment for prostate cancer, then here is a general idea of what you can expect:
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
What Does The Psa Test Involve
The PSA test involves taking a blood sample and sending it to a laboratory for analysis. The results indicate:
Normal levels: Most healthy adult males have PSA levels below 4 nanograms per milliliter .
Borderline levels: PSA levels of 4â10 ng/ml are borderline. There is a 1 in 4 chance that cancer is present.
High levels: If PSA levels are over 10 ng/ml, there is a 50% chance that the person has prostate cancer. The specialist will likely recommend more testing, including a prostate biopsy.
It is important to note that PSA levels can naturally vary from person to person. A person with high levels may not have prostate cancer. On the other hand, about 15% of people who test positive for prostate cancer after a biopsy have PSA levels below 4 ng/ml.
Prostate cancer is not the only cause of high PSA levels. Find out more about the other causes here.
What Procedures Do Urologists Perform
When you visit a urologist, theyll start by doing one or more of these tests to find out what condition you have:
- Imaging tests, such as a CT scan, MRI scan, or ultrasound, allow them to see inside your urinary tract.
- They can order a cystogram, which involves taking X-ray images of your bladder.
- Your urologist can perform a cystoscopy. This involves using a thin scope called a cystoscope to see the inside of your urethra and bladder.
- They can perform a post-void residual urine test to find out how fast urine leaves your body during urination. It also shows how much urine is left in your bladder after you urinate.
- They can use a urine sample to check your urine for bacteria that cause infections.
- They can perform urodynamic testing to measure the pressure and volume inside your bladder.
Urologists are also trained to perform different types of surgery. This may include performing:
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What If A Screening Test Shows An Elevated Psa Level
If a man who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the man continue with PSA tests and DREs at regular intervals to watch for any changes over time.
If a mans PSA level continues to rise or if a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. A urine test may be recommended to check for a urinary tract infection. The doctor may also recommend imaging tests, such as a transrectal ultrasound, x-rays, or cystoscopy.
If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. Most often, the needles are inserted through the wall of the rectum . A pathologist then examines the collected tissue under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to diagnose prostate cancer.
Prostate Cancer Diagnosis And Screening
It is essential to get a periodic preventative screening for prostate cancer as the symptoms are not very apparent at the initial stages. When you go for your annual health examination, you might want to speak to your doctor about prostate cancer screening. If you are 40 years old, then doctors recommend that you get yourself screened especially if one of your close family members has prostate cancer.
Doctors say that if you are 45 and if you are African American and you have someone close to you who was diagnosed before they were 65, then you should get a screening done for prostate cancer as you have a high statistical risk.
The following tests are used for screening and diagnosing prostate cancer.
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