Highly treatable, especially when caught early, prostate cancer affects one in nine men in the United States, according to the American Cancer Society.
A reproductive organ about the size of a walnut, the prostate gland makes the fluid that carries sperm during ejaculation.
Risk factors include:
- Family history
- Being over 50, with increasing risk over age 65
- Being African American
Early Detection Saves Lives
"There are usually no symptoms with prostate cancer, so screening is vital because early detection provides the greatest chance for cure," according to Doylestown Health urologist Steven Flashner, MD.
"Every man should have an annual physical and digital rectal exam after age 50," notes Dr. Flashner. The rectal exam allows physicians to detect lumps, enlargement, or other abnormalities.
"In our practice, we recommend a Prostate Specific Antigen (PSA) blood test every year between the ages of 50 and 70. Because prostate cancer often has no symptoms, a patient can have a normal physical, and still have cancer," says Doylestown Health urologist Albert Ruenes, MD. "The test identifies a protein which can signify prostate cancer, so we watch for trends over time."
"It's a good idea to discuss risks and benefits of PSA screening with your primary care provider," says Dr. Ruenes. "There is debate about PSA because of the potential for false positive results leading to unnecessary biopsies."
If the results of a PSA test or rectal exam show a need for further testing, your urologist may order a biopsy or MRI to diagnose prostate cancer.
Doylestown Health urologist Albert Ruenes, MD, had monitored Ron Sparks' unusually large, but normally functioning prostate gland for 20 years with an annual physical and PSA blood test. In 2018, Dr. Ruenes noticed a trend in Ron's PSA results and suggested a biopsy which identified that Ron, then age 59, had prostate cancer.
"We discussed options, including the possibility of waiting, because prostate cancer is slow growing, but I chose to have my prostate removed," says Ron, who decided on a perineal approach, which offers direct access to the prostate via a small incision between the anus and scrotum.
Dr. Ruenes performed Ron's surgery, and his cancer was contained, so no further treatment was necessary. After a two-night hospital stay, Ron returned to his Point Pleasant home, where visits from a home health nurse supported his recovery.
"I'm back to doing everything I did before my surgery," says Ron who says his tight knit family and strong Catholic faith sustained him throughout his cancer treatment.
"I can't say enough about my family," says Ron. "My wife and sons were with me every step of the way. I was so happy to see them at my bedside after the surgery." The Sparks clan also includes Ron's siblings who live less than a mile away. "They did everything they could to support me," says Ron.
"I feel blessed, and I'm grateful for the excellent care I received at Doylestown Health. I'm working out, back on the job and best of all, enjoying time with my family."
Tailoring Treatment to the Individual
"We match the aggressiveness of treatment to the aggressiveness of the tumor, the man's age and overall health while trying to maintain a good quality of life," says Dr. Flashner. "The prostate is close to the urine control muscles and the nerves that allow a man to have an erection. The goal is to cure cancer while preserving those functions."
"Thanks to early screening, most cancers are limited to the prostate, curable through either surgery or radiation alone," says Dr. Ruenes. "In some advanced cases, we know up front that preserving the nerves will not be possible. For these patients, medication can often restore sexual function."
Treatment options include:
- Watchful waiting or medication to lower testosterone – for patients with non-aggressive cancer
- Surgery, including minimally invasive options, to remove the prostate
- External beam radiation and brachytherapy (radioactive seed implants) – available at Penn Radiation Oncology at Doylestown Hospital
- Chemotherapy – may be recommended for hormone-resistant cancer or cancer that has spread
- Cryotherapy (freezing) and high frequency ultrasound – targeted focal therapies that preserve healthy tissue by pinpointing and destroying cancer
Men with aggressive cancer may benefit from a combination of treatments. Our urologic cancer patient navigator coordinates treatment and follow-up care, answers questions and facilitates participation in clinical trials, support groups and other resources.
A Range of Surgical Options
If surgery is necessary, Doylestown Health urologists are skilled in a range of surgical approaches to remove the prostate (radical prostatectomy):
- Perineal: Provides direct access to the prostate with the incision between the anus and scrotum. Includes nerve-sparing methods.
- Retropubic: Removes the gland through a large, abdominal incision.
- Robotic-assisted laparoscopic: Removing the prostate through small abdominal incisions using the da Vinci® Surgical System.
About Doylestown Health Cancer Institute
Doylestown Health Cancer Institute offers patients the quality care they expect from a leader in cancer diagnosis and treatment - close to home. Accredited by the American College of Surgeons Commission on Cancer our board-certified physicians and oncology-certified practitioners provide comprehensive, coordinated care and services for the full range of cancer diagnoses including breast, lung, urologic, gastrointestinal and other cancers.
About Doylestown Health Urology
Board-certified Doylestown Health Urology specialists offer specialized treatment of a wide range of diseases and disorders of the urinary tract which includes the ureters, urethra, prostate, bladder and kidneys in men and women, as well as the reproductive tract in men. Our highly skilled surgeons treat common disorders as well as provide minimally invasive and advanced surgical options for complex conditions such as cancer.