Urologic Cancer

Cancer that forms in the male and female urinary tract and the male reproductive organs

 

Conditions

Prostate Cancer: Prostate cancer is cancer that occurs in the prostate, a small walnut-shaped gland in males which produces the seminal fluid that nourishes and transports sperm. For men in the United States, prostate cancer is the most common cancer, and one of the most common causes of cancer death. Each year there are approximately 175,000 new cases diagnosed, and approximately 32,000 deaths.

Prostate cancer generally occurs most often in older men. Many prostate cancers grow very slowly, with some never causing symptoms. Some slow growing prostate cancers may only require minimal or no treatment at all. However, other types of prostate cancer (especially when cancer spreads to other parts of the body) may require more aggressive treatment in an effort to control the disease.

Prostate cancer may cause no signs or symptoms in early stages. Once prostate cancer has advanced, symptoms may include: 

  • Difficulty urinating

  • Weakened urinary stream

  • Blood in urine

  • Blood in semen

  • Bone pain

  • Losing weight without trying

  • Erectile dysfunction

In some men, symptoms only develop after the cancer has spread. If the cancer has spread to the spine bones, the spinal cord may be affected causing pain, numbness, weakness, and urinary incontinence. 

There are several different treatment options for prostate cancer, and each person’s treatment plan will depend on several factors. These factors include how aggressive (how fast the cancer is growing), whether it has spread, and the individual’s overall health. Your healthcare provider will also weigh the potential benefits or side effects of treatment. Prostate cancer treatment looks different for each patient, and patients are encouraged to work with their team of healthcare providers to individualize a plan that the patient feels comfortable with. For some men with prostate cancer, treatment may not be needed right away, and in some cases, may not ever be needed. 

Treatment of prostate cancer usually involves one of three strategies based on the aggressiveness of the cancer and how far it has spread. These are: 

Active surveillance: Active surveillance (previously referred to as ‘watchful waiting’) means the patient receives no treatment unless the cancer is progressing or changing. In this strategy, the patient is not burdened by potential side effects of treatment.

Curative treatment: Curative treatment is intended to remove or kill the cancer and can include surgery, radiation, high-frequency ultrasound, and cryotherapy (freezing).

  • Surgery: Surgery to remove the prostate is beneficial if the cancer has not spread beyond the prostate. If the cancer is a low-grade prostate cancer, prostatectomy (removal of the prostate) has been proven to be very effective.

  • Radiation: Radiation therapy may cure cancer that has not spread outside the prostate, and can also cure cancers that have spread into tissues near the prostate. If the prostate cancer has spread to distant organs, radiation therapy will not cure the cancer, however can still be beneficial in relieving pain when the cancer has spread to the bone. Radiation is sometimes given after surgery to treat areas around the prostate, or if there is suspicion that the surgery did not remove all of the cancer.

Palliative treatment: Palliative treatment is intended to treat symptoms rather than curing the cancer. Palliative treatment includes hormonal therapy, chemotherapy, and radiation therapy. Palliative treatment is indicated for those with widespread prostate cancer that cannot be cured.

  • Hormonal therapy: Most prostate cancers require testosterone to grow and spread. As such, treatments that block testosterone production can be used to slow the progression of tumors. This type of treatment is often used to delay the spread of cancer that has come back after surgery or radiation, or to treat widespread prostate cancer. Hormonal therapy can be used with other treatments to help prolong life and decrease symptoms. 

  • Other drugs: Cancer that does not respond to hormonal therapy is referred to as castration-resistant prostate cancer (CRPC). In recent years, several other life-prolonging treatments for CRPC have been introduced.

Medications

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