Prostate Cancer

When a man is diagnosed with prostate cancer, it means cancerous cells are present in the prostate, the small, walnut-sized gland that produces seminal fluid.

According to the American Cancer Society, prostate cancer is one of the leading causes of cancer deaths among men, especially those who are 55 and older. Most men who have been screened and diagnosed with prostate cancer have a very good prognosis, and may not even need immediate treatment.

The urologists and oncologists at University of Missouri Health Care's Ellis Fischel Cancer Center are highly experienced in treating prostate cancer. Our team confers with other specialists to provide second opinions when a diagnosis of prostate cancer has been given. We work closely with other specialty groups – such as medical oncology and radiation oncology – to develop a comprehensive, personalized treatment plan for each of our patients. As an academic health system, our physicians have access to the latest research and technology, and consistently provide the best and safest treatments for our patients.

Prostate cancer screening guidelines

The American Urological Association (AUA) recommends men 40-54 get screened for prostate cancer if they have a strong family history of the disease or are African American.

Starting at age 55, all men should discuss screenings with their doctor, taking other medical problems into consideration. For those not in high-risk categories, screenings may be done every other year to lower the risk of false positives and over diagnosis. 

Beginning at age 70, routine screenings are not recommended in men with a life expectancy of less than 10-15 years.

Symptoms of prostate cancer

Most men who have prostate cancer are asymptomatic (have no symptoms). In advanced cases, a man with prostate cancer may have changes in urination patterns such as needing to urinate more frequently or having the urge to urinate or pain from the cancer spreading to the bones (metastasized).

Risk factors

The main risk factors for prostate cancer include your age, family history of prostate cancer, race and lifestyle habits. As men age, their risk of prostate cancer increases. After age 65, men have an increased risk. If you’ve had a first-degree relative with prostate cancer — a father or brother — you have a higher risk of developing prostate cancer. African-American men are also more likely to be diagnosed with prostate cancer than other races. Smoking might also increase your risk of prostate cancer. Physicians recommend eating a healthy diet, exercising and quitting smoking to decrease your risk of prostate cancer.

How prostate cancer is diagnosed

If your doctor suspects you may have prostate cancer, he or she will likely recommend the following to aid in diagnosis:

Prostate-specific antigen (PSA) test. Your doctor may order this blood test, which measures levels of PSA, a protein produced by the cells of the prostate. (See below for more information on this test.)

The MU Health Care team may use a PSA blood test for screening and assessment of the prostate. The PSA test may pick up cancer of the prostate before a man ever experiences symptoms.

There are advantages of detection by PSA screening.

• Cancer is more likely to be localized and responsive to treatment.
• Earlier diagnosis.
• More likely to have more treatment options available.

Digital Rectal Exam (DRE). Your doctor performs a physical examination of the prostate to assess for signs of cancer. Since prostate cancer is not the only condition that can elevate PSA results, we recommend men get a DRE in conjunction with a PSA to feel for growths in or enlargement of the prostate gland. A tumor in the prostate can often be felt as a hard lump. 

It is important to note many prostate cancer treatments may not help any individual patient and are associated with significant potential for complications. You should talk with your urologist at MU Health Care while weighing the pros and cons of undergoing DRE and a PSA test to check for prostate cancer.

Magnetic resonance imaging (MRI) facilitated targeted biopsy. Your doctor uses the UroNav Fusion Biopsy System to obtain a biopsy (small sample) of the prostate for analysis. MU Health Care is the only facility in mid-Missouri to offer this leading-edge technology to help diagnose prostate cancer. The UroNav System is especially useful for those patients with previously negative biopsies and abnormal PSA level.

Treatments for prostate cancer

MU Health Care offers a wide spectrum of treatment for prostate cancer. The treatment options available to each person depends on the type and progression of prostate cancer, as well as overall health.

The treatments we offer include:

• Active surveillance. In some cases – especially when the cancer is diagnosed early – patients can delay or defer definitive treatment to avoid the side effects of therapy.
• Brachytherapy. Also called “seed implant,” this treatment involves inserting radioactive implants directly into the tissue affected by the cancer.
• External beam radiation therapy. Using intensity modulated radiation therapy (IMRT), this type of radiation is highly targeted at the prostate and spares more of the surrounding healthy tissue.
• Open or robot-assisted radical prostatectomy. When other treatments are unsuccessful, the prostate may need to be removed, either by traditional (open) surgery or using robotic equipment to assist in the procedure.

Because Ellis Fischel is part of the academic health system at MU Health Care, we also offer participation in clinical trials, in combination with medical oncologists and radiation oncologists, for eligible patients. Clinical trials give patients access to the latest research studies being done for specific cancer types including prostate cancer.