Prostate Cancer, the most common cancer in men over the age of 50, kills approximately 36000 men each year. Symptoms of cancer are usually similar to the symptoms of BPH or are silent in nature. Prostate cancer may be diagnosed by physical examination coined a digital rectal exam (DRE). Cancer may also be diagnosed by an elevated PSA (Prostate Specific Antigen). PSA is a protein formed almost exclusively by the prostate and detected by a blood test. Increased PSA levels may be released in the blood by cancer but also is seen with BPH & urinary tract infections, including prostatitis. The normal level of PSA in the blood is age dependent. In men less than 50 years of age, the normal level of PSA is less than 2.5, however, in men over the age of 59, the normal PSA level is less than 4.0. Because other factors can cause an increase in PSA, an abnormal level does NOT automatically mean cancer is present. However, once an abnormal level is found or an abnormal rectal exam is present than further diagnostic testing is necessary. This testing is in the form of an ultrasound that is done through the rectum, which is usually accompanied by prostate biopsy, or sampling of the tissue which is subsequently examined with a microscope by a physician (Pathologist).
Cancer may be diagnosed at different stages or extent of involvement. Early diagnosis is classified as stage A or B. More advanced disease is classified as Stage C or D. This staging is performed by combing the results of the blood test(PSA), the rectal exam(DRE) and by undergoing an xray test(Bone Scan) to assess whether or not cancer has escaped into the bone which is where prostate cancer is usually found in advanced cases.
Once the diagnosis is made, the pathologist will grade the severity of the cancer. The system of grading is called the Gleason Score, which is how the cancer appears under the microscope. The range of scopes is between 2 and 10. A low Gleason Score, which is 4 or less, signifies a slower growing tumor(good prognosis). Whereas, a high Gleason Score, i.e. 8-10 signifies a fast growing tumor(poor prognosis).
The treatment of prostate cancers depends on the stage of cancer at the time of diagnosis. Cancer of the prostate is highly curable if it is found early prior to escape outside of the prostate. Early stage(A and B) cancer may be treated with surgery, (Radical Prostatectomy), or radiation (external or internal i.e. permanent seed placement)
Surgery implies total removal of the prostate and reconstruction of the urinary outflow track. Advanced stage cancer may include a combination of treatment strategies, comprising the use of surgery, radiation, or hormonal therapy. Hormonal therapy treatment focused at elimination of the male hormone Testosterone may be delivered via injections, (Eulexin, Casodex, or Nilandron) or Bilateral Orchiectomy i.e. removal of the testicles. Factors influencing the various treatment options include the patient’s age, health status, stage of disease and patient preference.
Please contact our physicians if your PSA levels are elevated, if you have an abnormal digital rectal exam, or if you are diagnosed with prostate cancer
Kidney cancer, the third leading cause of genitourinary cancer is diagnosed in 24,000 patients yearly. The symptoms, most commonly associated with cancer is blood in the urine which usually occurs painlessly. However, cancer may also be associated with back pain and/or hypertension or weight loss. Cancer diagnosed early may be curable by removing part or the whole kidney. Please make an appointment with our physicians who specializes in minimally invasive surgical options for kidney cancer.
Bladder cancer is the 4th most common cancer diagnosed in men behind prostate, colon, and lung cancer. There are over half a million of women and men in the United states living with bladder cancer. Most commonly they are diagnosed when the color of urine becomes red or there is blood in the urine. It is very important if you have blood in your urine to see us as soon as possible to make sure you do not have bladder cancer. Cystoscopy, or looking into your bladder with a tiny camera, is often done to evaluate it. Treatment options for bladder cancer include removing the cancer through surgery called transurethral resection of bladder tumor, placing immunotherapy agents such as BCG into the bladder, and if the cancer spreads deep into the wall of the bladder you may consider surgery to remove the entire bladder.
Testicular Cancer is the most common cancer in men between age 15 to 35, however it can occur in babies or in elderly men. Fortunately the cancer if very treatable, even in advanced stages where the cancer has spread beyond the testicle. Regular self examinations can help identify it at an early stage, which increases the success of its treatment. The treatment for testicular cancer include surgery to remove the testicle, radiation, chemotherapy, or surgery to remove the lymph nodes in your abdomen. It may require a combination of these treatments depending on the stage of the cancer. Please schedule an appointment with one of our physicians if you fell a lump in your testicle or if you have an abnormal ultrasound of your testicles.