Prostate Cancer Fact Sheet

Prostate cancer care at UK HealthCare

The Genitourinary team provides a multidisciplinary faculty practice which serves patients with prostate cancer.

The American Cancer Society estimates that one in six men will be diagnosed with prostate cancer in his lifetime. The prostate is a male sex organ located in front of the rectum and under the urinary bladder. It contains gland cells that produce some of the seminal fluid which protects sperm cells.

Some doctors believe that prostate cancer begins with prostatic intraepithelial neoplasia (PIN). PIN is a condition that men begin to develop in their 20s. Nearly 50 percent of men have PIN by the time they are age 50. PIN involves changes in the size and shape of prostate gland cells. These changes are classified as either low-grade, meaning they appear almost normal, or high-grade, meaning they look abnormal. A high-grade PIN diagnosis may indicate a 30 to 50 percent chance that cancer is present in the prostate.

There are usually no symptoms associated with the early onset of prostate cancer. Early detection tests such as the prostate-specific antigen (PSA) blood test and the digital rectal exam (DRE) are the most common ways to identify its presence. More advanced symptoms of prostate cancer include the following.
• weak or interrupted flow of urine
• blood in urine
• pain in hips, ribs or spine
• urinating often, especially at night

A core needle biopsy usually diagnoses prostate cancer. A sample of tissue is removed, then examined under a microscope. The doctor inserts several narrow needles into the prostate gland, using transrectal ultrasound (TRUS). TRUS uses wave echoes to create an image of the prostate to inspect for abnormal condition. Each needle removes a half inch long cylinder of tissue that is sent to the lab for testing. Other tools for evaluation may include a computed tomography scan (CT or CAT scan) or magnetic resonance imaging (MRI).

If cancer is present, it is assigned a number from one to five on the Gleason system. Grade one means the cancerous tissue looks much like normal prostate tissue. Grade five means the cancer cells are spread throughout the prostate.

Be sure to talk with your doctor before deciding on a treatment program. There are many things to consider before making a decision. Specially trained physicians at UK HealthCare are the first in Central and Eastern Kentucky to offer men state-of-the-art laparoscopic radical prostatectomy (LRP). This procedure is associated with lower blood loss and reduced surgical pain as compared to other procedures. LRP patients also return to normal activity in approximately two weeks, as opposed to four.

The American Cancer Society recommends that prostate cancer patients clarify the following questions.
• Has the cancer spread beyond my prostate? If so, is it still curable?
• What additional tests do you recommend? Why?
• What is the clinical stage and Gleason grade of my cancer?
• What other treatment(s) might be appropriate for me? Why?
• Among those treatments, what are the expected risks or side effects?
• What are the chances that I will have problems with incontinence or impotence?
• What are the chances that I will have other urinary or rectal problems?
• What are the chances of recurrence of my cancer with the treatment programs we have discussed?
• Should I follow a special diet?