Prostate Cancer

A blue cancer ribbon

Prostate cancer is the most common cancer among Canadian men, and the 3rd leading cause of death. Prostate cancer usually does not show symptoms until very late in the disease, and therefore most men in Canada are diagnosed due to prostate cancer screening. Risk factors for prostate cancer include:

  • Age
  • Family history
  • Ethnic background

African American men are more likely to develop prostate cancer. Diagnosis: Screening for prostate cancer includes a digital rectal exam to feel the prostate, and a PSA blood test. Your urologist will use the information from these two tests to determine the need for further investigation including a biopsy of the prostate. Prostate cancer is diagnosed by a prostate biopsy. This procedure is performed by the radiologist. An ultrasound probe is placed in the rectum, and local anesthetic is injected around the prostate. Samples are then taken from the prostate to be looked at under microscope. The main risks of a prostate biopsy include bleeding and infection. It is normal to have blood in the urine and stool for a few days after the procedure. You may also see some blood in the semen for several months. You will be given an antibiotic to take around the time of the procedure. There is a 2-3% risk of a severe infection, called Post-Biopsy Sepsis. Symptoms include feeling unwell, fever, nausea and/or vomiting after the procedure. This is an emergency and should take you to the nearest emergency department. Some patients may also undergo an MRI to visualize the prostate better; this may occur before or after a prostate biopsy. Treatment: Treatment of prostate cancer is dependent on the grade of said cancer. Your urologist will review this with you. You will then be assigned a stage and a risk category for your prostate cancer. These risk categories help to guide treatment. Risk categories include:

  • Very low risk
  • Low risk
  • Intermediate risk
  • High risk

Treatment options, depending on your stage and risk of cancer include: Active Surveillance

  • For very low and low risk disease
  • Careful monitoring of the prostate cancer, with a plan to proceed to definitive therapy if there is evidence of disease progression

Radiation therapy

  • Includes External Beam Radiation Therapy and Brachytherapy
  • The use of radiation to kill cancer cells

Surgery

  • Removal of the prostate

Cryotherapy

  • Freezing the prostate to kill the cancer cells

HIFU

  • High frequency focused ultrasound to kill the cancer cells

Androgen Deprivation Therapy

  • Decreasing the body’s testosterone, to starve the prostate cancer cells, thereby slowing the growth of prostate cancer

The decision about treatment is difficult, and it is important to review the pros and cons of the different treatment modalities with your doctor.

More information:

Up to date: Screening: Click Here

Treatment: Click Here

Mayo Clinic: Click Here