Specializing in Minimally Invasive Treatment of Urologic Conditions
Attention Patients: Patient Registration Forms Available.
If you would like to complete and bring to your first appointment, click here to download.
 

PROSTATE CANCER

Causes of prostate cancer

While the causes of prostate cancer are still unknown, some risk factors for the disease, such as advancing age and a family history of prostate cancer, have been identified
prostate cancer is thought not to be related to benign prostatic hypertrophy (BPH).

Some of the risk factors for prostate cancer include:

• Age (The chances of developing prostate cancer increase with age*)
• Genetics (Black American men have a higher risk of getting prostate cancer than do Japanese or White American men)
• Heredity (a person whose father, or paternal grandfather or uncle has prostate cancer is at an increased risk for also developing prostate cancer)
• Hormonal influences (Testosterone, the male hormone, directly stimulates the growth of both normal prostate tissue and, perhaps, prostate cancer cells)
• Environmental, dietary and lifestyle factors; such as, smoking, diets high in saturated fats, toxins, chemicals, and industrial products.

*Studies have suggested that among men over 80, between 50 and 80% of them may have prostate cancer. Dr. Robert Pugach refers to prostate cancer as a disease of aging

Signs and Symptoms of Prostate Cancer

Many cases of prostate cancer do not produce any symptoms in its early stages and isn’t detected until it has spread beyond the prostate. That’s why annual screening with a brief examination and PSA blood test is so important.

When signs and symptoms begin, they may include some of the following:

• Blood in your urine
• Dull pain in your lower pelvic area
• General pain in your lower back, hips or upper thighs
• Urgency of urination
• Difficulty starting urination
• Pain during urination
• Loss of appetite and weight
• Painful ejaculation
• Persistent bone pain
• Weak urine flow and dribbling
• Intermittent urine flow
• A sensation that your bladder is not empty
• Frequent urination during the night

Can prostate cancer be prevented?

To date, no specific prostate cancer gene has been identified and verified and no specific measures are known to prevent the development of prostate cancer. We can hope only to prevent the development of the cancer by making early diagnoses and then attempting to cure the disease. Early detection of prostate cancer can be made by screening men by routine yearly digital rectal examinations beginning at age 45 and the addition of an annual PSA test. The purpose of the screening is to identify early, tiny, or microscopic cancers that are confined to the prostate gland. Early treatment of these cancer cells can stop the growth, prevent the spread, and, possibly, cure the cancer.

Dietary measures have been suggested to prevent the growth of prostate cancer. Maintaining a diet low in saturated fats and avoiding red meats are recommended and believed to slow the down the growth rate of prostate tumors in a way not yet known.
Soybean products work by decreasing the amount of testosterone circulating in the blood and may also inhibit the growth of prostate tumors. Many studies show that tomato products (lycopenes), the mineral selenium, and vitamin E might slow the growth of prostate tumors in ways that are not yet understood.
How is prostate cancer diagnosed?

If the digital rectal exam of the prostate and the PSA blood test* is abnormal, a prostate cancer is suspected and a biopsy of the prostate is necessary. The definitive diagnosis of prostate cancer comes from a biopsy of the prostate gland. A pathologist then examines the tissue under a microscope for signs of cancer in the cells of the tissue and reports the findings back to the urologist.

When prostate cancer is diagnosed on the biopsy tissue, the pathologist will then grade each of two pieces of the tissue from 1 to 5 on the Gleason scale. The scale is based on certain microscopic characteristics of the cancerous cells and reflects the aggressiveness of the tumor. The two scores are then added together. Sums of 2 to 4 are considered low, indicating a slowly growing tumor. Sums of 5 and 6 are intermediate, representing an intermediate degree of aggressiveness. Sums of 7 to 10 are considered high, signaling a rapidly growing tumor.

If you are a man over 45 years of age and/or have any of the aforementioned risk factors, Dr. Pugach recommends you schedule a digital rectal exam and a PSA blood test.

*Refinements in the PSA test, including the PSA ratio, age-specific PSA, PSA subtypes and PSA velocity or slope have improved the accuracy of the test.

How is prostate Cancer treated?

The choice of treatment for prostate cancer depends on the size, aggressiveness, and extent or spread of the tumor, as well as on the age, general health, preference of the patient and recommendation of your doctor.

As Dr. Pugach discusses in his audio library (prostate cancer) there are many options for treating prostate cancer including surgery, cryoablation, brachytherapy, High Intensity Focused Ultrasound, hormonal treatment, chemotherapy, combinations of some of these treatments, and watchful waiting.

Cryoablation
The concept behind cryoablation is to create an ice ball within the prostate to achieve sub-freezing temperature – typically in the - 40°C range – using Argon gas. When the “lethal ice” temperature is reached, cancer cells (which are more susceptible to cold temperatures than normal, healthy cells) are killed.

Brachytherapy
The concept behind brachytherapy is to place tiny radioactive seeds, about ¼” long and the diameter of a pin, throughout the prostate in order to deliver a constant dose of radiation for several months to kill prostate cancer cells.
 

Dr. Pugach also is one of a few urologists in the United States trained and skilled in treating prostate cancer patients with HIFU. To learn more about High Intensity Focused Ultrasound (HIFU), click here.


If you have a question about a service or procedure, please email us or call our office at
(888) 735-4336.