Prostate Cancer Screening

Prostate-specific antigen (PSA) is a laboratory test currently used for early detection of prostate cancer, the most common non-skin cancer in US men.  An elevated PSA level does not in and of itself mean that you have prostate cancer, however.  Other diseases of the prostate such as benign prostatic hyperplasia (BPH) and/or prostatitis (inflammation of the prostate) can also lead to elevated PSA levels.  That being said, an elevated PSA level should prompt further evaluation by a physician and/or urologist and should include a digital rectal exam (DRE).

Management Options for Prostate Cancer

There are some important questions you should ask your urologist with regard to recently diagnosed prostate cancer. Was your biopsy performed because of an elevated PSA level, an abnormal rectal exam or both? What was your PSA?  You should also know the pathology results from your biopsy (i.e., what is your “Gleason” score?).  Assuming your prostate cancer is localized or confined to the prostate, most treatment options are aimed at cure and most are very successful.  Learn More

Active Surveillance  “Watchful Waiting”

Multiple factors have to be evaluated when considering “watchful waiting” or “active surveillance” as a means of managing prostate cancer.  These include age, general health status, concurrent medical problems as well as prostate cancer characteristics. Generally, watchful waiting or active surveillance is reserved for men with low volume, low grade prostate cancer, a low PSA and no evidence of cancer outside of the prostate. Some of the criteria we look at as urologists when considering active surveillance as an option for a gentleman with prostate cancer include the following:

Robotic-Assisted Laparoscopic (da Vinci) Prostatectomy

Robotic-assisted laparoscopic (da VinciÒ) prostatectomy is a minimally invasive option for definitive treatment of localized prostate cancer.  The benefits of open radical prostatectomy are offered through smaller (1 to 2 cm) incisions with less pain, less trauma, less blood loss, shorter hospital stay, faster recovery and more rapid return to normal activities.  In addition, the magnified 3D high-definition optics of the robotic camera coupled with the increased control and dexterity of the robotic instruments allow for a very precise cancer operation, while also facilitating meticulous preservation of normal tissue, including the nerves that control potency. Furthermore, advances in robotic prostatectomy technique are striving towards better and more rapid return of potency and urinary continence.  Learn More

HIFU (High Intensity Focused Ultrasound)

HIFU, or High Intensity Focused Ultrasound, is a minimally invasive technique for treatment of localized prostate cancer.  HIFU focuses ultrasound energy and sound waves to a targeted area in the prostate resulting in rapid temperature increases and focal ablation of the treatment zone with great accuracy.  In most cases, HIFU is performed on an outpatient basis in one to four hours depending on the size of the prostate.  The biggest advantage of HIFU is a very low incontinence rate of less than 2% and a post-treatment erectile dysfunction rate of 20 to 30%.  The key to success with HIFU, however, is proper patient selection.  Learn More