Prostate Cancer Care

Prostate Cancer Specialist in Boston

The prostate is a gland that is part of the urinary system. It also produces some fluid that helps transport sperm. Prostate cancer is a tumor (one or more) that grows inside a man’s prostate. About one in eight men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society. It is the second most common cancer diagnosis among men in the United States after skin cancer.

As long as the cancer remains confined to the prostate itself, it typically doesn’t cause harm. When it escapes the prostate and metastasizes (spreads) to other organs, there is treatment but no cure. 

Therefore, experts have the best chance for successfully treating prostate cancer if we detect it early while the cancer remains within the gland.

The Prostate Cancer Program specialists at Beth Israel Deaconess Medical Center (BIDMC) have decades of experience in successfully detecting and treating prostate cancer. Our urologic surgeons are experts in minimally invasive approaches to treat prostate cancer.

Prostate Cancer Symptoms

Most men with prostate cancer don’t have any symptoms, particularly in the early stage. Later stage prostate cancer can include these symptoms:

Some of the above symptoms may not indicate prostate cancer. They may result from a non-cancerous condition called benign prostate hyperplasia (BPH).

Prostate Screening & Diagnostic Services

Radiologists use an array of imaging options to diagnose and stage prostate cancer. BIDMC radiologists are among the finest in the field in performing exams and evaluating results. Depending on your symptoms and needs, your doctor may order one or more diagnostic tests for prostate cancer. 

Screening for Prostate Cancer

We recommend that men between 40 and 55 years of age with risk factors for prostate cancer — and all men between 55 and 69 years — should speak to their primary care doctor about the risks and benefits of prostate cancer screening.

There are two main tests:

• Digital rectal exam (DRE). During the DRE, your doctor feels your prostate, checking for abnormalities in size, shape or texture. If you’re over age 50, your primary care doctor should perform a DRE each year during your annual wellness exam.
• Prostate-specific antigen (PSA) test. This blood test measures the level of an enzyme that the prostate naturally produces. If the number is high, it may signal the presence of cancer, but not always. Some medical groups advise against regular PSA testing because it can lead to unnecessary biopsies and, in some cases, unneeded treatments. Speak with your primary care doctor about whether a screening PSA test makes sense for you.

PSA Levels

Typically, a PSA level of 4 ng/dl of blood is a red flag. Usually, the doctor will repeat the test at a later date to determine whether the high reading was typical. PSA levels can fluctuate wildly. Certain things can cause an elevated reading, such as prostatitis (inflammation), sex in the days before the test or even a bicycle ride.

If the level is high again on the second test, your doctor may want you to have regular PSA tests to see if the number is increasing over time. Alternately, your doctor may want you to have a prostate biopsy to check for cancer cells. An abnormal DRE may cause your doctor to schedule a biopsy or an ultrasound right away.

Biopsy

A biopsy is an outpatient procedure in which the doctor uses transrectal ultrasound or MRI guidance to stick your prostate with a needle, usually between 12 and 20 times. The doctor takes a sample of tissue from each area they stab.

The doctor sends the samples to our laboratory. There, a pathologist analyzes the tissue to determine if the cells are cancerous and, if so, how aggressive the cancer cells look.

Here’s the key information obtained from a biopsy:

Prostate Cancer Treatments

Our Prostate Center offers the latest treatment options for men with prostate cancer. You’ll have staging and treatment planning so your care team can plan your care. If your prostate cancer is low-grade, your team may suggest active surveillance with no immediate treatment.

Some men with prostate cancer need surgery as part of their treatment. We are Boston’s foremost center of robotic surgery for prostate cancer. Our fellowship-trained surgeons have performed thousands of minimally invasive procedures. The BIDMC Cancer Center is a national leader in this approach.

Your care team also may suggest radiation or brachytherapy as part of your prostate cancer treatment.