Prostate Cancer

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Prostate cancer is the most common cancer among men in the United States. One in seven men in the U.S. will be diagnosed with prostate cancer. It is the second leading cause of cancer death in men in the U.S. and appears in over 80 percent of men over the age of 80.

Despite the high diagnosis rate, the survival rate continues to increase thanks to screenings, awareness, and expert treatment by teams like the prostate experts at Henry Ford Health System. If discovered and treated early, prostate cancer often poses little risk.

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Prostate cancer treatment at Henry Ford Health System

Our prostate cancer team specializes in the most advanced treatments for prostate cancer. The robot-assisted surgery experts at Henry Ford have performed the most procedures in Michigan and we are one of the most experienced prostate cancer teams in the country.

Our team approach brings together the expertise of urologic oncologists, radiation oncologists, medical oncologists, robotic surgeons, physical therapists and pathologists, all focused on one goal: treating your cancer. Our treatments include:

  • Intensity-modulated radiotherapy
  • Cryotherapy
  • Hormone therapy
  • Chemotherapy
  • Genetic research

Prostate cancer: what you need to know

Prostate cancer is the presence of cancerous cells in the prostate. It tends to grow slowly over many years, but in later stages, the growth usually speeds up. As the cancer grows, it can spread outside the prostate -- usually into nearby lymph nodes and bones.

We don’t know the specific cause of prostate cancer. However, researchers believe there are several factors that cause and encourage prostate cancer to grow, including diet, genetics, other environmental factors. Prostate cancer generally occurs in older men, but younger men can have the disease, too. African-American men and men with a family history of prostate cancer are at a higher risk.

Regular prostate cancer screening tests are important for all men, and especially those at high risk. Your best chance of successfully treating the cancer rests on finding it early and beginning treatment as soon as possible.

  • Symptoms and risk

    What are the symptoms of prostate cancer?

    Many men who have prostate cancer have no physical symptoms because of the cancer’s slow growth and the prostate’s location in the body. But if the prostate grows large enough, you may have all or some of the following warning signs:

    • Blockage of urinary flow
    • Dribbling at the end of urination
    • Frequent urination
    • Nighttime urination
    • Straining to empty the bladder
    • Urgent need to urinate
    • Urinary leakage

    These may not necessarily be prostate cancer symptoms. They’re also frequent symptoms of benign prostatic hyperplasia. However, if you have any of these potential warning signs of prostate cancer, it’s important to talk to your doctor about them.

    What are the risk factors for prostate cancer?

    We don’t know the specific cause of prostate cancer. However, researchers believe there are several factors that cause and encourage prostate cancer to grow, including:

    • Diet
    • Genetics, or family members passing down genes that cause cancer
    • Other environmental factors

    Prostate cancer generally occurs in older men, but younger men can have the disease, too. African-American men and men with a family history of prostate cancer are at a higher risk.

    Regular prostate cancer screening tests are important for all men, and especially those at high risk. Your best chance of successfully treating the cancer depends on finding it early and beginning treatment as soon as possible.

  • Diagnosis and screening

    We use four tests to screen for and diagnose prostate cancer:

    DREs and PSA screenings are the first line of defense against prostate cancer. If these tests return a result that could indicate prostate cancer, your doctor may order a prostate ultrasound or a prostate biopsy.

    Digital rectal exam (DRE)

    For a DRE, your doctor will insert a gloved, lubricated finger into the rectum to feel the back wall of the prostate. A normal prostate should feel soft, smooth, and round. Your doctor will feel to make sure your prostate has no:

    • Firm areas
    • Hard nodules (swollen spots)
    • Lumps

    These abnormalities don’t necessarily indicate prostate cancer. But if they’re present, your doctor may order more tests to be sure.

    PSA screening

    Prostate-specific antigen is a protein that your prostate produces as part of its normal function. Small amounts of PSA leaks out into the bloodstream, and we can detect it with a simple blood test.

    High levels of PSA in the bloodstream could signify a few different prostate problems, such as:

    • Prostate cancer
    • Prostate enlargement (noncancerous)
    • Prostate inflammation (noncancerous)

    Elevated levels of PSA don’t always mean a patient has prostate cancer. And patients can have low PSA levels and still have prostate cancer. That’s why it’s important for you to have both a PSA screening and a DRE for the best chance of detecting prostate cancer as early as possible.

    Prostate ultrasound

    In a prostate ultrasound, your doctor places a lubricated ultrasound probe into the rectum. This probe emits high-frequency sound waves that we use to create a picture of the prostate.

    This test for prostate cancer lets us see how big your prostate is and if there are any visible problems with it. Theprostate ultrasound also helps us more accurately perform prostate biopsies, which we usually perform for questionable DREs or PSA screenings.

    Prostate biopsy

    This prostate cancer test involves removing small pieces of tissue from the prostate. We look at these pieces under a microscope to see if they contain cancerous cells. The biopsy only takes about 15 minutes.

    You’ll probably only feel mild discomfort during the test. There may be some bleeding afterward. Rarely, some patients have developed infections or experienced significant bleeding, swelling of the prostate, or difficulty urinating after a prostate biopsy.

    If your biopsy is negative, that means we didn’t see cancer on the tissue we analyzed. But there still may be cancerous tissue in other parts of the prostate. Your doctor may order a repeat biopsy if your case is suspicious but your biopsy is negative.


  • Prostate cancer treatment

    If we detect prostate cancer, our pathologists (doctors who diagnose diseases) will determine the grade and stage of your disease. This allows us to determine what your options are so we can work with you on a personalized treatment plan. Your diagnosis will include both the grade and stage of your prostate cancer.

    Prostate cancer grading

    Cancer grading describes how abnormal or aggressive the cancer cells appear. A cancer’s grade helps our doctors predict long-term results, likely response to treatment, and chance of survival.

    We use the Gleason scale to grade prostate cancer. This system assigns cancer cells a score of 1 to 10. The Gleason scale has three main levels:

    • Score of 4 or less: This is a low-grade, slow-growing form of prostate cancer that looks most like normal prostate cells. It is the least dangerous form of prostate cancer.
    • Score between 4 and 7: This is a middle-grade prostate cancer and is the most common form. It can act more like a low-grade or high-grade cancer depending on PSA levels and the amount of cancer present.
    • Score of 8 or above: This is a high-grade cancer that looks least like normal prostate cells. It is the most dangerous form and is very aggressive in its growth. This type of prostate cancer is hard to treat and more likely to reappear after treatment.

    Prostate cancer staging

    Cancer staging describes how much cancer is present and where it is located. More cancer in the body means a higher likelihood of the cancer spreading. It also means treatment is less likely to be effective.

    We use the TNM system to stage cancer, which describes three features of prostate cancer:

    • T stands for tumor and uses different numbers and letters to explain the size of the prostate cancer tumor.
    • N stands for nodes and describes if the prostate cancer has spread to the lymph nodes.
    • M stands for metastatic and describes if the prostate cancer has spread elsewhere in the body.

    Prostate cancer T status

    There are four main stages in this system: T1, T2, T3 and T4. Each one also has various sub-stages.

    Stage T1

    Characteristics of stage T1 prostate cancer include:

    • The tumor is only in the prostate and is undetectable by a DRE or a prostate ultrasound.
    • Stage T1a: we found Cancer in 5 percent or less of a prostate biopsy tissue sample.
    • Stage T1b: we found Cancer in more than 5 percent of a prostate biopsy tissue sample.
    Stage T2

    Characteristics of stage T2 prostate cancer include:

    • The tumor is only in the prostate and is detectable by a DRE or a prostate ultrasound.
    • Stage T2a: The tumor involves less than half of one lobe of the prostate and usually can be detected during a DRE.
    • Stage T2b: The tumor involves more than half of one lobe of the prostate and usually can be detected during a DRE.
    Stage T3

    Characteristics of stage T3 prostate cancer include:

    • The tumor has spread to surrounding tissues or to the seminal vesicles (the glands that make the fluid that mixes with sperm to form semen).
    • Stage T3a: The tumor has spread outside the prostate on only one side.
    • Stage T3b: The tumor has spread outside the prostate on both sides.
    • Stage T3c: The tumor has spread to one or both of the seminal tubes.
    Stage T4

    Characteristics of stage T4 prostate cancer include:

    • The tumor is still in the pelvic region but may have spread to other organs near the prostate, such as the bladder.
    • Stage T4a: The tumor has spread outside the prostate to any or all of the bladder neck, external sphincter and/or rectum.
    • Stage T4b: The tumor has spread beyond the prostate and may affect the levator muscles (which raise or lower the prostate), and it may be attached to the pelvic wall.

    Prostate cancer N status

    There are four stages in this system:

    • Stage N0 : Prostate cancer cells have spread but have not yet spread to the pelvic lymph nodes.
    • Stage N1: Prostate cancer tumors have spread to a single lymph node in the pelvic area and are approximately 2 centimeters (about 0.75 inch) or less.
    • Stage N2 -- prostate cancer cells either have spread to a single lymph node and are more than 2 centimeters but less than 5 centimeters (about 2 inches) or have spread to more than one lymph node and are no larger than 5 centimeters.

    Prostate cancer M status

    There are two stages in this system:

    • Stage M0: Prostate cancer cells have spread to the pelvic area.
    • Stage M1: Prostate cancer cells have spread outside the pelvic area to other areas of the body.
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Prostate Cancer Support Group

This monthly group offers prostate cancer patients and survivors an opportunity to express their feelings and concerns, and hear how others are...

Prostate Cancer Support Group

This monthly group offers prostate cancer patients and survivors an opportunity to express their feelings and concerns, and hear how others are...

Prostate Cancer Support Group

This monthly group offers prostate cancer patients and survivors an opportunity to express their feelings and concerns, and hear how others are...

Prostate Cancer Support Group

This monthly group offers prostate cancer patients and survivors an opportunity to express their feelings and concerns, and hear how others are...

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