Prostate Cancer

Prostate cancer occurs when cancer cells develop in or around the prostate. It is the most diagnosed cancer in men in the United States each year, and according to the National Cancer Institute (NCI), approximately 11.2 percent of all men in the U.S. will be diagnosed with the disease at some point during their lifetime. The NCI projects more than 174,000 new cases of prostate cancer will be diagnosed in 2018, and an estimated 31,000 men will die from the disease.

Over the past several decades, early detection led to a decrease in death rates among men with prostate cancer, however after 20 years of significant decline (1993 to 2013), the overall prostate cancer mortality trend stabilized from 2013 to 2015. Distant-stage disease also increased from 2010 to 2014. These trends coincide with a decline in screening for the disease among men 50 years and older that occurred after the U.S. Preventive Services Task Force released their 2012 guidelines discouraging screening. According to a 2017 study, screening rates for prostate cancer have now stabilized, and about one in three men 50 years or older still receives routine screening.

Prostate Risk Factors

  • Age – the majority of prostate cancer is found in men over the age of 65.
  • Race – African American men have greater incidence and death rates for prostate cancer.
  • Family history – the chance of developing prostate cancer rises when immediate family members have the disease.
  • Nationality – prostate cancer occurs more in North America and northwestern Europe.
  • Diet – a diet that includes a lot of red meat and/or high-fat dairy products can yield a greater risk of prostate cancer.
  • Exercise – men over the age of 65 who do not regularly exercise may have increased risks of prostate cancer.

Prostate Signs and Symptoms

Usually, the early stages of prostate cancer are often asymptomatic, or without obvious symptoms. However, any of the symptoms listed below should be viewed as a potential warning sign requiring investigation.

  • Trouble having or keeping an erection
  • Blood in urine
  • Pain in the spine, hips, ribs or other bones
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control

Prostate Screening

Screening tests are performed to determine the presence of abnormal or cancerous cells in the prostate. According to the 2018 screening guidelines from the U.S. Preventive Services Task Force, men aged 55 to 69 should have a discussion with their doctor about the potential benefits and harms of screening. There are many uncertainties associated with screening that should be carefully considered. Many men who are screened will experience potential negative events, such as false-positive results, overdiagnosis and overtreatment, as well as complications from treatment, such as incontinence and erectile dysfunction. An in-depth discussion with a doctor about these risks enables informed, individualized decision-making incorporating each person’s values and preferences in the decision. Screening is not recommended for men 70 years and older, as the potential benefits of screening at that age do not outweigh the expected harms.

Each screening method listed below may be used alone, or in combination with another.

  • Prostate-Specific Antigen (PSA) – tests your blood for traces of PSA.
  • Digital Rectal Exam (DRE) – allows a doctor to physically examine the prostate for any lumps or hard places.

Prostate Staging

If cancer is found, an oncologist will need to determine the progression of cancer. This classification, called staging, allows the healthcare provider to properly identify a treatment plan and to determine the prognosis. All cancers are staged on a Roman numeral scale, I-IV (1-4), where the higher stage represents a more advanced cancer.

Prostate Treatment

Treatment for prostate cancer can be different for each case, but may include surgery, radiation therapy or chemotherapy. One form of radiation therapy that is exclusive to Comprehensive Cancer Centers in Las Vegas is CyberKnife® Radiosurgery. Established in 2010, the robotic technology of CyberKnife® offers patients with tumors a painless, non-invasive treatment alternative that uses computer-operated robotics and image guidance technology to treat hard-to-reach tumors like those found in prostate cancer.

Within the past six years, Comprehensive has developed one of the largest prostate cancer research programs in Nevada. Dr. Nicholas Vogelzang completed more than a decade’s worth of work, having participated in the early testing phases of a novel treatment all the way to the FDA approval of Provenge ®. Provenge® is designed to create an immune response against prostatic acid phosphatase, which is found in most prostate cancers, by mixing a person’s white blood cells with a bioengineered molecule. Most recently, The Food and Drug Administration approved Radium 223, commercially known as Xofigo, which is designed as liquid radiation to attack prostate cancer cells that have grown in patients’ bones. This enables oncologists to reach those spreading cells when surgery or other options have been unsuccessful. Las Vegas was one of a few cities in the United States treating prostate cancer patients during the research study. More recently, the practice is participating in the study of apalutamide, which will help delay the spread of prostate cancer by two years as well as phase I research of the p53 gene agent which has been shown to display anticancer activity. For more information about our research efforts, click here.