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Prostate Cancer

Questions to Ask About Prostate Cancer

An estimated 1 in 7 American men will be diagnosed with prostate cancer during his lifetime. If you receive a diagnosis of prostate cancer, remember there is always time to get a second opinion. In fact, a second opinion can be lifesaving. It’s critically important to confirm that your diagnosis is correct before treatment begins. When weighing where to receive treatment, consider these questions to ask about prostate cancer.

Prostate Cancer Questions and Answers

  • Absolutely. After being diagnosed with prostate cancer, you are likely to have questions to ask your doctor about prostate cancer. While your first inclination may be to “get it out” as soon as possible, there is always time to seek additional opinions and weigh your treatment options with the help of your loved ones. If you’re told there isn’t time to get a second opinion and you feel rushed into surgery, that’s a good reason to look elsewhere. It is important to get a second opinion from an institution that offers all treatment options, like The University of Kansas Cancer Center.

  • When researching prostate cancer questions and answers, you’ll find the very latest treatment options are developed, refined and offered to patients first at NCI-designated cancer centers like The University of Kansas Cancer Center. Patients treated at NCI-designated cancer centers have a 25% better chance of survival. There are only 71 NCI-designated cancer centers nationwide and The University of Kansas Cancer Center is the only one in this region.

  • It’s important to see specialists who treat your cancer day-in and day-out. A urologic oncologist is significantly different from a general surgeon or a general urologist. At The University of Kansas Cancer Center, our urologic oncologists, medical oncologists, radiation oncologists and pathologists have specialized training in prostate cancer and know what works for each subset of disease type. Your care team may also include a radiologist, dietitian, genetic counselor and others. Our specialists are national and international leaders in prostate cancer treatment. They present lectures at meetings across the country and the globe and have written textbooks on prostate cancer treatment.

  • There are many options for treating prostate cancer. The right treatment plan will be determined by the aggressiveness of the cancer and the patient’s goals and expectations. For early-stage prostate cancer, active surveillance (which involves monitoring the cancer without immediate treatment) may be an option. For patients with more advanced disease, there are different types of surgery and radiation options – including robotic surgery, brachytherapy (radiation seeds) and stereotactic body radiation. If the cancer has spread beyond the prostate, hormone therapy and chemotherapy may be considered. The University of Kansas Cancer Center is the only cancer center in the region to offer all the treatment options for prostate cancer – including advanced surgical and radiation techniques and a wide array of clinical trials.

  • Not all prostate cancers require immediate treatment. If treatment is not advised, we recommend active surveillance and offer a comprehensive active surveillance clinic to guide you through this process. During active surveillance for prostate cancer, our urologic oncologists carefully monitor you for signs of disease progression. Our specialists may suggest active surveillance if your cancer is slow growing and diagnosed early.

  • Radiation therapy. We are the only cancer center in the region offering shortened radiation treatments, called stereotactic body radiation therapy, which is a very precise type of radiation treatment. This allows patients to complete treatment in about one week compared to 9 weeks at other centers. In addition, we provide:

    • Brachytherapy, often referred to as radiation seeds, which is a one-time outpatient procedure that places radioactive seeds directly into the prostate.
    • Proton therapy, the most technologically advanced method to deliver radiation treatment to cancerous tumors available, which The University of Kansas Health System will offer in late 2021.
     
  • Yes, we offer many clinical trials and will assess your eligibility if you are interested. Cancer clinical trials provide access to potential advancements in care and lead to innovations in cancer prevention and treatment. Participating in a clinical trial may offer you access to promising therapies and will contribute to research that can improve care for future cancer patients. Be sure to ask your doctor about prostate cancer clinical trials. 

  • We offer a survivorship program after treatment to monitor for recurrence, manage treatment side effects and help promote general health.

  • Advances in prostate cancer treatment continue. For example, stereotactic body radiation therapy is an advanced form of radiation treatment which can treat early prostate cancer in as little as a week (compared to older treatments which take 9 weeks). The University of Kansas Cancer Center has been offering patients this advanced treatment for several years and has the most experience in the region. Brachytherapy (radiation seeds) may be the most effective form of radiation for more aggressive prostate cancer, and we are the only team offering brachytherapy in the area. There are also newer hormone therapy agents which improve outcomes for cancers that have spread beyond the prostate.

     

    Additionally, most surgical procedures are performed robotically. Our urologic oncology surgeons specialize in advanced prostate surgical procedures including extended lymph node dissections, salvage operations after cancer recurrence and improved quality of life approaches. We are one of the only centers in the United States offering the Retzius-sparing prostatectomy, which can dramatically improve urinary control after surgery. 

    The University of Kansas Cancer Center also offers many clinical trials for early-stage, advanced and metastatic prostate cancer. Our physicians lead some of these national and international clinical trials that continue to advance prostate cancer treatments. We offer genomic testing specific to your prostate cancer to determine which treatment would be most beneficial to you. We are at the forefront of clinical studies with immunotherapy and targeted therapy used for the treatment of prostate cancer.

  • Some men who have genetic changes that increase their risk of prostate cancer and other related cancers.  Understanding these changes can help in treating you – as the patient – and your family as well.  When we evaluate men who have, or are at risk, of prostate cancer we review your personal and family cancer histories in order to identify if genetic testing would be helpful in your care.

  • Anyone at high risk for prostate cancer may benefit from genetic counseling and testing. Those at high risk for prostate cancer include:

    • African Americans
    • Men over age 50
    • Men with a prior history of elevated PSA
    • Men who have an abnormal prostate exam
    • Men who have family history of prostate cancer
    • Men who have family history of other cancers (breast, ovarian, pancreatic and Lynch syndrome)

Prostate Cancer Bench To Bedside

WILLIAM PARKER, MD, TALKS ABOUT PROSTATE CANCER AND WHY ALL MEN SHOULD DISCUSS WITH THEIR DOCTORS WHETHER SCREENING IS RIGHT FOR THEM. HE ALSO EXPLAINS WHAT SCREENING PROCEDURE OR COMBINATION OF PROCEDURES THEY SHOULD CHOOSE.

Speaker 1: Welcome to Bench-to-Bedside, a weekly series of live conversations about recent advances in cancer, from the research bench to treatment at the patient's bedside. And now, your host and the Director of The University of Kansas Cancer Center, Dr Roy Jensen.

Dr. Roy Jensen: Hi, I'm Dr Roy Jensen and with me is Dr William Parker, urologic surgical oncologist at The University of Kansas Cancer Center. Today we're gonna discuss prostate cancer and why all men should discuss with their doctors whether screening is right for them, and if so, what screening procedure or combination of procedures they should choose. This is an important question, because it is estimated that one in seven men will be diagnosed with prostate cancer in their lifetimes, and it's the number three cause of cancer death in men. So, Dr Parker, could you please tell us, who is at high risk for prostate cancer?

Dr. William Parker: Certainly. So the highest risk men are those who are African American, those with a family history of either urethral or any prostate cancer, be that in a father, or a brother, or an uncle. And then those men who have a family history of related cancers like breast cancer, ovarian cancers, and in particular the BRCA or BROCA positive cancers.

Dr. Roy Jensen: Okay. So, if you're just joining us, we're talking about prostate cancer and the importance of PSA screening in detecting the disease. And as always Alesha Miller is here in the studio to take your questions. Remember to share this link with people you think might benefit from our discussion, and use the hashtag BenchtoBedside. So, over the last decade or so prostate cancer screening has become pretty controversial, could you tell us what is driving this, and give us your viewpoint in terms of this issue.

Dr. William Parker: Absolutely. So the way we screen for prostate cancer is with a blood test called PSA or prostate-specific antigen, and widespread use of this test led to historically fairly broad diagnosis, and particularly over-diagnosis of prostate cancer. Not all prostate cancers are created equal, and there are lot of men who have low grade cancers who often don't require treatment. However, because we've diagnosed a lot of prostate cancers using widespread PSA screening, we also over-treated a lot of men and that really led to a lot of this controversy. Now, I think the important thing to keep in mind is that PSA screening is very important, and while it's a test that's not very accurate at diagnosing cancer, it's a great test at identifying men at risk for prostate cancer. In my personal opinion PSA screening and prostate cancer screening should obviously still be done, it just has to be done in a thoughtful way. There are newer more accurate tests that we have now to help refine that search, and refine that screening, so that that over-diagnosis and over-treatment is much less common.

Dr. Roy Jensen:How does prostate cancer typically present? Dr William P.: Most of the time it's asymptomatic, so the vast majority of men are diagnosed based on an elevated PSA or digital rectal exam. When symptoms are present, which again is very rare, it can be urinary in nature, so difficulty urinating, pain with urination, blood in the urine. But again, that's very rare.

Dr. Roy Jensen: So, if you're just joining us, we're talking with Will Parker, urologic surgical oncologist about the importance of prostate cancer and whether or not you should be screened for this disease. If an individual is diagnosed with prostate cancer, what are the treatment options that are available?

Dr. William Parker:There are a multitude of treatment options that we have at our disposal now, certainly as I alluded to you earlier, lower grade less aggressive cancers we'll tend to watch, so active surveillance, which is the strategy fantastic keeping a close eye on the prostate cancer and making sure it's not progressing, is the mainstay of therapy. With higher grade and more aggressive cancers, aggressive intervention such as surgery or radiation are really the mainstays of therapy that have long-term data to support their use.

Dr. Roy Jensen: Okay. How do we tell which prostate cancers should be aggressively treated, and which ones we can kind of engage in watchful waiting on?

Dr. William Parker: Prostate cancer is graded with a grading system called the Gleason score, it's a score that's made up of two different components. One is the most common type of prostate cancer identified in the prostate, and the second is the second most highest grade that they identify. That score ranges from a lower score of a 6, to a high score of a 10. The lower on the spectrum, the less likely it's going to be aggressive, and the more we'll recommend surveillance. Whereas when you start getting into scores of 7, 8, 9, or 10, those are the men who really benefit from intervention.

Dr. Roy Jensen: If being over-treated for prostate cancer, what are the significant consequences of that?

Dr. William Parker: Unfortunately the treatment for prostate cancer does carry with it some quality of life impacts, namely with urinary function and sexual function. When we expose low risk men, where the chance that the prostate cancer is going to cause them some lethal event, when we expose them to intervention, we really are exposing them to the potential harm of urinary side effects, and sexual side effects.

Dr. Roy Jensen: Okay. Again, Alesha Miller is here in the studio to take your questions, and Alesha, do you have any final words for us?

Alesha Miller: We don't have any questions currently, but as the live broadcast ends we encourage you to continue the conversation, and we will be monitoring the questions throughout the day.

Dr. Roy Jensen: Well, thank you Dr Parker, it's been a pleasure having you with us today. Please join us next Wednesday at 10:00 a.m. for Bench-to-Bedside as we discuss cancer survivorship. Thanks for watching.

Your first choice for a second opinion.

If you receive a diagnosis of prostate cancer, remember there is always time to get a second opinion.

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