Prostate Cancer Resources

Screening and Diagnosis


What is the Prostate?

The prostate is roughly the size of a walnut and sits right below the bladder, surrounding the urethra which is the tube that carries urine from the bladder out through the penis. The prostate and seminal vesicles (two, smaller paired glands attached to each side of the prostate) are part of the male reproductive system and their main job is to make fluid for semen. 

What is prostate cancer? 

If prostate cells grow abnormally, they can form a tumor, in the prostate gland. Tumors can be either benign (non-cancerous) or malignant (cancerous). Prostate cancer cells can remain inside the prostate gland or they can travel and invade nearby tissues.

Even if you are diagnosed with prostate cancer, many men will not die from it, but rather from other causes. Most prostate cancer is slow growing and many are cured after having treatment.

In the early stages, prostate cancer often has no symptoms.  When symptoms do occur, they can be like those of an enlarged prostate called benign prostatic hyperplasia (BPH). Prostate cancer can also cause symptoms unrelated to BPH. If you have urinary problems, talk with your healthcare provider about them.

Symptoms of prostate cancer may include the following:

What are my risks?

Though it is not known how or why prostate cancer starts, many factors may increase risk for the disease. 

Some of these include:


What is prostate cancer screening? Who should get screened?

Screening for prostate cancer refers to testing for the disease through two ways: prostate-specific antigen (PSA) blood test and digital rectal examination (usually performed by a doctor in the exam room). These are not perfect, and abnormal tests from either test may be due to an enlarged cancer, not cancer. Even if you don’t have symptoms, it’s important to screen for prostate cancer early.

Screening is recommended if you are a man and meet one of the following criteria:

This recommendation is from a guideline issued by the American Urological Association

What is the prostate-specific antigen, or PSA, blood test? 

PSA is a blood test measuring the amount of prostate-specific protein being produced by the prostate. PSA is produced in the prostate. Checking your PSA levels may help detect prostate cancer early. 

For a short video on PSA testing, please see below:

What is a Digital Rectal Exam (DRE)?

A DRE is when a healthcare provider examines the prostate by placing a lubricated, gloved finger in the rectum. The doctor feels for an abnormal shape or thickness to the prostate. This test cannot detect early cancer by itself and should be done with a PSA test. 

Prostate cancer staging

How is prostate cancer diagnosed?

Prostate cancer is diagnosed by a prostate biopsy. During a prostate biopsy procedure, tiny pieces of tissue are removed from the prostate and examined under a microscope by a pathologist (a doctor who will look at the tissue specifically for cancer cells). A biopsy report is provided to your doctor which includes useful information to determine if there is cancer.



What is a Gleason Score?

After a prostate biopsy, a pathologist looks at your cells found within the tissue and compares abnormal cells to healthy cells. They assess how likely they are to grow and spread by assigning a Gleason Score to each tissue sample to decide the risk of the disease and to make an accurate diagnosis.  


Gleason scores are recorded between 3 – 5 (3 having less abnormal cells or low risk cancer and 5 having a lot of abnormal cells or higher risk cancer). The two most common grades/patterns (known as primary and secondary pattern) found in the biopsy sample are then combined to a Gleason score. A Gleason Score is written as Pattern 1+ Pattern 2 = Overall Gleason Score, helping you and your doctor understand if the cancer is low, intermediate, or high risk. 


What is staging?

Along with a Gleason score, the tumor is also staged and can be determined by a DRE and imaging (e.g., transrectal ultrasound)  to describe where the cancer is within the prostate, how extensive it is, and if it has spread to other parts of the body. The system used for staging is called TNM staging which stands for Tumor, Nodes, and Metastasis. 


Treatment

What should I know before making a decision?

Choice of Treatment for Prostate Cancer is Based on a Shared Decision Between You and Your Doctor

The choice of treatment for prostate cancer depends on factors related to the severity and extent of the cancer, as well as, your preferences related to the benefits and side effects of treatment. Talk to your doctor and your family as you consider what treatment option is best for you.

Watch the video on prostate cancer treatment options testing.

Making a Shared Decision

P3P is a web-based program to help men prepare for making a decision, with their doctors, about how to manage a diagnosis of early stage prostate cancer. A recent national study* showed that using P3P reduced the amount of conflict experienced by men while making a decision. 

To learn more about the P3P program, please click here.



What is Active Surveillance?

Active Surveillance (AS): active monitoring of prostate cancer; scheduled follow-up visits every 6-12 months including PSA blood test, DRE, repeat biopsy or MRI imaging. 

May be a good option for men who:

To learn more about Active Surveillance for prostate cancer, please click here.

What is Watchful Waiting(WW)?

Watchful Waiting (WW): less involved system of monitoring of prostate cancer. Follow-up tests include PSA blood test and DRE, and it does not require repeat biopsies or imaging tests.

May be a good option for men who:

What is Radical Prostatectomy(RP)?

Radical prostatectomy: surgery to remove the prostate from the body.

May be a good option for men who:

To learn more about surgery for prostate cancer click here.

How will I feel if I have my prostate surgically removed?

Every patient’s journey is different, but some of the most common side effects are urinary leakage and erection problems.

To help your doctor understand your symptoms and optimize your recovery pathway, your doctor will encourage you to participate in the MUSIC Patient Reported Outcomes (PRO) program. As part of the PRO program, patients complete a questionnaire related to their health and function, before and at several time points after the surgery.

Click the linked image below to learn more about the MUSIC PRO program.

What does sexual recovery after prostate cancer surgery look like?

Although each patient’s postoperative journey is individual, sexuality is more than just having and maintaining erections. The TrueNTH Sexual Recovery Intervention is an online, tailored interactive program to support men and their partners on their journey toward sexual recovery after prostate cancer treatment.  It was developed by funding from the Movember Foundation and is designed to help patients understand key points and provide ideas for how to work on sexual recovery alone or with a partner. Register to find out more about what you can do to address this common issue.

The TrueNTH Sexual Recovery Program can help in several ways:

Click below to find out more information about TrueNTH:

What is Radiation Therapy?

Radiation therapy: uses high-energy beams to kill or slow the growth of cancer cells; may be used as a primary treatment or after surgery.

May be a good option for men:

More information about radiation therapy, and other treatments, can be found here.


What is Chemotherapy?

Chemotherapy: drug administered intravenously (through a vein) or by mouth to kill cancer cells.

May be a good option for men with:

Most of these side effects can be managed, and lessen once treatment ends.

Are there any alternative options?

Androgen deprivation therapy (ADT): uses drugs to block or lower testosterone as well as other male sex hormones that fuel cancer to grow. 

May be a good option for men who:


More information about ADT, and other treatments, can be found here. 

Questions to ask your doctor

The following questions may be helpful to ask your doctor to better understand your diagnosis and available treatment options that are best suited for your prostate cancer care.

Diagnosis: 

Treatment:

Side Effects & Recovery:

Post-Treatment

What are Kegel exercises and pelvic floor therapy?

Kegel exercises help strengthen muscles, called pelvic floor muscles, that are  involved with urinary control.

If you are pursuing surgery for your prostate cancer treatment, your doctor may have recommended you start doing Kegel exercises. Some doctors may suggest beginning Kegel exercises before while others may suggest beginning Kegel exercises after surgery. Please talk to your doctor about when to start your Kegel exercises.

To learn more about Kegel exercises and pelvic floor therapy, please click on the image below: 

Finding a Pelvic Floor Therapist Near you

Your doctor may recommend a pelvic floor physical therapist to help improve urinary leakage. Pelvic floor physical therapists can help you identify the correct muscles to perform Kegel exercises and create an individualized plan to aid in your recovery.

To find a pelvic floor physical therapist near you, please click on area closest to you below: Finding the right pelvic floor physical therapist should be a decision between you and your doctor.  Your doctor may recommend a pelvic floor therapist not on this list. Please talk with your doctor to find out which pelvic floor physical therapist may be best for you and your care. 

Where can I find a support group?

Wherever you are in your prostate cancer journey, joining a support group with men going through or have gone through similar experiences may be a helpful resource to navigate your diagnosis, treatment, and recovery. Please find prostate cancer support groups below:

 

Cancer Support Community of Greater Ann Arbor

First Wednesday of the month, 6 PM – 7:30 PM

Email: info@cancersupportannarbor.org

Phone: 734-975-2500

Website: cancersupportannarbor.org 


Us Too

To find a support group near you, please visit:

https://www.ustoo.org/Support-Group-Near-You


Reel Recovery

Fly Fishing Retreats for Men Living with Cancer

www.reelrecovery.org


State Coordinator/MI Contact:

Reg Tidball

810.877.0199

regtidball@att.net

What can I expect as a caregiver during the prostate cancer journey?