Prostate Cancer Chattanooga TN
The urologic surgeons and oncologists at UT Urology offer state-of-the-art technology, compassion and hope for prostate cancer patients in Chattanooga, Tennessee and Alabama. Our providers are leading participants in many cancer research projects and clinical trials offering treatment options you may not find elsewhere.
Currently, we are the only urology team in the region participating in the AQUA Prostate Cancer Registry, an international collaboration through the American Urology Association, for the betterment of prostate cancer treatment. We can help patients in their battle against this terrible disease.
The Prostate Gland
The prostate is a male reproductive gland, located in front of the rectum, below the bladder. The prostate’s job is to secrete prostate fluids that make up the semen. Just behind the prostate gland are the seminal vesicles that make other fluids that protect and nourish the sperm. The urethra, the tube that carries urine and semen out of the body, runs through the prostate.
For most men prostate cancer is slow-growing and is diagnosed at an early stage when they have the most treatment options. In fact, most men with prostate cancer die from other causes, not from their prostate cancer. If cancer is detected before it spreads, the 5 year survival rate is almost 100%. When the cancer has spread beyond the prostate to other parts of the body, more critical treatments are needed.
Who is at Risk of Prostate Cancer?
In the U.S. 17% of men are at risk of developing prostate cancer. The cause of prostate cancer is not known, but there are things that can increase your risk of developing it.
- Before age 40, it is relatively rare. After 50 the risk increases. Over age 65, 6 in 10 men will develop prostate cancer.
- Family history. A first degree relative, like your brother or father diagnosed with prostate cancer significantly increases your risk.
- Race and ethnicity. African American men are more likely than white men to develop prostate cancer, and they are more likely to die from the disease.
- Obesity and sedentary lifestyle raise your risk of aggressive prostate cancer.
Symptoms of Prostate Cancer
Prostate cancer has few, if any symptoms. More advanced prostate cancer symptoms include:
- Problems with urination
- Erectile dysfunction
- Pain in the spine and other bones
- Blood in the urine
- Loss of bowel or bladder control
However, these symptoms can be caused by many benign conditions as well.
How is Prostate Cancer Diagnosed?
- The PSA Test. Prostate cancer is the second leading cause of death in American men, and the PSA test is currently the only blood test available. The PSA test measures blood levels of a protein made by the prostate gland. The higher the level, the more likely there is a need for further investigation.
- The Digital Rectal Exam (DRE) is a physical exam of the prostate and allows the doctor to feel lumps and other abnormalities.
- Transrectal Ultrasound/sonogram of the prostate.
- Prostate biopsy and microscopic examination of the prostate tissue resulting in a Gleason score, which helps grade the tumor for aggressiveness.
- CT scans, MRI, X-rays and bone scans will also help grade the tumor.
Results from these tests will help identify whether the cancer is contained inside the prostate gland or has spread to other parts of the body. This is important to determine the appropriate treatment.
Staging and Grading Prostate Cancer
Staging indicates the extent of the tumor and how far the cancer has spread. It is based on the results of the PSA test, the DRE, and the Gleason score from a biopsy of the prostate tissue.
Grading is based on how the tissue looks under the microscope, and indicates how likely the tumor may grow and spread.
Prostate Cancer Treatments
- If the cancer is slow- growing and confined to the prostate gland, you may be advised to undergo Active Surveillance. This means careful monitoring with PSA tests, DREs, and ultrasounds at regular intervals. Sometimes additional biopsies may be recommended as well.
- Radical prostatectomy is the surgical removal of the prostate gland when the tumor has been classified as aggressive. In the early stages, it may provide a cure and reduce the risk of recurrence. It can be performed by open surgery or robotic/laparoscopic surgery with or without sparing of the nerves, depending on your specific cancer. Nerve-sparing prostatectomy is designed to preserve sexual function.
- Our urology specialists offer the da Vinci® It is a robot-assisted, minimally invasive surgery that enhances vision, precision and control for removal of the prostate following early diagnosis of prostate cancer.
- Radiation therapy can be accomplished outside the body or internally with radiation beads implanted in the prostate gland (brachytherapy).
- Cyrosurgery (freezing the prostate gland cells) is an alternative to prostatectomy where the patient does not want radical prostatectomy or is not a candidate for that surgical technique. It destroys the entire gland and some surrounding tissue.
- Hormone therapy is used to stop production of male hormones. If the prostate tumor does not respond to hormonal therapy it is called hormone-resistant. In this case, chemotherapy may be a good option.
- Transurethral resection of the prostate (TURP) may be used to relieve symptoms of BPH or the prostate tumor, or for men who’s tumor is confined to the prostate gland and cannot have a prostatectomy.
Any of these options can be combined for the best result.
What are the stages of prostate cancer?
Doctors must know how far cancer has progressed to develop the most effective treatment plan. The starting point of staging may differ from one case to another. There are two types of staging for prostate cancer, clinical and pathological.
Clinical staging is based on the results of tests such as a digital rectal exam and prostate-specific antigen (PSA) test, diagnostic imaging, and the Gleason score of the prostate biopsy samples. Pathological staging is based on information taken from tissue obtained via prostate surgery or biopsy. The Gleason scoring system is the pathologic grading scale for prostate cancer. The Gleason score is determined by a pathologist who looks at prostate biopsy samples and grades prostate cancer cell appearance by aggressiveness. The higher the number in the Gleason score, the more aggressive the cancer cells are.
After prostate cancer is confirmed through the biopsy, the doctor may order additional tests, such as CT scan or bone scan, to see if cancer has spread to the lymph nodes, bones, or other parts of the body.
Diagnostic evaluation helps the doctor determine the key elements of cancer staging. This is often based on the TNM system developed by the American Joint Committee on Cancer and includes:
- Tumor, which describes the tumor’s location, size, and depth in affected tissue.
- Node, which indicates whether cancer cells have spread to lymph nodes or other aspects of the lymphatic system.
- Metastasis, which indicates whether cancer cells have spread to other organs or tissue.
What are the risk factors for developing prostate cancer?
There are several well established risk factors for developing prostate cancer. As men age, the risk of developing prostate cancer increases. It is extremely rare for men to have prostate cancer before the age of 40, but becomes more common with each additional decade of life. A family history of prostate cancer in first degree relatives (father, brother(s)) increases one’s risk of having prostate cancer. Finally, African Americans are at an increased risk of developing prostate cancer compared to other ethnic groups. African Americans are also more likely to be diagnosed with more aggressive types of prostate cancer and to die from prostate cancer.
Is it safe to drink alcohol with prostate cancer?
Studies regarding the safety of alcohol consumption and prostate cancer are ongoing. Some studies, such as one published by the National Cancer Institute, have found little association between alcohol consumption and the risk of prostate cancer. Others, such as one published in the Journal of Clinical Oncology (June, 2019), have found beneficial aspects of alcohol consumption in relation to the risk of prostate cancer. This particular published study suggested that moderate consumption of red wine may slow the progression of the disease. That said, no study has proven that alcohol consumption can reduce the risk of prostate cancer.
It may not be unsafe to drink alcohol after receiving a prostate cancer diagnosis. However, it is important to understand that clinical researchers who have uncovered perceived benefits admit that further study is necessary to fully understand the connection between alcohol and this type of cancer.
- A study on Alcohol Consumption and PSA-detected Prostate Cancer Risk by NIH researchers found that heavy alcohol consumption could depress PSA levels. This finding is important to reaching an accurate diagnosis. Men who drink regularly should inform their doctor so appropriate tests can be conducted.
- Patients should understand that alcohol has been associated with several other types of cancer, leading us to believe that a reduction in consumption can only be beneficial.
- Heavy drinking can cause similar symptoms as prostate cancer, including erectile dysfunction, frequent nocturia and weak urine flow, fatigue, weight loss, and swelling of the legs or feet.
Is prostate cancer painful?
Prostate cancer can eventually cause pain, but perhaps not in the way people may expect. Men with advancing prostate cancer may experience bone pain, though this can be a difficult symptom to describe. It is important for men to obtain routine physical exams from their primary physician and undergo PSA screening based on current guidelines. If symptoms such as erectile dysfunction or frequent urination occur, it certainly doesn’t hurt to schedule a consultation and screening with a urologist.
What is the prostate cancer survival rate?
Survival rates provide an estimated percentage of patients with the same type and stage of cancer who live a certain amount of time after their cancer diagnosis. Cancer survival rates are not intended to determine how long a patient will live. Rather, they help patients understand how likely it is that their treatment will be successful based on their type and stage of cancer. According to the American Cancer Society, prostate cancer survival rates are currently measured at approximately 98% based on the SEER (Surveillance, Epidemiology, and End Results) database, maintained by the National Cancer Institute.
Can prostate cancer be prevented?
It may not be possible to completely resolve the risk of prostate cancer. However, studies indicate that this risk can be reduced by:
- Eating a healthy diet abundant in fresh fruits, vegetables, and whole grains. This recommendation has not been proven but is based on evidence that a healthy, whole-foods diet feeds the body the vitamins, minerals, and antioxidants it needs to perform more efficiently.
- Exercise regularly to maintain a healthy weight. Exercise needn’t be strenuous to achieve health benefits. Walking, biking, lifting weights, and performing other physical activity for 30 minutes, several days a week, has been shown to boost cellular function and increase immunity against many common diseases.
- Obtain regular health exams from a primary care physician. At a certain age, most patients will begin hearing from their doctor that they need prostate cancer screening. For the man at an average risk for prostate cancer, this is typically around age 50-55. Men who have an inherent risk for prostate cancer, such as race or family history as described above,, should talk to their doctor sooner and begin screening around age 40.
UT Urology is a regional leader in urology, providing care to the people Chattanooga, Tennessee, Alabama and Northern Georgia. We offer state-of-the-art diagnostic tools and cutting-edge solutions for your prostate cancer treatment. We have multiple fellowship-trained and general urologists who can assist with care, compassion and excellence.