Overview
Benign Prostate Hyperplasia (BPH) is a non-cancerous enlargement of the prostate that does not result in Prostate Cancer. The tumor causes the prostate gland to swell or enlarge, thus, the symptoms for Prostate Cancer are parallel to those of BPH. Due to the similarities, when a patient arrives at the office with the above symptoms, further testing is performed to rule out the possibility of malignancy.
Symptoms
Along with the symptoms listed for BPH, there are a few other symptoms related to Prostate Cancer but are not direct indications. This includes hematospermia (blood in the semen) and a painful or burning sensation during urination or ejaculation.
Diagnosis
As mentioned, BPH and Prostate Cancer symptoms are parallel. When a patient’s primary complaint involves any of the symptoms mentioned under BPH, the workup includes one or more of the following tests to rule out malignancy.
- Digital Rectal Exam (DRE) – checks for any abnormalities in the texture, shape or size by feeling the prostate gland.
- Prostate-Specific Antigen (PSA) – measures the antigen levels produced by the prostate. Small amounts are usually secreted into the bloodstream; however, the secretion of larger amounts indicates that the gland is enlarged, infected, or malignant.
- Transrectal Ultrasound of the Prostate (TRUS) – a small, lubricated probe placed into the rectum to capture video and pictures of the prostate. Checks for any abnormalities not detected by a DRE as well as estimates the size of the gland. This aids us in finding the patient’s PSA density which helps strongly distinguish between BPH from Prostate Cancer. If PSAD indicates prostate cancer, the patient will undergo a Prostate Needle Biopsy.
- Prostate Needle Biopsy – an in-office surgical procedure in which several small samples of tissue are removed from the prostate and examined by a pathologist for malignancy.
Treatment
Depending on the severity of prostate cancer, your doctor may recommend a different treatment approach.
Watchful waiting
Observation and monitoring of cancer without immediate active treatment.
Hormone Therapy
Hormone therapy is designed to reduce the levels of male hormones (androgens) that fuel the growth of prostate cancer cells. Doctors reduce hormone levels by using drugs that lower or suppress testosterone levels.
Cyberknife
A robotic radio-surgery system, which is used to treat a variety of benign and malignant tumors. It is composed of a compact linear accelerator (a source of radiation), which is mounted on a computer-controlled arm. The CyberKnifeSystem uses real-time continuous image guidance during each treatment session. It delivers multiple beams of high-energy radiation to the tumor from many different directions and constantly adjusts for any movement of the target organ. The net result is a high dose of radiation delivered to cancer, in the most precise way currently possible. Radiation treatments are accurately delivered to the prostate and a small amount of tissue surrounding the prostate, minimizing the amount of radiation received by sensitive nearby structures (such as the bladder, rectum, and penis).
Radioactive Seed Implantation
Also known as prostate seed implantation or radioactive seed implantation involves placing tiny radioactive pellets (“seeds”) directly inside the prostate tumor. Low-dose seeds are implanted permanently and give off radiation for several months before losing their radioactivity. High-dose, or high-energy, seeds are implanted for less than a day and deliver a concentrated dose of radiation to the tumor.
Robotic Prostatectomy
Robotic prostatectomy, also known as a robot-assisted laparoscopic prostatectomy, is the most advanced treatment option for patients who are candidates for surgery. Operating through five or six tiny holes in the abdomen, surgeons remove the cancerous tissue while preserving the vital nerves and arteries that control bladder and sexual function. This nerve-sparing prostatectomy approach helps men retain their urinary control and sexual function.
