MultiCare Health System

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Types of Cancer

Prostate Cancer

If you’ve been recently diagnosed with prostate cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field on oncology. Our world-class treatment facility offers cutting edge technology in a welcoming and positive healing environment.

Learn about our comprehensive treatment approach, our cancer care team or more about prostate cancer in the tabs below.


Prostate Cancer Facts

Prostate cancer is the abnormal growth of cells in the tissues of the prostate gland, a walnut-shaped organ located below a man's bladder that produces fluid for semen. It is the most common cancer in men older than 65.


It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.

Prostate cancer is often curable. More than 90 percent of new cases of prostate cancer are caught early. Almost 100 percent of men with these early cancers survive 5 years or more after being diagnosed.

What Causes Prostate Cancer?

Experts don't know what causes prostate cancer, but they believe that age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.
Symptoms of Prostate Cancer

In most men, the prostate gland gets larger as they get older. Having symptoms of an enlarged prostate does not mean you have cancer, but you should be checked by your doctor.

Because the prostate surrounds part of the urethra, symptoms are usually related to urination and can include:

  • Not being able to urinate at all.
  • Having a hard time starting or stopping the flow of urine.
  • Having to urinate often, especially at night.
  • Having pain or burning during urination.
  • Difficulty having an erection.
  • Blood in your urine or semen.
  • Deep and frequent pain in your lower back, belly, hip, or pelvis.

When to Call Your Doctor

Call your doctor immediately if you:

  • Are completely unable to urinate.
  • Have painful urination and a fever higher than 100°F (38°C), chills, or body aches.
  • Have blood or pus in your urine.

Call your doctor if you have painful urination and signs of a possible urinary tract infection that last longer than 24 hours. These signs include:

  • A burning sensation while urinating.
  • Pain in your lower back just below your ribs that is not related to any injury or physical exertion.
  • Painful ejaculation.
  • Difficulty starting or controlling your urination.

Call your doctor to schedule an appointment within 1 to 2 weeks if you have unexplained:

  • Weight loss.
  • Dull, aching pain in your lower back, belly, hip or pelvis.
Prevention

Risk Factors

A risk factor is anything that makes you more likely to get a particular disease. Being older than 50 is the main risk factor for prostate cancer. About 65 out of 100 new prostate cancers are diagnosed in men who are 65 or older. About 70 out of 100 prostate cancer deaths occur in men who are older than 75.

Your chances of getting the disease are higher if other men in your family have had it. Your risk is doubled if your father or brother had prostate cancer. But most men who get prostate cancer have no family history of the disease.

Men whose families carry the gene changes that cause breast cancer, BRCA1 or BRCA2, are thought to be at increased risk for prostate cancer.

Early Screening and Prevention

If any of these risk factors are present in your life, you may consider getting regular screenings to find cancer growth early. As with all cancers, early detection is the best hope for a cure. 

Routine screening is recommended beginning at age 50 for most men and age 45 for African-American men or others at high risk for prostate cancer.

Some initial tests include a digital rectal exam, urine test or PSA test. 

You can take steps that may lower your chances of getting prostate cancer by
consuming more low-fat, high-fiber foods, or foods with omega-3 fatty acids, such as:

  • Soy products, like tofu and soy beans.
  • Tomatoes and foods that contain tomato sauce.
  • Vegetables like broccoli, cauliflower, and cabbage.
  • Fish, like salmon, albacore tuna, and sardines.
  • Walnuts and flaxseed, and their oils.
  • Drinking red wine or green tea.

More Information

Learn more about risk factors.
Learn more about screening tests and exams.

Detection & Diagnosis

If you are experiencing problems with urination, painful ejaculations, unexplained lower back pain or weight loss, it is essential to have your doctor perform some tests to detect if you have prostate cancer. 

Initial Tests

  • Digital Rectal Exam: in which the doctor inserts a gloved finger into your rectum to feel your prostate gland. Some prostate tumors can be found this way.
  • Urine Test: in which some of your urine is sent to a lab and checked for blood, infection, or abnormal cells. Prostate cancer can cause blood in the urine.
  • PSA Test: to measure the levels of prostate-specific antigen (PSA) in your blood. A higher level of PSA may be a sign of an enlargement, infection, or cancer of the prostate. If it is possible that an infection is raising your PSA, you may first have 4 to 6 weeks of antibiotics. Your doctor may suggest a second PSA test before thinking of doing a biopsy.
  • AUA Symptom Score: This is a series of questions from the American Urological Association (AUA) that measures how serious your urinating problems are. Sometimes these problems are caused by prostate cancer that is blocking your urine flow.
  • Urine-Flow Rate Test: This test measures your urine and how fast it comes out. Sometimes a low flow rate is caused by prostate cancer.

Next Steps

If tests point to prostate cancer, your doctor may recommend a prostate biopsy, in which tissue is taken from the prostate and examined under a microscope. A biopsy is the only way to confirm whether you have prostate cancer.

Tests that are done to evaluate the spread of the cancer and to plan further treatment may include:

  • Blood Tests: Different types of blood tests are used to see whether cancer has spread to your bones or liver.
  • Bone Scan: Radioactive material that shows up on X-rays is injected into your arm. An X-ray camera passes over your body, taking pictures as the radioactive material moves into your bones. Areas of bone damage show up in the pictures. Prostate cancer that has spread to the bones can cause this kind of damage.
  • CT Scan: A CT scanner directs a series of X-rays through your body. CT scans can show tissue damage or diseases, such as an infection or tumor.
  • Pelvic Lymphadenectomy: This is an operation in which the lymph nodes  near your prostate are removed and checked under a microscope to see if they contain cancer. It may be done at the same time as surgery to remove your prostate.
  • MRI: An MRI uses a strong magnetic field to make pictures of the prostate. The MRI can show tissue damage or disease, such as infection or a tumor.
  • ProstaScint Scan: This scan may be used to look for cancer cells after you have had surgery to remove cancer. Radioactive material that attaches itself to prostate cancer cells and shows up on X-rays is injected into a vein. Four days later, your body is scanned with a special camera, and lymph nodes and other areas that have been invaded by prostate cancer cells show up in the picture.

Staging

The most common staging system for prostate cancer is the TNM system, which labels the cancer in three categories: the size of the tumor (T), the spread of the cancer to lymph nodes (N), and the spread of the cancer to other parts of the body (M, for metastasis).

Besides using the TNM labels, your doctor also will give your cancer a Gleason score. A Gleason score is a way to describe differences in prostate cancer cells. Prostate cancer cells that have a low Gleason score grow more slowly than cells that have a higher score.

More Information

Treatments

Active Surveillance

Active surveillance may be a good option if you have cancer that is low-risk and has not spread (early stage). With active surveillance, you will have regular checkups with your doctor to see if your cancer has changed. But if you have cancer that is more likely to spread might need to have other treatments such as surgery or radiation.

Surgery

For many prostate cancer patients, surgery is the most common treatment option. If your physician recommends surgery, you may be a candidate for the da Vinci Surgical System, an alternative to traditional prostate surgery that uses the latest advances in robotics and computer technology to enable surgeons to perform precise, minimally invasive surgeries.

Radiation Therapy

Your doctor may recommend one or two forms of radiation therapy – external or internal – to eliminate any cancerous cells in your body. External therapy is administered using high-energy x-ray beams directed at the cancer. Over time, treatment destroys or weakens the cancer cells so they cannot reproduce.

We offer intensity modulated radiation therapy (IMRT), which involves image-guided technology to determine the location, shape and size of a tumor and determine the ideal amount of radiation to use.

If your prostate cancer requires internal radiation, you may be a candidate for prostate seed implantation, which delivers radiation directly to cancerous tissue while minimizing the impact to the surrounding healthy tissues.

Hormone Therapy

If your cancer is hormone-responsive, your doctors may consider hormone therapy as part of your treatment plan. The goal of hormone therapy treatment is to shrink the tumor by lowering the level of male hormones in your body. Reducing the size of the tumor can sometimes increase the success of surgery or radiation therapy.

Chemotherapy

MultiCare is one of only a handful of health care facilities in Washington State that provides Provenge, an effective immunotherapy used to treat patients with advanced prostate cancer.
Doctors, nurses and staff are required to undergo special training to administer Provenge. Provenge is designed to train your body’s immune cells to seek and attack prostate cancer cells. 

Learn more about Provenge

Treatments for Advanced Prostate Cancer

If your cancer is not responding to traditional care, there are other options. Our research programs offer you direct access to the latest clinical trials of promising anti-cancer drugs and drug combinations, radiation therapies and surgical techniques. 

Supportive Therapies

In addition to the therapies described above, we offer integrative therapies such as nutritional therapy, physical therapy, yoga, massage and emotional counseling. Many of these therapies are remarkably effective in addressing the side effects of chemotherapy, surgery and radiation. 

Managing Side Effects

During any stage of prostate cancer, there are things you can do at home to help manage the side effects of cancer or treatment.