Welcome to our health education library. The information shared below is provided to you as an educational and informational source only and is not intended to replace a medical examination or consultation, or medical advice given to you by a physician or medical professional.
Cancer occurs when abnormal cells form a tumor (a lump of cells that grow uncontrolled). If the results of your exam and tests lead your doctor to suspect prostate cancer, a core needle biopsy will be done. A thin needle is used to remove small samples of prostate tissue. These samples are checked for cancer.
Taking Tissue Samples
A biopsy takes about 15 to 20 minutes. Before it starts, you may be given an enema or suppository to clear the bowels. Antibiotics are given at least one hour pior to the biopsy. During the procedure:
Risks and Complications of Core Needle Biopsy
Many men have problems with the prostate at some time in their lives. The prostate gland is part of the male reproductive system. It’s located just below the bladder. The prostate surrounds the urethra (the tube that carries urine out of the body). When problems occur in the prostate, the bladder and urethra are often affected as well. Urinary symptoms can result. The most common prostate problems are described below.
BPH
BPH (benign prostatic hyperplasia) develops when changing hormone levels cause the prostate to grow larger. This often begins around age 50. Excess tissue can block the urethra, making it harder for urine to flow. The enlarged prostate can also press on the bladder, so you may need to urinate more often. Other symptoms include straining during urination, a weak urine stream, and feeling that the bladder isn’t emptying all the way. Note that BPH is not cancer and does not cause cancer.
How BPH Affects the Bladder
Pushing to urinate through a narrowed urethra can cause the bladder walls to thicken or stretch out of shape. A stretched bladder may have problems emptying all the way. Infections or bladder stones can occur. Also, the kidneys can’t drain properly into a bladder that doesn’t empty completely. This can lead to kidney failure. Pressure from urine buildup can also cause leaking of urine (called overflow incontinence).
Other Prostate Problems
If a potential prostate problem is identified through a digital rectal exam or a PSA (prostate-specific antigen) blood test, your doctor may suggest that you have an ultrasound. This imaging technique, possibly along with a biopsy (tissue sample), helps your doctor discover cancer early, when it’s more likely to be treatable.
What Ultrasound Reveals
Ultrasound uses high-frequency sound waves to create an image of the prostate gland. This can help your doctor identify abnormalities in the gland.
How Ultrasound Is Done
The ultrasound test is simple and is often done in your doctor’s office. It usually takes less than 15minutes. To clear your rectum, you may be asked to use an enema or suppository beforehand. If a biopsy may be done, you’ll be given antibiotics both before and after the test.
Creating the Image
You’ll lie on your side or with your feet in stirrups. A tubelike probe barely bigger than a thumb is covered with a condom. Your doctor gently inserts the probe into your rectum. The probe emits sound waves, creating an image of your prostate on a video screen. Your doctor views the image, looking at the size, shape, and structure of your prostate.
To help treat your enlarged prostate gland and relieve your symptoms, your doctor may recommend laser prostatectomy. A laser (concentrated light energy) is used to destroy the part of the enlarged prostate gland that is squeezing the urethra. Because the laser destroys the obstructing prostate tissue, it can’t be examined for signs of cancer. Your doctor will rule out the possibility of cancer before the procedure is performed.
Preparing for the Procedure
During the Procedure
Retrograde Ejaculation
If a muscle involved in ejaculation must be cut during surgery, semen may travel into the bladder instead of out of the penis during ejaculation. This side effect is called retrograde ejaculation. As a result, there may be little or no semen when you ejaculate. This is harmless, and the feeling of orgasm won’t change. Retrograde ejaculation can also be a side effect of certain medications.
Risks and Complications
You may go home the same day after your laser prostatectomy. Or, you may stay up to 2 nights in the hospital. An adult friend or family member should drive you home. To get the best results from your laser prostatectomy, follow your doctor’s instructions and keep your follow-up appointments.
After Your Procedure
Your prostate will likely be sore at first. This will improve as you heal. Here are some things you can expect:
Healing
For the first few weeks after your surgery, you may notice that your urine is cloudy or that you have blood or blood clots in your urine. This is normal while your body rids itself of the treated tissue. Your symptoms may begin to improve during the first few weeks, but it may take up to three months before they go away. Your doctor can tell you when you can resume sexual activity and how soon you can return to work.
Special Instructions
You may be told to:
Getting Back to Sex
You may be glad to know that BPH and its treatments rarely cause problems with sex. Even if you have retrograde ejaculation, orgasm shouldn’t feel any different than it used to. If you notice any problems with sex, talk to your doctor. Help may be available.
When to Call Your Doctor
The prostate gland is part of the male reproductive system. It sits just below the bladder and surrounds the urethra(the tube that carries urine and semen out of the body). Prostatitis is an infection or inflammation that causes the prostate to become painful and swollen. This narrows the urethra and can block the bladder neck. Prostatitis can cause urinary symptoms such as a burning sensation, pressure, or pain. Nonbacterial prostatitis is the most common form of prostatitis. In many cases, it’s annoying but not serious.
Causes
With nonbacterial prostatitis, the prostate is inflamed (swollen), but not infected. Possible causes include:
Symptoms
Symptoms of nonbacterial prostatitis are often vague and tend to be mild. They may include:
Treatment
Your healthcare provider may suggest one or more of the following to relieve symptoms:
Chronic Prostatitis
Prostatitis can develop into a chronic (ongoing) problem:
The prostate gland is part of the male reproductive system. It sits just below the bladder and surrounds the urethra(the tube that carries urine and semen out of the body). Prostatitis is an infection or inflammation that causes the prostate to become painful and swollen. This narrows the urethra and can block the bladder neck. Prostatitis can cause urinary symptoms such as a burning sensation, pressure, or pain. Bacterial prostatitis is one form of prostatitis. It is often acute (sudden and severe), and can make you very sick.
Causes
Bacterial prostatitis occurs due to a bacterial infection in the prostate. In some cases, bacterial prostatitis is caused by a sexually transmitted infection. With a healthy prostate, urine flows easily through the urethra. With an inflamed prostate, the urethra narrows. It’s harder for urine to go through.
Symptoms
Symptoms of bacterial prostatitis may be severe and come on quickly. They may include:
Treatment
Antibiotics will be prescribed. Take all of your medication, even if you start to feel better. Your healthcare provider may also suggest bed rest, stool softeners, and drinking more fluid.
Chronic Prostatitis
Prostatitis can develop into a chronic (ongoing) problem:
The prostate specific antigen (PSA) test is a blood test used to help in the early detection of prostate cancer. PSA, an ingredient of semen, is made by the prostate. Some PSA naturally leaks from the prostate into the bloodstream. The PSA test measures the amount of PSA in the blood. As a man ages, more PSA leaks into the blood. Problems with the prostate-such as prostatitis (prostate infection), BPH (benign prostatic enlargement), or cancer-may cause extra PSA to enter the blood. A prostatic massage or prostate biopsy can also raise PSA levels. If a PSA test shows higher than normal blood levels of PSA, other tests are necessary to help determine the cause of the increase.
Why a PSA Test Is Done
How It’s Done
If your doctor recommends a PSA test, a routine prostate exam has probably been done first. Then you’ll be sent to have your blood drawn for the PSA test. The test is done at a blood drawing station-usually in the doctor’s office or at a lab, clinic, or hospital. Blood is taken from your arm and sent to a laboratory for evaluation.
Getting Your Results
The time it takes to get your test results varies from lab to lab. Ask your doctor when you can expect them. When the results return, you and your doctor can discuss what they mean. A normal range for your PSA depends on a number of factors. These include your age, the size of your prostate, your risk factors for cancer, your symptoms, and the results of your previous PSA tests, if any. These factors are taken into account when your PSA test numbers are interpreted and evaluated.
For Your Health
Even if your PSA level is normal, continue to have regular prostate exams. If you are African-American or have a family history of prostate cancer, your doctor may recommend PSA tests by age 40-45.
TURP is a type of surgery used to treat a benign enlargement of the prostate, also known as BPH (benign prostatic hyperplasia). This surgical treatment removes prostate tissue to relieve pressure on the urethra. This helps relieve symptoms. TURP is the most common BPH procedure. But certain other procedures also help relieve BPH symptoms. Your doctor may do one of these instead of TURP. They include TUIP, TUNA, or laser ablation. If you will have one of these procedures, your doctor can tell you more about it. Your preparation and experience during surgery will be similar to TURP.
Preparing for Surgery
Your doctor will tell you how to prepare for your procedure. For instance, you may be asked to stop taking certain medications a few days before the procedure. If your procedure will be done in a hospital, you may be asked not to eat or drink anything after the midnight before surgery. Be sure to follow any special instructions you’re given.
During the TURP Procedure
Possible Risks and Complications of Prostate Procedures
Retrograde Ejaculation
After some surgical treatments, semen may travel into the bladder instead of out of the penis during ejaculation. This side effect is called retrograde ejaculation. As a result, there may be little or no semen when you ejaculate. This is harmless, and the feeling of orgasm won’t change. Retrograde ejaculation can also be a side effect of certain medications.
Take it easy for the first month or so while you heal. During the first few weeks, you may feel burning when you pass urine. You may also feel like you have to urinate often. These sensations will go away. If your urine becomes bright red, it means that the treated area is bleeding. This may happen on and off for a month or so after a TURP. If this occurs, rest and drink plenty of fluids until the bleeding stops.
While You Are Healing
To help prevent problems during the first month after your surgery, follow these tips:
Follow-up Visits
You will visit your doctor to make sure you are healing without problems. If tests were done on your prostate tissue your doctor will discuss the results with you.
When to Call Your Doctor
Getting Back to Sex
BPH and its treatments rarely cause problems with sex. Even if you have retrograde ejaculation, orgasm shouldn’t feel any different than it used to. If you notice any problems with sex, talk to your doctor. Help may be available.
After surgery, you’ll first go to the recovery room, then to a regular hospital room.
In most cases, you won’t go home until you can pass urine on your own. The hospital stay is usually 1-7 days.
Having a Catheter
Urinating On Your Own
Before Going Home
You will be told what to do while you heal. You may be given certain medications, such as antibiotics to prevent infection. Ask your doctor when you can start taking aspirin and other medications again. When you are ready to go home, have an adult friend or relative drive you.
Cancer occurs when cells in the body begin changing and multiplying out of control. These cells can form lumps of tissue called tumors. Cancer that starts in the prostate is called prostate cancer. Cancer can grow and spread beyond the prostate, threatening health and life.
Understanding the Prostate
The prostate is a gland about the size and shape of a walnut. It surrounds the upper part of the urethra in men, the tube that carries urine from the bladder.The prostate produces most of the semen in which sperm travel. During orgasm, semen exits the body through the urethra.
When Prostate Cancer Forms
As a man ages, his prostate may change. Inside a changing prostate, groups of cells may form tumors or other growths. Some may be benign (not cancerous), but they may still cause symptoms. Others may be cancerous.
Diagnosing Prostate Cancer
Prostate cancer may not cause symptoms at first. Urinary problems often are not a sign of cancer, but of another condition. To find out if you have prostate cancer, your doctor must examine you and order tests. Tests help confirm a diagnosis of cancer. They also help give more information about a cancerous tumor. Tests include:
Cancer that has spread beyond the prostate can often be treated. Hormone therapy can slow the growth and spread of the cancer. Chemotherapy may help relieve symptoms and control the cancer. Cancer pain can be managed with medications.
Testosterone can cause the cancer to grow. Treatments can include:
Chemotherapy
Chemotherapy (chemo) uses medications to destroy cancer cells anywhere in the body. Chemo may be given by pill or injection. It may be used with or instead of other treatments. It may slow the growth of cancer, and may relieve pain and other symptoms. A medical oncologist manages chemo treatments.
Pain Control
Prostate cancer that has spread may cause pain. This pain can be treated. Pain medications can improve your quality of life. Using them can relieve stress, helping you to better withstand the cancer. Discuss the side effects of these medications, and any other concerns you have, with your doctor.
Risks and Complications of Hormone Therapy
Problems with the prostate (a gland in the male reproductive system) become more common as a man ages. These problems include prostate cancer, a common cancer in men. This cancer can often be cured or controlled, especially if it is found and treated early. Screening tests help detect prostate cancer before it causes any symptoms.
Prostate Cancer
Cancer is an uncontrolled growth of abnormal cells. These cells form in one area and can spread through the body. Prostate cancer causes no symptoms in its early stages. In fact, urinary problems are more likely to be symptoms of another condition.
Risk Factors for Prostate Cancer
The things that can increase a man’s chance of developing prostate cancer are called risk factors. These include:
Screening for Cancer
Screening for prostate cancer is done with a physical exam and blood tests. These tests can help determine whether it is likely that you have cancer. The American Urological Association recommends that men with risk factors begin yearly screening at age 40. Men with no risk factors are offered yearly screening at age 50.
Tests You May Have
Prostate cancer screening tests include the digital rectal exam (DRE) and a lab test called the PSA test. If the DRE or PSA suggests that cancer may be present, other tests are then done. These tests help show whether a man has prostate cancer.
Medical History and DRE
During your medical exam:
The PSA Test
PSA (prostate specific antigen) is a protein produced by prostate tissue. The PSA level is measured with a blood test. The result helps assess the likelihood of prostate cancer. To screen for prostate cancer, the PSA test is done once a year.
Evaluating the PSA
A high or rising PSA level suggests that prostate cancer may have formed. A lower PSA level indicates that cancer is less likely. In addition to the PSA level, your doctor may look at:
Factors That Affect PSA
Many factors can affect PSA levels. Some, such as age, BPH, and prostate cancer, are ongoing. Others, such as prostatitis or recent sexual activity, have only a temporary effect on PSA. Your healthcare provider can explain how these factors may affect the timing of the PSA test and your results.
Further Testing
Abnormalities found with DRE may not be tumors. And a high PSA level doesn’t always mean cancer. More tests need to be done. After looking at the results of your screening tests, your doctor may recommend other tests.
Biopsy
This test involves taking tissue samples from the prostate. With transrectal ultrasound (TRUS) as a guide, a thin needle is used to remove samples. The tissue samples are then analyzed in a lab to check whether there are cancer cells and, if so, how likely they are to grow quickly.
Imaging Studies
If cancer is found, imaging studies may be done to check for its spread. Bone scans(x-rays) check whether cancer has spread to bones. CT and MRI can detect tumors in bones and soft tissues.
Should you be screened yearly for prostate cancer, even if you have no symptoms? Experts disagree. Below are some factors to think about as you make a decision.
Pros
Cons
Weighing Your Options
Before making a decision about screening, talk to your doctor. Ask any questions you have about testing. Talking to your partner, friends, or family members may also be helpful. Things to consider include:
Being told that you have cancer is frightening. But most men diagnosed with prostate cancer don’t die from it. Even though a cure can’t be guaranteed, treatment can often keep the cancer under control. The treatment your healthcare team will suggest depends on many factors. These include your age, your overall health, how fast the cancer is growing, and whether it has spread. Discuss your options with your healthcare team.
Your Healthcare Team
The professionals who assist in your care include:
Choosing the Best Treatment
Knowing the cancer’s grade and stage helps with forming a treatment plan. Discuss your treatment options with your healthcare team to find what is best for you.
New Treatment Options
New treatment options for prostate cancer may become available in the future. These may include new surgical or radiation techniques or new medications. Your healthcare team can tell you if any of these options might be right for you. Ask the members of your healthcare team whether you could be treated as part of a clinical trial (a research project to study a new treatment).
Radical (total) prostatectomy is surgery to remove the entire prostate. It may be done if diagnostic tests show that the cancer is confined to the prostate. Your surgeon will give you detailed instructions on preparing for surgery. After surgery, you’ll be told how to care for yourself at home as you recover. Be sure to ask any questions you have about the procedure and recovery.
Before Surgery
How Surgery Is Performed
After Surgery
Call Your Doctor If
Risks and Complications of Prostatectomy
Radiation therapy is one way to destroy cancer cells. Cancer cells continue to die for months after the therapy ends. Radiation can be delivered from material placed inside the prostate gland. This is called interstitial brachytherapy. “Seeds” (tiny pieces of radioactive material) are implanted in the prostate. These seeds can be either permanent or temporary.
Permanent Seeds
Permanent seeds release decreasing amounts of radiation over a period of months. You can most likely go home soon after the seeds are implanted.
Temporary Seeds
Temporary seeds release a single high dose of radiation. They are implanted and removed. You may stay in the hospital for a day or more after the first dose. One or more doses may be given during the next day.
Before, During, and After Treatment
Risks and Complications of Interstitial Brachytherapy
No matter what type of treatment you choose, life with prostate cancer can be a challenge. Your goal during treatment should be to live as normal a life as possible. Your healthcare team can help you to cope with any physical and emotional issues that result from treatment. The support of your family and friends can help, too. Don’t be afraid to ask your loved ones for help with the challenges you are facing.
Sexuality
Treatment for prostate cancer may affect your sexuality. It can result in erectile dysfunction or a lowered sex drive. Often, these problems can be treated. Ask your urologist for help. And talk to your partner about ways to nurture your relationship so that it will be satisfying for both of you.
Urinary Problems
Incontinence or other urinary problems can occur due to treatment for prostate cancer. Effective treatments exist for most urinary problems. Talk to your urologist or radiation oncologist about what may help you.
The Future
During and after treatment, your urologist will monitor your prostate health. Your healthcare team will also help you control any ongoing symptoms resulting from treatment. Keep in mind that each man responds differently to prostate cancer treatment. Continue working with your team throughout treatment. Mention any concerns you have, and be sure to get your questions answered. Above all, think about how best to live your life. Prostate cancer may or may not shorten your life. But living life to the fullest is a good goal for anyone.
To form your treatment plan, your healthcare team must learn more about your cancer. What do the cancer cells look like? Has the cancer spread beyond the prostate? Cells removed during biopsy will be viewed under the microscope. Treatment will depend on how the cells look (grade) and where they are located (stage).
Grading the Cancer
A cancer is graded using tissue removed during a biopsy. A pathologist (a doctor who identifies diseases by studying cells and tissues) looks at this tissue under a microscope. He or she then determines the cancer’s grade, from 1 to 5. Low-grade cancers are similar to normal tissue. High-grade cancers differ from normal tissue in the way cells are organized, and in cell size and shape. The higher the grade, the faster the cancer is likely to be growing. The pathologist will give a report to your urologist.
Grade 1 or 2
Seen under a microscope, grade 1 or 2 cells are abnormal, but still appear to be organized in rings. This may indicate a slow-growing cancer.
Grade 3 or 4
Grade 3 or 4 cells vary more in size and shape. Fewer rings are visible. These cancer cells may grow more rapidly.
Grade 5
Grade 5 cells don’t form rings. They vary even more in size and shape than lower-grade cells. This indicates a fast-growing cancer.
The Gleason Score
Often there is more than one cancer grade within a tumor. The two most common grades found in the tumor are added together to get the Gleason score (or sum), a number between 2 and 10.
To form your treatment plan, your healthcare team must learn more about your cancer. What do the cancer cells look like? Has the cancer spread beyond the prostate? Cells removed during biopsy will be viewed under the microscope. Treatment will depend on how the cells look (grade) and where they are located (stage).
Staging the Cancer
Your urologist will assign your cancer a stage based on PSA, DRE, and imaging tests. Lower-stage cancers are confined to the prostate. Higher-stage cancers have spread from the prostate to nearby organs, bone, or other body tissues.
Stage T1
A tumor that is completely inside the prostate. It can’t be felt during DRE.
Stage T2
A tumor that can be felt during DRE, but is still completely inside the prostate.
Stage T3 or T4
Cancer that has spread to the outside of the prostate or to the seminal vesicles.
Stage N+, M+
Cancer that has spread to the lymph nodes (N+), or to the bones or other organs (M+).
Serving people of all ages from Shawano to Oshkosh. Please contact our Main Office in Neenah, WI for more information, (920) 886-8979 or (877) 897-7747.
Fax: (920) 886-2225.