The good news is that there are various treatments and management options for prostate cancer, even if it is found at a later stage. When detected early, the cancer is highly treatable, and most men with the disease survive.
“Prostate cancer is quite complex, which makes it difficult to predict how fast or slow it will grow and the risk associated with it,” says Dr. Jonathan Jay. “That is why, during diagnosis, we evaluate several factors to determine the aggressiveness of the tumor. After we determine the risk associated with the cancer, we are better placed to recommend the right treatment for our patients, which can yield great results,” he affirms.
The cancer is categorized as low risk, intermediate risk, or high risk depending on its ability to grow and spread to other areas of the body. Low risk prostate cancer is slow-growing and unlikely to spread quickly. In contrast, a high risk cancer is likely to spread rapidly outside the prostate.
Improved PSA Screening
One recent advance in prostate cancer research is the proper use of the prostate-specific antigen (PSA) test. Although the PSA test has had its limitations, it is still valuable for identifying and categorizing cancer as high risk or low risk, aggressive or indolent. When correctly used, it shows with accuracy those patients who have the aggressive type of cancer. This finding effectively guides the doctor to develop a more targeted treatment plan.
“The PSA got a bad reputation because it was used wrongly,” says Dr. Jonathan Jay. “But today, urologists understand that the PSA is still a very valuable tool in prostate cancer diagnosis and treatment. And it is now known that the significance of the PSA is not in whether it is elevated relative to the average, but in how it changes over time,” he asserts.
Studies have shown that the PSA is not abnormal just because it is elevated compared to the average. If the PSA of a man is stable over time, it doesn’t show prostate cancer, let alone an aggressive type of the disease. But if the PSA of a man has been stable for a prolonged period and then changes suddenly, it shows that something is wrong.
“If your PSA is one over the years, but changes to 3, then something is wrong, regardless of the fact that 3 is still within the normal range,” explains Dr. Jonathan Jay. “And if you’ve had a PSA of 6 over the past many years, then it’s not abnormal since it remains stable, regardless of the fact that it’s not within the normal range,” he adds.
Enhanced Precision with Molecular Biology
Significant progress has been made in prostate cancer research in the area of biopsies. Traditionally, prostate cancer has been confirmed and graded through a biopsy. To confirm a diagnosis, a urologist takes 8-12 needle biopsies along the prostate in a random sample and examines the cells under a microscope. However, while a biopsy tends to provide more accuracy than a typical PSA, it doesn’t give a perfect picture of the cancer.
“It is difficult to detect an aggressive cancer through the way cells look or behave,” says Dr. Jonathan Jay. “Besides, a biopsy may miss the specific areas of the prostate that would help to distinguish an aggressive from an indolent cancer,” he adds.
Advances in this area have ensured more accuracy and reduced the risk of misdiagnosis. For instance, abnormal prostate cancer genes can now be used to identify high risk cancer. The look of genes, occurrence of virulence factors, behavior, and other features are studied to better understand how likely it is that a cancer will grow and spread.
“Nowadays, we look at genes to determine the aggressiveness of prostate cancer,” says Dr. Jonathan Jay. “For example, genes of cancer cells may contain virulence factors or show how fast the cells will multiply and spread to other areas. This helps determine which cancer should be treated faster, and which categories of patients may benefit from therapeutic interventions,” he adds.
Apart from genomics, urologists can now use magnetic resonance imaging (MRI) technology before a biopsy to look for areas in the prostate that are suspicious of the cancer. This is possible thanks to new technology that fuses MRI images with real-time ultrasound to guide prostate needle biopsies to areas of specific concern.
Why Seek Prostate Cancer Treatment At Advanced Urology Institute?
At Advanced Urology Institute, we understand that prostate cancer is highly treatable when detected early and accurately.
We offer comprehensive prostate cancer care that includes the use of the latest research knowledge and techniques. With the advances in prostate cancer research, we can know who has aggressive or indolent cancer with greater accuracy, minimizing the chances of overtreatment and unnecessary biopsies.
Moreover, our urologists are acquainted with up-to-date prostate cancer knowledge, tools, and techniques. All of this helps guide treatment and enables us to develop more targeted treatment plans for our patients.
When you come to see us at our Naples, Florida office for diagnosis or treatment, we will consider your unique situation from a point of knowledge and recommend the best possible treatment for you.
For more information on prostate cancer treatment and diagnosis, visit the Advanced Urology Institute website.