The Urological Institute of Northeastern New York (518) 262-3341

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Prostate Cancer

Although prostate cancer is a common cancer in men, we understand that it is most likely foreign to you. A cancer diagnosis often doesn't come with a warning and can be very scary. The Urological Institute of Northeastern New York understands. We can help you with what to expect and how to prepare for what comes next.

By the time you get to our office, you probably have either had a suspicious rectal exam or an abnormal PSA blood test, or you may have already been diagnosed with prostate cancer. It's important to understand what your test results mean and what your actual diagnosis is. First, it's important to find out the type of cancer you have, the size, location and severity (aggressiveness of the cancer). It's also important to find out the prostate cancer is localized (meaning isolated to the prostate gland) or if it has spread (metastatic prostate cancer). Your general health will play a big role in decision-making.

A prostate cancer diagnosis is a lot to handle. It is sometimes helpful to bring a spouse, family member or friend with you to your urologist appointment to take notes and listen to the doctor's instruction. There's a lot of information you'll receive, and you may not absorb it all because you have a lot on your mind. So, having an advocate can help in the long run.

Your Urologist will work with you throughout the course of your treatment. It's critical that you have a good working relationship with your urologist so that you can trust them and the care plan that you developed. In looking for a Urologist for your prostate cancer treatment, it's important to look for someone who listens, explains things in clear language and terms that you can understand, and who understands you and what's important to you throughout treatment. This includes what quality of life you expect after your treatment. You don't want to suffer major side effects while being cured of your prostate cancer. Each cancer treatment option, including surgery, has predictable side effects. So, it's important to discuss these side effects with your urologist before your prostate cancer treatment so you have a plan to cope with them. Ask your doctor what to expect in regards to urinary control, sexual function, returning to work and participating in athletic activities.

If there is ever any doubt in your mind about information or decisions, ask questions. If you still don't feel comfortable, seek a second opinion. A good urologist will never be unhappy or threatened when you seek a second opinion. You may also seek opinions from other types of doctors, like those that provide radiation therapy.

Finally, you can seek information from other sources. Think about the Amercian Cancer Society or the American Urological Association as sources. Your local Man-to-Man support group might also be helpful. Remember though, not all information available (especially from random sites on the web) is accurate. Don't hesitate to run this information by your urologist.

You don't have to travel outside of the Capital Region for clinically proven, advanced prostate cancer treatment options. The Urological Institute of Northeastern New York consists of expert Urologists who use the most advanced cancer treatments, like the DaVinci Robot which helps our surgeons perform the operation more accurately and with less blood loss and less postoperative discomfort. Many people think they need to travel to big cities like New York City or Boston for this kind of treatment, but it's right here in Albany, NY. Our physicians have treated thousands of prostate cancer cases using many different modalities, from robotic surgery to advanced types of radiation therapy. We have very high success rates with low side effects.

There is a wealth of information online about prostate cancer symptoms, prostate cancer diagnosis, and prostate cancer treatment. Don't let this information overwhelm or scare you. Although it is important to be fully informed and evaluate all your treatment options after your prostate cancer diagnosis, your best source of information is your Urologist and your primary care physician. He/she can explain everything clearly as it relates to you and your prostate cancer diagnosis, including side effects and outcomes.

Prostate Cancer Screening

Treated in its earliest stages, prostate cancer can be cured. Early detection through regular screening is essential. The entire screening takes less than 5 minutes. It consists of a Prostate Specific Antigen (PSA) blood test and a digital rectal exam (DRE).

PSA is a substance made by the normal prostate gland. Elevated or rising PSA levels may be a signal that there is something wrong with the prostate. Cancer is not the only cause for elevated PSA levels. Infection, recent sexual activity, and benign prostate hyperplasia can all affect the PSA level. Your physician will evaluate and track your level of PSA and the rate at which the level changes over time. A "normal" but quickly rising PSA level may suggest a need for further study.

The DRE is a physical exam that checks for abnormalities on the surface of the prostate. Prostate cancer may appear as a "nodule" or an unusually firm texture of the gland. Sometimes prostate cancer is apparent only upon rectal exam, even when the PSA test is normal. This is no time for men to be squeamish! Both PSA and DRE are recommended for adequate cancer screening.

Who Should be Screened For Prostate Cancer?

Screening has significantly increased the number of cancers diagnosed at an early, and usually curable, stage. Men who are elderly and/or in poor health, need not undergo screening for prostate cancer because there may be little or no benefit to finding the prostate cancer at an early stage in these men. However, men over the age of 50 (or age 40 for African-American men or those with a family history) should be offered or recommended to undergo yearly screening with PSA and DRE.

Since the advent of screening with the PSA test in 1987, there has been a 4-fold decrease in men with advanced prostate cancer which had already spread at the time of diagnosis.

Recent news stories have provided confusing and conflicting information on two recent medical research articles about the benefits of a PSA blood test for early detection of prostate cancer. The links below provide more information on this.

PSA Update for Patients   |   PSA Update for Healthcare Professionals

Risk factors for prostate cancer include family history, high fat diet, smoking and ethnicity. African-American men have a 60% higher incidence rate of prostate cancer than Caucasian men. They are more likely to get this disease at a younger age and often have more aggressive cancer.

Treating Prostate Cancer

The detection of prostate cancer while it is still localized (hasn’t spread past the prostate), combined with improvements in technology and our understanding of prostate cancer, means the chances for recovery have improved significantly. Today, men with newly diagnosed prostate cancer, who have an expected life span of at least ten years, have a number of options for treatment with high likelihood of cure. These include surgery to remove the cancerous prostate or delivering radiation therapy (either external or with radioactive seed implant) to the prostate, sometimes with hormonal therapy.

DaVinci Robot

The most recent advance in the management of localized prostate cancer is the robotic-assisted, laparoscopic prostatectomy (surgical removal of part of the prostate gland). The laparoscopic instruments are attached to the robotic arms of the DaVinci robotic system at the bedside. The surgeon controls the movements of the robotic arms from a remote console while visualizing the surgical field through a 3-D camera.

Instead of a larger incision needed for a standard operation, there a four small, keyhole like incisions. The blood loss during robotic-assisted procedure is reduced significantly to about one-sixth of what is noted with standard open surgery. The precision of movements and improved visualization of the surgical field allows for preservation of vital structures and reduces the risk of potential side effects such as impotence or urinary dysfunction. Also, the time to full recovery may be reduced by one half for most patients.

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