Diagnosis and Treatment

One of the first options your doctor may recommend is a digital rectal exam. Your doctor will insert a gloved, lubricated finger into your rectum to check for bumps or irregularities on your prostate. Another option is a blood test to measure your levels of prostate-specific antigen (PSA), a protein made by your prostate. Elevated PSA levels could indicate prostate cancer.

There are several imaging tests used to help identify prostate cancer and whether it has spread. These highly specialized tools can also be used later as part of precision treatments. Among the options:

• 3T MRI: This cutting-edge imaging technology allows our specialists to peer into the prostate to look for abnormalities that might not be possible through conventional lab tests and imaging studies. The MRI can help guide the true need for a diagnostic prostate biopsy or help guide treatments when cancer is diagnosed.
• MRI-fusion prostate biopsy: This is a more precise prostate biopsy using an MRI to help us target suspicious areas of your prostate. This integration of images is all done in real time in the procedure room during an MRI fusion prostate biopsy. This results in better rates of cancer detection during your prostate biopsy. This technology can only be used if you have an abnormality seen on MRI. If there is no abnormality, specialists can use a standard ultrasound guided prostate biopsy when there is a high suspicion for cancer.
• Transrectal ultrasound (TRUS): A small, lubricated probe is inserted into your rectum, where it uses sound waves to create images of your prostate. It can help examine suspicious areas of the prostate and can help guide needles during a biopsy.
• Positron emission tomography (PET) scan: Also known as a PSMA PET scan, prostate-specific membrane antigen (PSMA) is a protein specific to prostate cancer cells. This test uses a special camera and a radioactive tracer – injected into your blood stream – to look for the presence of cancer cells. It is often used with aggressive prostate cancers and disease recurrences to look for signs that the cancer may have spread beyond the prostate.

In cases where prostate cancer is discovered early and is growing slowly, you may be offered a wait-and-see approach referred to as “active surveillance.”

SpaceOAR is a hydrogel spacer, made mostly from water, that temporarily separates the rectal wall further away from the prostate to protect it from unintentional damage during radiation treatment. We inject the gel using a small needle that is placed between the prostate and the rectum. The hydrogel material has been successfully used for other implants, such as surgical sealants used in the eye, brain and spine. The hydrogel is also biocompatible, meaning it can be used in the body without causing injury or reaction.

Chemotherapy uses drugs to target cells – including cancer cells – that grow quickly. It is often used when prostate cancer has spread to other parts of the body.

This is an outpatient procedure where small needles are placed into your prostate to freeze the inside of your prostate.

Genetic testing can offer benefits both for you and your family. It can help your team learn more about your specific cancer and how to treat it. Testing may also reveal whether your family members have increased risk for the disease.

This treatment works by reducing your body’s ability to create testosterone, which fuels prostate cancer growth. Medication can stop testosterone production or block it from reaching cancer cells.

Immunotherapy uses drugs to harness the power of your own immune system. The treatment encourages your immune system to identify and attack cancer cells.

These medications focus on the specific weaknesses of your cancer. Exploiting those abnormalities can cause those cancer cells to die.

In some instances, your doctor may recommend removing the prostate gland. Orlando Health surgeons are world leaders in the use of robotic technology for these complex and delicate procedures. Surgeons remove the entire prostate through a few small incisions in your abdomen. The procedure also allows for a cleaner removal of malignant tissue, while reducing damage to healthy tissue. In these techniques, which are more precise, require smaller incisions, offer quicker recoveries and result in fewer complications.