What is prostate cancer?
The prostate is a walnut-sized gland that all men have. It sits between the bladder and the urethra and produces seminal fluid to protect sperm.
Prostate cancer is the second-most common cancer diagnosed in American men after skin cancer, and it is the most common solid tumor cancer type in the male population. In 2024, the National Cancer Institute estimated that almost 300,000 new cases would be diagnosed in the United States.
How common is prostate cancer?
- Prostate cancer is very common, occurring in 28% of men in their 40s and 70% of men in their 70s. With early detection, patients have excellent survival rates.
- By the age of 50, one in four men will have some cancerous cells in their prostate. At age 80, the ratio becomes one in two. However, most men outlive their prostate cancer diagnosis.
- In more than two-thirds of men diagnosed with prostate cancer, the disease is confined to just the prostate and has not spread.
- On average, prostate cancers found through common early detection cancer screening tests are smaller and more contained than cancers discovered after the patient notices symptoms.
- Adenocarcinoma of the prostate is the most common form of prostate cancer, accounting for more than 95% of all cases. This form occurs when abnormal cells slowly progress to become malignant tumors, which are often located in the outer part of the prostate. Cancerous tumors can eventually metastasize or spread beyond the prostate, both signs of advanced prostate cancer.
What are the symptoms of prostate cancer?
Prostate cancer develops slowly and may cause few, if any, symptoms. If symptoms appear, they may include one or more of the following:
- Difficulty or an inability to urinate, or pain or burning while urinating
- Blood in urine
- Painful ejaculation
- Loss of appetite
- Weight loss
- Continual lower back, pelvic, or upper thigh pain
What are the risk factors for prostate cancer?
The exact cause of prostate cancer is unknown, but it is thought that some prostate cancers may be inherited and caused by DNA mutations. However, others may be related to hormones, environment, or diet.
Prostate cancer risk factors include:
Age
The older a man is, the higher his risk of prostate cancer.
Race
There is a higher incidence of the disease in African American men than in American men of other ethnicities. Asian American men have the lowest rates.
Family history
The risk increases if a person’s father or brother has the disease.
Diet
Some researchers have linked a high-fat diet to prostate cancer. Others have found that eating too many calories (regardless of the food source) raises the risk.
How do we diagnose prostate cancer?
A prostate cancer diagnosis is made through a series of tests, starting with a blood test that detects the amount of prostate-specific antigen (called a PSA test). A PSA test gives a numerical value to the amount of a protein produced by both normal and cancerous tissue. This test is the first step in screening for prostate cancer and other prostate conditions.
Experts recommend that men take an active surveillance approach to prostate cancer prevention by having an annual PSA blood test starting at age 50 (or 40 if any of their close relatives have had the disease). African American men should undergo annual PSA tests starting at age 45.
Does an elevated PSA always indicate prostate cancer?
No, an elevated PSA level does not always indicate cancer. But it tells your urologist that you may (or may not) need more testing or possibly a prostate biopsy, which extracts prostate tissue with a needle.
However, to determine the need for a biopsy, our urologists may use some (or all) of the following diagnostic tools:
Free PSA test
This test measures the percentage of free PSA (PSA not bound to other molecules) in the blood. A lower rate of free PSA indicates a greater risk of having prostate cancer.
Digital rectal exam
In this annual test, recommended by physicians, a finger is inserted into the rectum to examine the prostate gland by touch and detect any irregularities, such as firm areas that may be associated with cancer.
PSA Velocity analysis
This measures how quickly your PSA level changes over time, calculated by comparing results from multiple PSA tests, and can indicate the likelihood or aggressiveness of prostate cancer if PSA levels rise rapidly.
PSA density
This is the ratio of the PSA level in your blood to the volume of the prostate. It is calculated by dividing the PSA level by the prostate volume and is used to help distinguish between non-cancerous benign prostatic enlargement (BPH) and prostate cancer.
Imaging studies
These can include a transrectal ultrasound, a magnetic resonance imaging (MRI) scan, a bone scan, or a computed tomography (CT) scan.
What are the options for prostate cancer treatment?
Choosing the best treatment option(s) for a patient diagnosed with prostate cancer depends on several factors, including:
- The man’s age and life expectancy
- His feelings about the side effects associated with each treatment
- The grade and stage of the cancer
- Other health conditions
Active treatments for prostate cancer include:
- Surgery to remove the cancer
- Radiation therapy with SpaceOAR Hydrogel, radiation therapy with high-dose X-rays, or other forms of energy to kill cancer cells
- Cryotherapy (using cold to freeze cancer cells)
- Hormone therapy, which can slow or stop the cancer’s growth
- Chemotherapy, or the use of drugs to kill cancer cells
- Immunotherapy
What are the surgical options for prostate cancer?
Surgical treatment for prostate cancer primarily involves a procedure called a radical prostatectomy. This is where the removal of the entire prostate gland (and sometimes the surrounding lymph nodes if the cancer has spread to them) is performed. This surgery can be performed in various ways.
The traditional method is an open radical prostatectomy. Tower Urology deprecated this significantly invasive surgical approach years ago. The same goes for a laparoscopic approach, which is less invasive than an open procedure but more invasive and more difficult to recover from than a robotic approach.
The gold standard prostate cancer surgery is the robotic-assisted radical prostatectomy, which Tower Urology has used for years. It results in less blood loss, a shorter hospital stay, and faster recovery.
During this procedure, Tower’s very experienced surgeon controls robotic arms to perform the procedure through significantly smaller incisions than any other method.
Tower Urology’s expertise and experience make us among the nation’s most experienced robotic surgery practices.
Diagnosed with prostate cancer? Choose Tower Urology for the most comprehensive prostate cancer care in Los Angeles
Tower Urology employs a multispecialty care team approach for our cancer patients. Our patients receive urologic oncology insights from a team of healthcare professionals that includes the most qualified genitourinary cancer doctors (including medical oncologists and radiation oncologists) and urological surgeons, enabling you to select the best treatment options and quality of life.
Together, we’ll develop the most appropriate, customized treatment that includes:
- Hormone therapy for intermediate or high-risk prostate cancer
- Calypso technology to target and treat the tumor with real-time monitoring
- Treatment of regional lymph nodes
- Measures to lessen urinary symptoms during and after therapy
- Potency preservation rehabilitation program to maintain erectile function
About Tower Urology’s team approach and expertise
- Our prostate cancer providers’ collective experience spans well over 75 years and over 10,000 cases. Tower Urology has the most extensive and unparalleled wealth of experience in the Western United States.
- Our surgeons are board-certified, fellowship-trained, and experts in laparoscopic and robotic-assisted surgery.
- We offer each individual a personalized, tailored treatment approach. We don’t believe there is a one-size-fits-all model.
- Your physician and prostate cancer specialist are responsible for every aspect of your treatment plan. No students, interns, residents, or fellows are involved in delivering the best quality patient care.
- Our top-level success rates with daVinci robotic prostatectomy enable over 96% of our patients to regain urinary control and 85% to restore potency.
- Online and phone consultations are available for expert second opinions about your prostate cancer care.
- We are also on hand to guide you through prostate cancer survivorship, support you as you navigate through your diagnosis and treatment, and help you create strategies as you move beyond that to lead a full, healthy, and long life.
Tower Urology is the best prostate cancer specialist near you
Tower Urology is a proud affiliate of Cedars-Sinai Medical Center, ranked #1 in California and #2 nationwide by U.S. News & World Report. This partnership reflects our dedication to delivering the highest standard of urologic care alongside the best urologists in Los Angeles.
Our years of experience and access to Cedars-Sinai’s world-class facilities ensure that our exceptional and innovative urological care positions Tower Urology as a leader in Southern California. Tower Urology also conducts numerous clinical trials throughout the year.
We invite you to establish a care plan with Tower Urology.
Tower Urology is conveniently located for patients throughout Southern California and the Los Angeles area, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, and Downtown Los Angeles.
Our services include treatment for all urologic cancers, including kidney cancer, prostate cancer, testicular cancer, and cancer fertility management.
