What is Prostate Cancer?
Function of the Prostate Gland
As part of the male reproductive system, the prostate gland’s main job is to secrete a slightly alkaline fluid that forms part of the seminal fluid. This is the fluid that carries sperm. During ejaculation, the muscular glands of the prostate help to propel the prostate fluid, and sperm that was made in the testicles, into the urethra and out of the body.
The Anatomy of the Prostate
The prostate gland, approximately the size of a walnut, is only found in men. It surrounds the urethra; the tube carrying urine out of the body and is located just below the bladder. When the prostate enlarges as men age, the urethra is squeezed, making it difficult to urinate. The gland is also part of the male reproductive system, and its purpose is to secrete a fluid that forms part of the seminal fluid, the fluid that carries sperm.
Neurovascular bundles, delicate 1-2 mm structures vital to erectile function, run between a few millimeters to one-tenth an inch from either side of the prostate. Because of the close proximity, it is challenging to treat cancer without destroying the nerves. Millimeter precision is crucial to maintaining these nerves.
The prostate gland can grow as a man ages. An enlarged prostate can cause no outwardly visible symptoms, but if not treated could impact urinary and erectile functions.
Grading Prostate Cancer
After a PSA test, a digital rectal exam (DRE), and a recommended mpMRI indicate a likely prostate cancer diagnosis, a radiologist specializing in prostate imaging will attribute a PI-RADS score. Following a biopsy, a pathologist examines the cells under a microscope to determine how aggressive the tumor looks. A Gleason score is then assigned.
PI-RADS and Gleason Scores
PI-RADS stands for Prostate Imaging Reporting and Data System and was designed by radiologists to help radiologists read a mpMRI and report the likelihood that a suspicious area contains clinically significant cancer. Each PI-RADS score indicates to the degree that significant prostate cancer (PCa) exists.
Gleason Scores were designed by a pathologist to identify five different patterns of prostate cancer and assign a grade to each. Your Gleason score will always be shown as the sum of two numbers, 1-5 (e.g. 3+3 = 6 or 4+3 = 7). This set of numbers is based on the most aggressive patterns in each sample.
Physicians use the Gleason Score to help stage the severity of cancer and plan treatment. Tissue that looks healthy is given a lower number, and tissue that looks like cancer is given a higher number. A score of 7 or above usually requires treatment that is more intensive for the purpose of eliminating the presence of cancer.
Questions to Ask
It’s important for every man to be armed with as much information about his current state of health and diagnosis. Each of the questions below can serve as talking points to guide the best course of treatment.
- How big is the tumor?
- What is my Gleason Score?
- How do my age and health affect the treatment I receive?
- Do I need treatment now?
- What are my treatment options?
- Am I a candidate for laser focal therapy, also known as FLA, or TULSA-PRO?
Prostate Cancer Treatment Options
There are three primary categories of treatment options for men diagnosed with prostate cancer:
- active surveillance
- invasive therapies
- minimally invasive focal therapies
Prostate Laser Center performs laser focal therapy and TULSA-PRO minimally invasive procedures. Both procedures may be relevant treatment options for men with low to medium grade prostate cancer. However, every man is different, and so are their prostate concerns and treatment options.