Prostate cancer is the most common cancer diagnosed in men in the United State. There are over 190,000 cases diagnosed each year. One out of seven men in America will be diagnosed in their lifetime. It is the second most common cause of cancer deaths in men in our country, however survival rates are increasing with improved awareness, access to care and improved therapies for early and advanced disease. When found early prostate cancer can be curable and the treatment approaches improve every year to maximize effective therapy options and reduce side effects.
Diagnosis and Types
Prostate cancer is diagnosed through a biopsy of either the prostate gland or another location that is suspected to be involved with cancer cells. Almost all prostate cancers are adenocarcinomas. The Gleason Score along with other characteristics help define how aggressive an individual’s cancer will behave. Gleason scores typically range from six to ten. The higher scores represent more aggressive cancers. Some cancers will evolve over years and be managed as chronic diseases, while other prostate cancers can be very aggressive and require more intensive treatment. Because prostate cancer can have a wide range behavior it is important for treatments to be individualized and tailored to a patient’s specific disease. Therapy needs to balance affective treatment while avoiding over-treatment for less aggressive disease.
Once the appropriate workup has been completed, treatment typically focuses on either local treatments or systemic therapy based on individual needs. Local treatments include radiation therapy and radical prostectomy. In the appropriate setting, hormonal therapy can be combined with radiation therapy for more aggressive prostate cancers. For more advanced disease multiple newer options for therapy are available including androgen deprivation therapy, immunotherapy, bone protective therapy, and chemotherapy. Over the past few years multiple new agents have been approved for advanced prostate cancer including abiraterone, enzalutamide, radium 223, sipuleucel-T, denosumab and cabazitaxel. The goals of therapy are to tailor the appropriate effective agents when needed by individual patients. We utilize all the above agents to provide individualized therapies to our patients and maximize the benefits while trying to reduce the side effects of the therapies used.
Prostate Cancer Specialists
Dr. Abraham Schwarzberg
Dr. Schwarzberg is the Senior Vice President of Network Development & Chief of Oncology at Tampa General Hospital. He is a member of the American Society of Clinical Oncology.