Prostate Cancer

Signs & Symptoms

While early detection of prostate cancer is the best defense, there are often no symptoms in the early stages. The first indications may be an elevated prostate-specific antigen (PSA) level or a rising trend in levels over time, and/or an abnormal firmness or growth on the prostate felt by the provider during a digital rectal exam (DRE). If symptoms are present, they can include:

• Frequent urination (especially at night)
• Difficulty stopping/starting urine
• Blood in the urine
• Erectile dysfunction
• Painful or burning sensation during urination or ejaculation
• Dull pain in the lower pelvis
• Widespread pain in the lower back, hips or thighs

If you are experiencing any of these symptoms, we encourage you to contact your primary care physician or urologist. They will be able to identify which screenings or tests should be done to help determine whether prostate cancer is present.

Screening, Gleason Scores & Staging

Based on your symptoms or family history, your primary care physician or urologist may perform various screenings and tests to determine the presence of prostate cancer, including:

• Digital Rectal Exam
• Prostate-Specific Antigen Test
• Transrectal Ultrasound
• High Definition (3T) MRI
• 4Kscore® Test

The results of those tests will indicate whether a prostate biopsy is necessary. Performing a biopsy is the only way to definitively confirm a cancer diagnosis.

After diagnosis, your prostate cancer is given a Gleason Score based on the aggressiveness of the cancerous cells. The Gleason Score determines the grade of the cancer.

• Gleason Score 6 or below: Grade 1
• Gleason Score 7: Grade 2 or 3
• Gleason Score 8: Grade 4
• Gleason Score 9 or above: Grade 5

Prostate cancer staging combines clinical factors like a physical exam, PSA level, Gleason score and imaging to determine an alphanumerical score:

• Stage I
• Stage II
• Stage III (A, B or C)
• Stage IV (A or B)

For cancer in general, Stages 1 and 2 are usually localized, or limited to the original site. Stage 3 typically indicates the cancer has spread to nearby tissue. Stage 4 generally means the cancer has spread elsewhere within the body.

Treatment Options

We encourage you to be your own health advocate. We believe the quality of your life during and after treatment matters. That’s why it’s important to understand all of your treatment options and the possible side effects of each. In general, prostate cancer treatment options may include surgery, chemotherapy, hormone therapy, brachytherapy, traditional radiation (x-ray/IMRT) and proton therapy.

If you have been diagnosed with prostate cancer, our Cancer Care Experts are ready to answer any questions about your diagnosis and help you through the next steps of your cancer care.

Benefits of Proton Therapy

Proton therapy is a more precise form of radiation therapy that is an ideal treatment option for many prostate cancer patients. It can be used alone or combined with other forms of treatment. Protons have distinct characteristics that allow the radiation beam to precisely target the cancer, avoiding unnecessary radiation to nearby healthy tissue and organs. Ultimately, this reduces the risk of long-term side effects.

• Non-surgical, non-invasive
• Reduces risk of incontinence³ and erectile dysfunction.⁴
• Excellent success rates
• 99% for low risk prostate cancer
• 94% for medium risk prostate cancer
• 74% for high risk prostate cancer²

To see how proton therapy compares to traditional radiation (x-ray/IMRT), please view our Treatment Comparison.