Prostate cancer is second only to skin cancer in frequency of diagnosis of all cancer types in North America. Since the routine use of the PSA (Prostate Specific Antigen) blood screen since the early 1990’s, detection of prostate cancer has in general been made earlier with increasingly better treatment outcomes. The Digital Rectal Exam (DRE) is still a very important part of the prostate cancer screening process. Factors for increased risk of developing prostate cancer includes advancing age, a family history of prostate cancer, ethnicity (black Americans have not only a greater propensity to develop prostate cancer in general but also a greater risk of developing a more aggressive prostate cancer), and dietary factors.

There are several management options for prostate cancer and finding the best for each individual patient is an extremely important part of the physician-patient relationship. Patients should seek a physician who is not only well trained/educated in each of the treatment options but who will also take the time to treat them as an individual and not have a "one size fits all" mentality. Our physicians will discuss the risks and outcomes associated with any of the management options that are available to the patient.

Management options for prostate cancer include:

"Watchful waiting"

This is chosen when a specific form of treatment is not felt to be indicated or desired. In general, PSA and DRE screening is continued on a routine basis to monitor the cancer stage. Benefit of the management approach includes avoiding the risks and side-effects associated with surgery, radiation therapy, or hormone therapy. Risk of this approach to management of prostate cancer of course includes possible advancement of the cancer.

Radical Prostatectomy

Radical Prostatectomy is complete removal of the prostate gland either via an "open" surgical incision (retropubic or perineal approaches) or laparoscopic approach. Which approach is best for each individual patient is an important part of the consulting process. Dr. Mark Jalkut has been performing laparoscopic radical prostatectomies using the da Vinci Robot since October 2004. All of our physicians are all certified in Robotics.

Da Vinci Prostatectomy is performed with the assistance of the da Vinci® Surgical System – the latest evolution in robotics technology. The da Vinci Surgical System enables surgeons to operate with unmatched precision and control using only a few small incisions. Recent studies suggest that da Vinci Prostatectomy may offer improved cancer control and a faster return to potency and continence.

Radiation Therapy

Radiation to the prostate can be given via radiation "seeds" (rice sized pellets) which are surgically implanted into the prostate, or via external beam radiation therapy. The seed implantation surgery is conducted at the direction of a Radiation Oncologist with the urologist participating in the placement of the seeds.

Hormone Therapy

Surgical or medical castration is achieved with the goal of stopping the growth of the cancer. This is not a curative therapy and is generally chosen when more aggressive therapy has failed to cure the cancer or when it is felt that a more aggressive treatment option is not necessarily indicated but that there is a risk of cancer advancement.

Chemotherapy

This treatment option may be chosen for more advanced prostate cancer, perhaps in conjunction with radiation or hormone therapy. Our physicians will refer the patient to a Hematologist/Oncologist who would discuss the risks of chemotherapy.