Prostate

What is Prostate Cancer?

The prostate is a small organ that exists only in men, and is located just below the bladder. The prostate surrounds the urethra, which carries urine out of the body. Cancer can cause the prostate to swell and obstruct the urethra, making urination difficult. Most men that are having urination problems however are suffering from non-cancerous enlargement, usually referred to as prostate hypertrophy. Conversely, the absence of urinary symptoms does not exclude the presence of prostate cancer.

Prostate cancer forms from the cells that normally make prostate secretions, important for men in the fertile years. Like other cancers, prostate cancers begin when some damaged cells begin to grow out of control. Unlike normal cells, which live for a time and then die in the body’s natural renewal process, cancerous cells live beyond their normal life and begin to crowd out healthy tissue.

Diagnosis

Prostate cancer can cause difficulty in urination, and it can sometimes be felt as a lump on the prostate during a rectal examination.  To determine if you have prostate cancer, we may use:

  • Thorough clinical examination to check for lumps or other changes.
  • Blood testing, such as prostate-specific antigen (PSA), to measure the amounts of certain substances in the blood that may indicate the presence of cancer.
  • Biopsy to obtain prostate tissue for examination under a microscope to determine the presence of cancer.
  • Ultrasound-guided biopsy (a transrectal ultrasound) to remove a sample of tissue from the prostate for examination under a microscope.
  • Bone scan to determine if the cancer has spread to the bones
  • CT scan or MRI to see if the cancer has spread to the tissues around the prostate or to the lymph nodes

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Treatment

The prostate cancer specialists at Indiana Unviersity Health Melvin and Bren Simon Cancer Center provide care to patients from throughout the United States. This extensive practice provides a level of expertise you can’t easily find at other medical centers. As a result, we are very familiar even with the rarest forms of these cancers. With experience comes the knowledge to deliver the best outcomes.

If you are diagnosed with prostate cancer, an individualized treatment plan will be created for you based on the most current treatment recommendations for your type of cancer and on your specific needs.

When appropriate, therapeutic options for prostate cancer can include one or more of the following:

  • Surgery to remove the cancer
  • Chemotherapy to destroy cancer cells with drugs.
  • Radiation therapy that uses high energy, penetrating waves or particles to destroy cancer cells or keep them from reproducing.
  • Hormonal therapy to slow or stop tumor growth by using synthetic hormones to block or lower the body’s production of testosterone to the cancer cells.

Should you be diagnosed with prostate cancer that needs removal, this may be done using special robotic tools that require only five keyhole-sized incisions (the da Vinci Surgical Robotic System). This method results in excellent outcomes and faster recovery time.
Radiation therapy treatments can include:

  • Computed Tomography (CT) Simulation. A radiation planning process using a CT scan to define tumor targets and internal anatomy in three dimensions to enable the radiation oncologist to precisely target the tumor while saving normal tissues.
  • Four-Dimensional CT Simulation. A CT simulation which also visualizes internal anatomy changes (such as changes in tumor location with the breathing cycle) allowing the radiation oncologist to target the tumor more accurately and further spare normal tissues.
  • Image Guided Radiation Therapy (IGRT). Uses precise radiographic imaging to more precisely target tumors while sparing normal tissues at each daily radiation treatment.
  • Cone-Beam Computed Tomography (CBCT). An IGRT technique that uses a limited CT scan prior to a daily radiation treatment to verify targeted internal anatomy in three dimensions before the treatment is delivered.  This technique allows extreme precision of targeting the radiation beams.
  • Three-dimensional conformal radiotherapy. Guided by a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while sparing the normal tissue as much as possible.
  • Intensity Modulated Radiation Therapy (IMRT). Advanced radiation delivery that allows delivery of radiation to areas surrounding, or in close proximity to, radiation sensitive tissues.  This technique uses a computerized optimization algorithm that allows the radiation oncologist to “paint” the dose around critical normal tissues to more effectively spare them from radiation side effects.
  • Stereotactic Body Radiation Therapy (SBRT). Special equipment is used to precisely deliver a large radiation dose to a tumor and not to normal tissue.
  • Proton Beam Radiation. Particle radiation treatments using charged particles (protons) that can be used to treat tumors in close proximity to critical radiation sensitive tissues and re-irradiate previously treated tissues.  This type of therapy allows the highest probability of sparing normal tissues, and lessens the possibility of second tumors related to radiation exposure.

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Physicians

Medical Oncology

Constantine Albany, M.D.

Urology

Thomas A. Gardner, M.D.
Michael O. Koch, M.D.
Timothy Masterson, M.D.
Chandru Sundaram, M.D.

Radiation Oncology

Peter Johnstone. M.D.

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Research

Our commitment to research and to advances in prostate cancer distinguishes our program from other cancer centers.  We perform many clinical trials, examining new technologies and new medical therapies we feel have the potential to advance clinical care. Examples of current or recently completed trials include:

  • Focused ultrasound heat therapy to treat prostate cancer after radiation failure.
  • New chemotherapeutic, immunologic and hormonal drugs for treatment of advanced prostate cancer.

We have developed extensive research collaborations with researchers at Indiana University School of Medicine, at Indiana University and at Purdue University. Through the development of these collaborations, we can bring our patients the best that research and expert clinical care can offer. Current collaborations include:

  • Development of new imaging technologies for prostate cancer.
  • New strategies to detect the spread of prostate cancer during surgery.
  • New technologies that can detect changes in the chemical composition of tissue associated with cancer to screen for high-risk prostate cancer and the analysis of tissue during surgery.

More information about cancer research can be found on the IU School of Medicine website

Clinical Trials

At any given time, numerous clinical trials are going on at IU Health Melvin and Bren Simon Cancer Center. Clinical trials are tests of new drugs and other treatments that may be more effective than currently accepted screening, diagnosis, or treatments of prostate cancer. Depending on your diagnosis, you may have access to one or more of these trials.

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