Urology

Prostate Cancer

The prostate is the walnut-sized gland that produces semen. After skin cancer, prostate cancer is the most common form of cancer among men in the United States. More than 161,000 men will be diagnosed with the disease in 2017, according to the Prostate Cancer Foundation. Fortunately, when we find the cancer early, treatment can be highly effective. 

At Mount Sinai Urology, we provide the most up-to-date services available for the diagnosis, treatment, and management of prostate cancer. Our doctors are fellowship-educated clinicians and researchers known for their expertise and innovation in current and emerging treatment for prostate cancer. Our surgeons are among the few trained in open, laparoscopic, and robotic prostate surgery

In addition, Mount Sinai is considered one of the premiere centers for brachytherapy and intensity-modulated radiation therapy (IMRT). Brachytherapy, which Mount Sinai helped to pioneer, and IMRT are advanced types of high-precision radiation treatment that deliver radiation doses more precisely while minimizing damage to nearby normal tissues. 

Risk Factors

All men should be screened for prostate cancer. Certain risk factors can influence the timing and frequency of screening. These include age, race, and family history. About two-thirds of prostate cancers affect men over age 65, especially African Americans.

In its early stages, prostate cancer has no obvious symptoms. With advanced prostate cancer, you could experience problems with urinating, though that could also be a sign of an enlarged prostate, benign prostatic hyperplasia, or prostatitis. Other symptoms of advanced prostate cancer include: 

  • Trouble having or keeping an erection (impotence)
  • Blood in the urine
  • Pain in the spine, hips, ribs, or other bones
  • Weakness or numbness in the legs or feet
  • Loss of bladder or bowel control

Screening and Diagnosis

The medical world continues to debate the value of screening for prostate cancer in healthy men. At Mount Sinai, our guidelines align with those of the American Urological Association. You should discuss your prostate cancer risk profile and screening benefits with your primary care physician or urologist. There are no risks associated with prostate cancer screening.

Many men have a baseline prostate-specific antigen (PSA) test at age 40. Screening should also include a digital rectal exam (DRE), which can uncover physical abnormalities of the prostate that could be a sign of cancer.  

There is no PSA level that guarantees you are cancer free. In fact, most men with an elevated PSA do not have cancer. At Mount Sinai, we do not look at the PSA blood test score in a vacuum; rather we consider it in the context of your age, race, family history, size of the prostate, and percentage of free PSA (PSA unbound to other proteins).

If we determine that we need further information, we may perform prostate biopsy. A biopsy is the only definitive way of diagnosing prostate cancer. Approximately 20 percent of men diagnosed with prostate cancer in the United States have a normal PSA but have cancerous cells in their prostate.

Prostate cancer is typically a slow-growing disease, allowing time to review your treatment options before making a decision.