Prostate cancer is now the most common cancer diagnosed in men in the United States (excluding skin cancer) and is the second leading cause of cancer deaths (after lung cancer). In 2010, approximately 217,730 men in the US will be diagnosed with the disease and 32,050 are projected to die from the disease this year according to the American Cancer Society. As a man gets older his chances of developing prostate cancer increases, with more than 75 percent of tumors being found in men over age 65. A family history of prostate cancer may increase the chances of developing the disease, particularly if his brother, father, or paternal uncle was diagnosed with prostate cancer, and especially if the relative was younger than 60 at the time of diagnosis. For a man who is now 50 years old, his probability of being diagnosed with prostate cancer is about 10 percent. Approximately 1 in 6 men will be diagnosed with prostate cancer in their lifetime and 1 in 35 will die of the disease.
Prostate cancer is usually curable when detected early. This underscores the need for screening. The Department of Urology at the University of Kansas Hospital conducts a number of free prostate cancer screenings around the state. Our goal is to provide awareness and early screening to those who might otherwise not seek care. While some men seek medical attention because they are experiencing symptoms that might indicate prostate cancer (such as frequent urination or an inability to urinate, trouble starting or holding back urine flows, or frequent pain or stiffness in the lower back, hips, or upper thighs), most men experience no such symptoms. Hence, for many men, an abnormal finding during a routine screening examination is the first indication that they might have prostate cancer. A recent update on PSA screening was published by the American Urological Association suggesting a man should get his first PSA at the age of 40 years. An abnormal-feeling prostate and an elevated PSA level (greater than or equal to 4.0 ng/ml) are both possible indicators of the disease.
We offer the most advanced methods for the detection and diagnosis of prostate cancer. For those with an elevated PSA or an abnormal digital rectal exam our physicians may recommend a prostate biopsy done under ultrasound guidance. Using newer techniques of local anesthesia, our physicians make the procedure as comfortable as possible. When indicated, the University of Kansas Hospital, offers state of the art diagnostic equipment including one of the nation's few combined PET/CT scanners to detect cancer that has spread at the earliest possible stage.
Dr. Jeffrey Holzbeierlein currently provides a high-risk prostate cancer clinic aimed at even more aggressive detection for men with risk factors for developing prostate cancer. The clinic is focused on preventing development of the disease in men with strong family history, elevated PSA at a young age, or other clinical risk factors.
Most men are diagnosed with early-stage prostate cancer (the disease is confined to the prostate). Our physicians will carefully discuss all treatment options including surgery, radiation therapy, and watchful waiting (careful observation without further immediate treatment) in terms patients can understand. In the past, surgery and radiation therapy have posed risks of side effects such as urinary incontinence, sexual potency problems, and rectal problems. Fortunately, the experience of our surgeons as well as our radiation oncologists helps to minimize these side effects. Our radiation oncologists offer the latest techniques in radiation including intensity modulated radiotherapy (IMRT) and brachytherapy (radioactive seed implantation into the prostate) which are aimed at providing cancer control while minimizing the side effects.
The urologic surgeons at the University of Kansas Hospital offer the latest techniques in prostate surgery. Dr. Brantley Thrasher is a well-known national expert in prostate cancer and is one of the only urologic oncologists in the United States performing radical retropubic, radical perineal, and robot-assisted laparoscopic prostatectomy for prostate removal. The perineal approach and the robot-assisted approach have been shown to have less pain and less blood loss. Dr. David Duchene is another faculty member who is an expert in robotic prostatectomy and other advanced laparoscopy and robotic surgery, and is one of only two fellowship-trained robotic physicians in the Kansas City metro area. Dr. Jeffrey Holzbeierlein and Dr. Moben Mirza perform robotic prostatectomies, robotic bladder and robotic kidney cancer cases. The Department of Urology at the University of Kansas is the only institution in the region where 4 fellowship-trained cancer experts are performing robotic procedures, making it the premier urology practice for cancer care in the region, and Dr. David Duchene is one of the only fellowship-trained robotic physicians in the Kansas City metro area.
With a dedicated team of physicians consisting of fellowship trained urologic oncologists, radiation oncologists, medical oncologists specializing in the treatment of genitourinary malignancies, pathologists, and radiologists, KU offers comprehensive cancer care to the patient with prostate cancer.
RECENT RESEARCH (June 2011) A recent British study has created a lot of press. Analyzed 50,066 men diagnosed with CAP between 1997 and 2006 from the Thames Cancer Registry , which covers a population of 12 million in South East England. They found that 50% of patients died of prostate cancer. In the US. approximately 15% of patients were estimated to die of the disease in 2010. Estimates from the UK , on the other hand suggests that approximately 30% of patients present with advanced disease and as you can see from the article, about half are dying from the disease long term. Although we in the US have been criticized for over diagnosing and potentially over treating the disease, this article speaks volumes for early screening and treatment at a stage when the disease is still curable. Obviously, in cases where the patients present with disease outside the confines of the prostate, the results are especially deadly. The Dept of Urology at the University of Kansas Cancer and Medical Center has a high risk prostate cancer clinic and current on going cutting edge research to help patients with prostate cancer.
RECENT CONTROVERSY ABOUT PROSTATE CANCER SCREENING Recent recommendations by the US Preventative Services Task Force (USPSTF) has recommended against prostate-specific antigen (PSA)screening for prostate cancer, asserting that there is "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," and discouraged the use of the test by issuing it a Grade D rating. The American Urological Association and American Board of Urology speaks out against this recommended. Dr Thrasher, Chair of Urology at the University of Kansas Medical Center and Hospital, and member of the national board speaks on the issue.