Risk FactorsThe major risk factors for prostate cancer are age, family history, and ethnicity.
Prostate cancer occurs almost exclusively in men over age 40 and most often after age 50. Two-thirds of prostate cancers are found in men over age 65. By age 70, about 65% of men have at least microscopic evidence of prostate cancers. Fortunately, the cancer is usually very slow growing and older men with the cancer typically die of something else.
Family History and Genetic Factors
Heredity plays a role in some types of prostate cancers. Men with a family history of the disease have a higher risk of developing prostate cancer. Having one family member with prostate cancer doubles a man's own risk, and having three family members increases risk by 11-fold. A specific gene, named HPC1 (for “hereditary prostate cancer”) was the first of several genes linked to inherited types of the disease.
Scientists are researching other genetic variations that may increase prostate cancer risk.
Race and Ethnicity
African-American men have higher rates of prostate cancer than men of other races. They are also more likely to develop prostate cancer at a younger age and to have more aggressive forms of the disease. However, race alone does not fully explain this difference. Prostate cancer is more common in North America and northern Europe, and less common in Africa, Latin America, and Asia. Diet and other factors may play a role. For example, Asians who live in the United States have a higher rate of prostate cancer than those who live in Asia.
SymptomsEarly prostate cancer usually causes no symptoms. Often it is diagnosed during the workup for an elevated PSA noticed during a routine checkup. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. These include frequent urination, nocturia (increased urination at night), difficulty starting and maintaining a steady stream of urine, hematuria (blood in the urine), and dysuria (painful urination).
Screening & Diagnosis
The PSA blood test measures the level of a protein called prostate-specific antigen. It is able to detect early prostate cancer, although it has limitations.
Digital Rectal Examination
The Digital rectal examination (DRE) is a physical examination. The doctor inserts a gloved and lubricated finger into the patient's rectum and feels the prostate for bumps or other abnormalities.
DiagnosisPSA Test Limitations
Prostate specific antigen (PSA) is a protein produced in the prostate gland that keeps semen in liquid form. Prostate cancer cells appear to produce this protein in elevated quantities. Measuring PSA levels increases the chance for detecting the presence of cancer when it is microscopic. There are many unresolved questions surrounding PSA testing. The test is not accurate enough to either rule out or confirm the presence of cancer. PSA levels can be increased by various factors other than prostate cancer, including benign prostatic hyperplasia, prostatitis, advanced age, and ejaculation within 48 hours of the test. Relying too much on the test can lead to unnecessary biopsies. Not relying on it enough may miss cancers.
PSA screening may result in the detection of some cancers that would never have bothered the patient and would never have posed a threat to his life. Several major studies have found that PSA screening saves few if any lives. The American Cancer Society recommends that men discuss with their doctors the uncertainties, risks and potential benefits of screening for prostate cancer before deciding whether to be tested.
If cancer is suspected, the doctor will order a biopsy. Only a biopsy, in which a tiny sample of prostate tissue is surgically removed, can actually confirm a diagnosis of prostate cancer. A biopsy is usually performed to confirm or rule out cancer based on a combination of PSA test levels, findings on the DRE, family history, and patient’s age and ethnicity. If a biopsy gives a negative result but the doctor still suspects cancer, repeat biopsies may be performed.
An ultrasound procedure called transrectal ultrasonography (TRUS) may be used to help the doctor see where to take the needle biopsy. Ultrasound is not effective as a diagnostic tool by itself because it cannot differentiate very well between benign inflammations and cancer.
TreatmentUsing a team approach, CHI Health offers patients comprehensive care at convenient locations. In addition, our support team is available to coordinate treatment, answer questions and guide patients and family through care. We also participate in a number of national research programs and clinical research trials to ensure patients have access to the most advanced and aggressive treatments available.
Treatment of prostate cancer varies depending on the stage of the cancer and may include surgical removal, radiation, chemotherapy, hormonal manipulation or a combination of these treatments.
Treatment choices are generally based on the patient's age, the stage and grade of the cancer, overall health status, and the patient's personal preferences for the risks and benefits of each therapy.
- External beam therapy
- Hormone Therapy
Cancer Medical TeamYour cancer medical team consists of a multi-disciplinary team of highly skilled professionals who care for every patient of the CHI Health Cancer Center. Using state-of-the-art technology and treatment regimens, our doctors, nurses and other healthcare professionals treat more cancer patients than any other health care provider in the Nebraska.
Nurse Navigator ProgramA Cancer Nurse Navigator is an oncology-certified nurse who is available to guide you and your family through the entire process of diagnosis and treatment at CHI Health. The Nurse Navigator is a single point of contact who will be there with you every step of the way.
Cancer Support ServicesThe CHI Health Cancer Support Team is comprised of a group of healthcare professionals who work together in a variety of ways to help the patient and family cope with cancer. Individual team members include Cancer Support Services Specialists, Medical Social Workers, Cancer Rehabilitation Specialist, Pastoral Services, Dietitians, Oncology Nurse Navigators, Hospice & Home Care Services, Inpatient Nursing Services, Radiation Oncology, and Volunteer Services.
Technologies & Therapies
CHI Health is the first in the Omaha area to offer the TomoTherapy® Hi·Art® (Highly Integrated Adaptive Radiotherapy) System. This all-in-one solution allows doctors to check the location of tumors before each treatment, then deliver painless, precise radiation therapy resulting in unmatched accuracy for cancer patients, especially those with breast, lung and prostate tumors.
- Varian Trilogy
The Varian Trilogy with RapidArc® radiotherapy technology is a revolutionary breakthrough in cancer treatment that delivers powerful tumor-destroying radiation with remarkable precision.
Brachytherapy is an advanced cancer treatment that places radioactive sources, either permanently or temporarily, in or near the tumor itself to deliver a high dose of radiation while reducing the radiation exposure to the surrounding tissues.
Cancer Clinical TrialsWe believe our patients should have access to the most advanced medicines or treatments available. Studies are available for cancer control, cancer prevention and cancer treatment. No patient is obligated to participate in cancer clinical trials and may withdraw at any time. However, those who do participate gain access to new medicines and other benefits, such as low or no-cost drugs and treatments.
Image Recovery CenterWhile cancer treatment outcomes are improving, hair loss, weight changes and skin changes leave you feeling like a shadow of your former self. At CHI Health, we won’t let you face those challenges alone. The Image Recovery Center is an appearance-enhancement program designed to help you copy with some of the physical side effects of cancer treatment.
Complementary TherapyThe purpose of integrative movement therapy is to "complement" conventional medicine by stimulating the body’s natural healing power. Healing the body, mind and spirit, CHI Health offers massage therapy, Yoga, T’ai Chi meditation and other therapeutic exercises during cancer treatment.
Second Opinion ProgramAfter you receive a cancer diagnosis, you will likely have many questions. It’s helpful to obtain as much information as possible to make informed decisions about your cancer management and treatment in order to feel confident about your care. Getting a second opinion from the CHI Health Cancer Center can help with these concerns.
Cancer Inpatient ServicesFor more acute, palliative or end of life phases of cancer care, CHI Health offers five locations throughout Omaha for inpatient cancer care services.
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Aquatic Therapy
- Stress Management
- Lymphedeman Prevention and Treatment
Cancer Support Groups
- Prostate Cancer Support Group
- US Too/Man to Man Prostate Cancer Support Group
- Cancer Related Fatigue Support Group
- Cancer Survivorship Program
- Just for Kids - Cancer Support Group
- Lunch & Learn Cancer Support Group
- Surviving Bereavement
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Aquatic Therapy
- Lymphedema Prevention and Treatment