Tests for Prostate Cancer
Tests Overview
Your doctor may prescribe one or more of the following tests to diagnose, locate, and stage your prostate cancer. Testing may involve radiologists specifically trained in prostate MRI, who have expert knowledge to determine the best treatment for you.
Prostate-Specific Antigen (PSA) Test
Description
Blood test that measures levels of PSA produced by your prostate. High levels may indicate cancer.
Digital Rectal Exam
Description
Your doctor inserts a surgically gloved finger into your rectum to examine your prostate, including an assessment of its size and if anything feels out of the ordinary.
Prostate MRI
Description
Our providers can use a specialized prostate MRI exam to determine the size, number, location, and aggressiveness of tumors within the prostate. We can use this imaging to determine exact locations for further testing, such as a biopsy, or treatment.
Description
If our providers suspect your prostate cancer may have spread, a PSMA PET scan includes injecting a safe, FDA-approved radioactive tracer drug that is specially made to find cancerous cells on a PET scan. This test can identify cancer in and outside the prostate gland, allowing for providers to track any spread and determine how well a treatment is working.
Biopsy
Description
Guided by prostate MRI, a provider inserts a needle into your prostate and collects a tissue sample that is analyzed for the presence of cancer. Depending on your individual needs, we may do this procedure either transrectally (via your rectum) or transperineally (the area between the anus and the scrotum or vulva).
Active Surveillance for Prostate Cancer
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Our active surveillance process uses sophisticated prostate MRI imaging to analyze the makeup of your tumor and provide a personalized risk assessment. This process is used for small, nonaggressive tumors that have a low probability of impacting your health and are not likely to grow or spread.
Your doctor may recommend active surveillance and periodic imaging tests to monitor your prostate cancer and determine whether treatment is needed. Active surveillance includes a prostate-specific antigen test every six-to-12 months and a prostate MRI every one or two years. A biopsy may be taken at the time of your prostate MRI as well.
Surgical Treatments for Prostate Cancer
Treatments Overview
When surgery to remove the tumor is needed, we explore all minimally invasive approaches. Our goal is to recommend options that are most beneficial to you and improve your quality of life.
Prostatectomy
Description
There are two types of prostatectomy, a procedure that removes the entire prostate and some surrounding tissue.
- Radical retropubic prostatectomy is performed through a single, small abdominal incision. It results in smaller scars and less pain.
- During robotic prostate surgery, your surgeon uses tiny robotic instruments to remove the prostate and tissue. The robotic approach allows your surgeon to operate with extreme precision.
Cryosurgery
Description
During this outpatient procedure, doctors use ultrasound images as a guide as they precisely insert a needle into the prostate. Cool argon is injected to freeze and and kill cancerous prostate tissue.
Description
This treatment is ideal for people with one or two low-grade tumors that are at low risk for growing or spreading. It targets a section of the prostate gland and kills the cancer with intense heat, cold, or electrical pulses while leaving healthy tissue intact. This treatment can minimize impacts to sexual and urinary function.
Non-Surgical Treatments for Prostate Cancer
Treatments Overview
If surgery isn’t an option or you need additional treatment beyond surgery, our oncologists coordinate care with providers who specialize in radiation therapy, chemotherapy, and hormone therapy for prostate cancer.
Description
Radiation therapy is an option for people with small, early-stage prostate cancer who want to avoid surgery. Highly focused radiation therapy uses advanced imaging technology that focuses radiation beams directly onto your tumor. In advanced cases, radiation reduces tumor size or relieves symptoms. We use 3D conformal radiation therapy and intensity modulated radiation therapy (IMRT).
High-Dose Brachytherapy
Description
If you have a tumor that can’t easily be removed, implants may be positioned inside your body near your prostate tumor to safely deliver high doses of targeted radiation for a specific period of time.
Chemotherapy
Description
This treatment kills or slows the growth of cancers too advanced for treatment with surgery or radiation therapy alone. Chemotherapy may also be used to help relieve symptoms.
Hormone Therapy
Description
Testosterone helps prostate cancers grow. Medication or surgical removal of the testicles (orchiectomy) reduces how much testosterone your body produces. Hormone therapy may help shrink tumors or slow the growth of cancer cells left behind after surgery or radiation therapy.
Leaders in Diagnosing and Treating Prostate Cancer
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National Reputation
We are one of the select centers designated by the National Cancer Institute as a Comprehensive Cancer Center, and we are part of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.
Surgical Expertise
Robotic prostate surgery is the gold standard for prostate cancer surgery. Duke was one of the earliest adopters of robotic surgery in North Carolina, and our care team includes surgeons that are fellowship-trained, meaning they studied additional years to become experts in urologic surgery.
Imaging Abilities that Make a Difference
A prostate MRI can be one of the most important ways your care team can find tumors and determine a course of treatment. Every person who undergoes an MRI for prostate cancer will receive imaging from our 3-telsa MRI machines that are twice as powerful as conventional scanners and just as safe. This advanced equipment allows us to provide the most specific diagnosis possible so radiologists and oncologists can collaborate on your course of treatment.
Expertise in Systemic Therapy
We are one of 13 Department of Defense Prostate Cancer Clinical Trial Consortium sites where new drugs and innovative therapies are being developed and delivered to people with advanced prostate cancer. Duke researchers have been closely involved in the development and approval of therapies now available to men with advanced prostate cancer, including newer hormonal therapies, immunotherapies, chemotherapies, and radiopharmaceuticals.
We Support You
Our comprehensive cancer support services help you with concerns ranging from how to minimize the side effects of treatment to coping with the emotional and psychological effects of your diagnosis and treatment. This includes a Prostate Cancer Survivors clinic and pelvic floor physical therapy to rehabilitate urinary function. Learn more about our prostate cancer support groups.
