Prostate cancer patients almost always have an excellent prognosis if their cancer is caught early. As a result, experts recommend that men speak with their doctors to develop a plan for regular screening.
There are two methods of screening for prostate cancer: the PSA blood test and a digital rectal exam.
The prostate specific antigen (PSA) blood test is the primary screening method for prostate cancer. It measures the level of PSA, a substance made by the prostate. Men who have prostate cancer may have an increased amount of PSA in their blood. However, an elevated PSA level alone doesn’t mean that you have prostate cancer. Other conditions can elevate PSA levels, such as infection or inflammation of the prostate.
WashU Medicine prostate cancer experts at Siteman pioneered the PSA test and have successfully developed the free-PSA test as a way of detecting cancer more accurately.
During a digital rectal exam, the doctor or nurse inserts a gloved finger into the rectum to check for an enlarged prostate, lumps or abnormal areas.
What are the screening guidelines for men of average risk?
If your doctor determines that you are at average risk for prostate cancer, you will be advised to begin PSA screening at age 45. Your doctor will then recommend a follow-up screening schedule based on your initial reading and your personal preferences.
What are the screening guidelines for men of above-average risk?
African-American men and men with a family history of prostate cancer are at a higher risk of developing the disease. These men are advised to begin regular PSA screening at age 40.
Prostate cancer is usually highly treatable, but it’s important to catch it early, before it can spread from the prostate to the rest of the body. Every man should be aware of the risk factors for prostate cancer and get an assessment of his own risk profile, if possible.
Common risk factors
The most common risk factor for prostate cancer is older age. Prostate cancer typically arises in men at least 65 years old, although men with a strong family history of prostate cancer may develop it earlier.
Another major risk factor for prostate cancer is race. African-American men are more likely to develop prostate cancer than men of other races. They also tend to develop the disease at younger ages. Consequently, African-American men should begin PSA screening at 45 years old instead of 50 years old.
If you have one or more close relatives (such as a father, son, brother, or uncle) with prostate cancer, then you have a higher risk of developing the disease yourself. Physicians recommend that men with a family history of the disease start prostate cancer screening at younger ages than men with an average risk.
Even if prostate cancer doesn’t seem to run in your family, you may still carry a higher-than-average risk. For example, some of the genetic mutations that have been linked to prostate cancer are also known to cause breast cancer. If you have a number of female relatives with breast cancer, you could have one of these mutations.
What’s my risk?
For an accurate assessment of your prostate cancer risk, it’s best to speak to your physician, especially if you have specific risk factors. There are also digital calculators and other tools you can use to evaluate your risk.
Your Disease Risk
Physicians and researchers at the WashU Medicine and Barnes-Jewish have developed Your Disease Risk, an online tool to help you determine your risk for six chronic diseases and 12 different cancers, including prostate cancer. Take the assessment for prostate cancer.
Remember that any information you receive through Your Disease Risk or other digital tools is only an estimate. You should share your results with your physician to get a better picture of what they mean for you.
Prompt® genetic test
The nation’s leading urologists, including WashU Medicine urologic cancer surgeon Gerald Andriole, MD, have collaborated to develop a commercial genetic test for prostate cancer. Known as Prompt®, the test checks your genetic information for cancer-causing mutations. Prompt® is an accurate assessment that has been evaluated in clinical trials. So far, it has only been tested for use in Caucasian men. Researchers are working to make sure Prompt® will be effective in men of other races as well.
To use Prompt®, you collect a sample of DNA using a cheek swab and send it away for evaluation in a laboratory. The results will be sent to your physician, who will discuss them with you.
Keep in mind that tests like Prompt® should not be taken lightly. People can experience a range of emotions and reactions upon learning their genetic risk factors. Before taking the test, you should talk to your physician about what your results might be and what you might do with the information you receive.
There are several approaches to prostate cancer treatment. At Siteman Cancer Center, our WashU Medicine physicians build a custom treatment plan for each patient. These plans draw upon the latest research and the most advanced therapies available.
Sometimes, our experts determine that careful monitoring is preferable to immediate treatment. This approach, known as active surveillance, allows patients to maintain their normal quality of life while physicians closely track any signs of cancer progression through regular tests.
Treatments We Offer
The standard treatments for prostate cancer our physicians at Siteman Cancer Center offer include:
Active surveillance means watching a low-grade and non-aggressive prostate cancer instead of pursuing treatment right away. Doctors can safely watch many prostate cancers that they catch early with PSA screening. With careful monitoring, they will not cause the patient any pain or impact his quality of life.
In other words, what this means is that the patient has prostate cancer but is not issued a treatment plan, sparing the patient the harsh side effects of cancer therapies without reducing their lifespan.
If you and your physician decide that active surveillance is right for you, you’ll meet with your care team regularly to ensure your cancer hasn’t changed. Tests and procedures you may need to have done include a digital rectal exam, PSA blood test, ultrasound or MRI, or prostate biopsy.
Watchful Waiting – or Watch and Wait
Similar to active surveillance, watchful waiting (also referred to as watch and wait) involves watching low-grade and non-aggressive prostate cancers. However, watchful waiting is a less intensive way of observation with fewer tests. A patient reporting a change in symptoms guides the determination of whether they need treatment.
Doctors may consider watchful waiting a good option for slow-growing prostate cancers that don’t cause symptoms and remain contained to the prostate. It can be a good option for older patients who are not eligible for other treatment options or are already near the end of life.
The goal of this approach is to keep the patient comfortable while sparing them the side effects of cancer treatment. If the cancer spreads or starts to cause symptoms down the road, the patient may then decide to pursue treatment.
We do know that high-quality imaging is key to reducing tumor growth. Surgeons use MRI scans or other imaging tests to first visualize tumors, then use various forms of energy to destroy them. Surgeons may order cryoablation (freezing), laser ablation, or high-intensity frequency ultrasounds (HIFU) to destroy cancer cells without harming the prostate.
Since focal therapy can carefully remove cancer without harming the rest of the prostate gland, there is a reduced risk of urinary or sexual side effects.
Surgery
There are two main surgical procedures that treat prostate cancer:
Radical prostatectomy: removal of the prostate gland
Transurethral resection of the prostate: removal of a portion of prostate tissue. Patients might undergo this procedure as part of a broader treatment program.
WashU Medicine surgeons at Siteman Cancer Center only recommend surgery for prostate cancer when it’s absolutely necessary. They use minimally invasive methods whenever possible to reduce the risk of side effects.
Our physicians also conduct clinical trials that involve using immunotherapy or advanced hormone therapy to shrink prostate tumors before proceeding to surgery. Don’t hesitate to ask your care team if there are any clinical trials available that could make surgery easier for you.
Radical prostatectomy
During this prostate surgery, the surgeon removes the whole prostate gland, along with surrounding tissue, seminal vesicles, and sometimes nearby lymph nodes. Doctors perform this procedure when the cancer is confined to the prostate.
Long-term data on radical prostatectomies demonstrate that this deepens remission in the majority of patients whose cancer has not spread.
Although doctors performed this surgery in an open fashion in the past, we now perform it either laparoscopically or robotically. These minimally invasive approaches have dramatically reduced the pain and recovery time after surgery.
What is a transurethral resection of the prostate?
Surgeons perform this prostate surgery through the urethra using a tube called a resectoscope to remove prostate tissue. Doctors usually perform it for benign prostatic hyperplasia (BPH), a non-cancerous enlarged prostate. It can also relieve symptoms caused by a cancerous tumor before or after other treatments.
What are the side effects of prostate cancer surgery?
Many quality-of-life side effects, including changes in urinary and sexual function, are associated with prostate cancer treatment. Although the high-caliber urologic surgeons at Siteman have a lower rate of these side effects in patients they treat, every patient will, at a minimum, endure temporary changes in these domains.
Urologists at WashU Medicine are not only experts in prostate cancer treatment, but also experts in urologic reconstruction. We have experts who can manage your urinary and sexual function side effects successfully so that your long-term quality of life will not suffer.
Systemic Therapy for Prostate Cancer
Systemic therapies are a group of treatments that target cancer cells in the prostate. They can also eliminate cancer cells that have spread to other areas of the body, like the bones or lymph nodes. In general, systemic therapy for prostate cancer treats later-stage or metastatic disease.
Patients might ingest systemic therapies as pills — or they can receive them through an IV or injection.
WashU Medicine physicians at Siteman use newer drugs, such as new hormonal and immunotherapies, to fight prostate cancer. Some of these therapies stop cancer cells from spreading through new tissues or forming new blood vessels. They also pioneer studies of effective systemic therapy for patients with advanced prostate cancer.
There are three main types of systemic therapy for prostate cancer:
Hormone therapy
Chemotherapy
Immunotherapy
Given the rapidly evolving landscape of treatment for advanced prostate cancer, you are in expert hands at Siteman. Our WashU Medicine prostate cancer specialists are knowledgeable about the latest developments in systemic therapy. They are also actively investigating future advances through research studies.
For patients looking for experimental approaches when standard therapy hasn’t been successful, Siteman also offers a range of clinical trials.
Hormone therapy
Prostate cancer growth depends on androgens, which include the male sex hormones testosterone and dihydrotestosterone. Hormone therapy prevents prostate cancer cells from obtaining androgens, either by limiting the production of androgens or making it impossible for androgens to attach to the cancer cells. This slows or halts the progression of prostate cancer.
For patients who have metastatic prostate cancer, or whose prostate cancer has come back after surgery and/or radiation, hormone therapy is the standard of care.
Doctors may give hormone therapies in different combinations, depending on the stage of the cancer and the health of the patient. Researchers are always testing new combinations of therapies in clinical trials, and Siteman may offer them before many other treatment facilities gain access.
Prostate cancer patients may receive hormone therapy in pill form or as injections. Most people tolerate it well, but some experience side effects, such as mood swings and hot flashes, which people have called “male menopause.” If necessary, your physician can prescribe extra medication to relieve these symptoms.
Chemotherapy
Doctors will prescribe chemotherapy for some cases of advanced prostate cancer. Only two chemotherapy drugs have received approval to treat it – docetaxel (Taxotere) and cabazitaxel (Jevtena). This does not include other types of systemic therapy drugs for prostate cancer approved by the FDA.
Immunotherapy
Doctors can use immunotherapy for patients who do not respond to chemotherapy or other types of systemic therapies. This advanced form of treatment uses the body’s immune system to destroy prostate cancer cells.
For prostate cancer, immunotherapy is advancing for patients diagnosed with an advanced stage of the disease – and physicians and researchers at Siteman are leading those breakthroughs.
Radiation Therapy for Prostate Cancer
Radiation oncologists may deliver radiation to the prostate with the intent of eliminating cancer. Your care team may decide to pursue this treatment instead of surgery.
Doctors can treat some patients with low-grade disease using radiation alone, often with shorter courses and fewer appointments. They can also give it to relieve cancer symptoms.
The radiation therapy options available to patients at Siteman include:
Intensity-modulated radiation therapy (IMRT)
Stereotactic body radiotherapy (SBRT)
Brachytherapy, given as low-dose-rate (LDR) or high-dose-rate (HDR)
Proton beam therapy
Radiopharmaceutical treatments including Xofigo (radium-223) and Pluvicto (Lutetia 177)
If you receive radiation at Siteman, your doctors strive to ensure that your treatment is safe and effective. The radiation oncology team from WashU Medicine has developed new methods to target prostate cancer without harming nearby healthy tissue.
Radiation therapy uses energy to attack prostate cancer cells. It can sometimes cure early-stage prostate cancer, sparing patients a prostatectomy. Patients may also receive radiation after surgery to prevent the cancer from recurring. It’s often delivered over multiple treatment sessions.
As a prostate cancer patient at Siteman, you can take comfort in knowing that the internationally recognized team at WashU Medicine affiliates with your radiation oncology team. Our radiation oncology specialists are leaders in tailoring radiation therapy to each patient’s needs.
WashU Medicine physicians use innovative, high-tech methods to target the tumor while protecting surrounding tissues. They also work to limit the number of radiation sessions, meaning that they achieve optimal results while reducing the treatment burden on their patients.
External-beam radiation therapy treats prostate cancer with X-ray beams. The treatment is painless and only lasts for a few minutes at a time.
For patients whose cancer comes back after prior radical prostate surgery, radiation therapy can be an effective treatment. If the patient has had a prostatectomy, radiation targets the space where the prostate used to be.
Brachytherapy
Brachytherapy is a therapy that implants a radioactive source within the body. There are two different types of brachytherapy: low-dose rate (LDR) and high-dose rate (HDR).
High dose rate brachytherapy (HDR) involves temporarily placing a single radioactive source in the prostate using catheters. Radiation oncologists carefully control the time and position of the radioactive source to maximize the dose to the prostate and minimize the dose to the urethra, rectum, and bladder.
A typical one-day procedure of HDR will go through the following phases:
First, the radiation oncologist inserts the catheters in the morning in the operating room with the patient under general anesthesia.
The CT scan shows the radiation oncologist where to target the treatment for the patient.
The patient takes a combination of a long-acting local anesthetic and other medications to stay comfortable until treatment delivery.
Later that afternoon, oncologists will deliver the targeted treatment in less than 15 minutes.
Finally, the radiation oncologist removes the catheters.
Patients go home the same day and are not radioactive.
Doctors can use HDR brachytherapy alone to treat low-risk patients. It can also serve as a boost for higher-risk patients receiving external beam radiotherapy. Sometimes, radiation oncologists will recommend HDR brachytherapy to undo damage from LDR brachytherapy or external beam radiotherapy.
Since opening in 2014, over 200 patients have received this treatment at Siteman Cancer Center. Ours was the first medical center in the region to perform HDR brachytherapy for prostate cancer.
Proton beam therapy
Proton beam therapy eliminates cancer cells with protons instead of X-ray beams. The main advantage of this treatment is that doctors can adjust the proton beam to specific depths, allowing it to stop at its target instead of passing through the entire body like other radiation treatments do.
Doctors may use proton therapy alone or in combination with other radiation therapies and/or hormone therapy. Your physician will determine if you are an appropriate candidate for proton therapy and if you are eligible for any clinical trials.
The S. Lee Kling Proton Therapy Center at Siteman Cancer Center is the only proton therapy center located in Missouri and the surrounding region. It houses the world’s first compact proton beam accelerator. Radiation oncologists and physicists here helped evaluate the system and developed the patient protocols as well as the quality standards for this advanced technology.
Theranostics for Prostate Cancer
Theranostics is the combination of diagnosis and therapy using radiopharmaceuticals to image and provide radioactive targeted therapy. Theranostics is an approach used in several cancer types, including prostate cancer, neuroendocrine tumors, and differentiated thyroid cancers, among others.
Theranostics’ targeted approach to cancer care combines:
high-resolution imaging from positron emission tomography (PET) or single photon emission computed tomography (SPECT) with a
highly specialized, radioactive, cancer-specific pharmaceutical, called a “radiopharmaceutical.”
Who is eligible for theranostics?
Theranostics works well for a few different cancer types, including advanced stages of prostate cancer. The term “theranostics” blends diagnostics and therapeutics. This cancer treatment uses radiopharmaceuticals to first image the cancer. Then, it delivers targeted therapy tailored to a person’s specific cancer growth.
WashU Medicine physicians in the Division of Nuclear Medicine and Department of Radiation Oncology will assess whether the specific radiopharmaceutical used in theranostics is a good treatment option for a patient with prostate cancer. Unlike external beam radiation therapy, the targeted radiopharmaceutical therapy delivers short-range beta or alpha particles directly to the tumor.
To see if a patient is eligible for theranostics, oncologists look for the presence (or absence) of a specific target on their cancer cells through specialized imaging, such as a positron emission tomography (PET) scan. If PET imaging shows enough targets on the cancer cells, then the radiopharmaceutical will be able to attach and deliver a high radiation dose to the cancerous tissue.
What radiopharmaceuticals are used in treating prostate cancer?
Currently, doctors are using two pharmaceuticals at different stages of prostate cancer: Pluvicto (also called Lu-177 PSMA) and Xofigo (also called Ra-223). A healthcare professional delivers both drugs through an IV.
As part of the therapy, the medical team will image the patient using single photon emission computed tomography (SPECT) scans to confirm that the therapy has reached the cancer cells.
Effects of Prostate Cancer Treatment
Cancer treatment focuses on positive outcomes, such as removing cancer cells, reducing tumor size, preventing recurrence, and improving survivability. However, many of these treatments can take a toll on patients. Knowing what to expect can help you make treatment decisions and get the support you need to deal with the side effects of treatment for prostate cancer.
What follows is not an exhaustive list but covers some of the more common side effects most patients report. It’s important to tell your physician during treatment about any unexpected symptoms that come up. Oftentimes, they have interventions they can prescribe to help you maintain comfort and your quality of life.
Side effects of hormone therapy for prostate cancer
Short term: Impotence and hot flashes
Intermediate: Metabolic syndrome (increased cholesterol and triglycerides, higher body fat and depression)
Long term: Accelerated osteoporosis, increased risk of diabetes and cardiac toxicity
Side effects of chemotherapy for prostate cancer
Low blood counts: 70% of patients who undergo chemotherapy have lower blood counts, increasing the risk for infection or anemia. Physicians help you manage these through active surveillance.
Nausea and vomiting: This side effect is very rare in prostate cancer treatment. If it does appear, our prostate cancer specialists have considerable experience managing this side effect so cancer therapy can continue, and you can live your normal life.
Peripheral neuropathy: Chemotherapy-induced peripheral neuropathy (CIPN) is a set of symptoms that can occur following damage to the nerves that control the sensation in your arms and legs.
Sleep disorders: Cancer, pain or certain drugs and treatments may disturb your sleep.
Depending on the type of chemotherapy, other side effects may apply. Your doctor should have information sheets available on the most common side effects for your specific drug. They will have recommendations on how to manage these symptoms or will prescribe medications that can help.
Cardiotoxicity
Physicians at WashU Medicine are ready to help if patients need intervention, even though patients who undergo prostate cancer treatment experience fewer cardiac issues.
Cardio-oncology is a newer medical discipline that focuses on optimally treating any associated heart conditions in patients who have received or are currently receiving cancer treatment – also known as cardiotoxicity. These subspecialized cardiologists assess patients for the potential risk of developing certain heart conditions, especially if they are receiving certain cancer drugs known to effect the heart or following radiation treatment to the chest.
Button: Learn more about cardio-oncology at Siteman
Siteman wants to be your first choice for cancer care, but that might not always be possible. If you have received a cancer diagnosis, started care somewhere else, or are a physician seeking specialized care for your patient, ask us about a second opinion. You can start the process. To make it easy, our care coordinators guide scheduling for yourself or your patient.
The only way for a physician to truly diagnose prostate cancer is through a biopsy. This involves collecting a small sample of prostate tissue and examining it under a microscope for cancerous cells. Recent research has found, however, that many patients with high PSA levels don’t actually need biopsies.
As a Siteman patient, your care team will only test you when absolutely necessary. WashU Medicine urologists use a range of techniques and tools to identify at-risk patients who require biopsies. Our experts perform all testing as precisely as possible.
The earlier doctors diagnose prostate cancer, the easier they can treat it. However, because prostate cancer usually causes no symptoms in its early stages, someone could have prostate cancer and not know it. That is why screening with the PSA blood test is very important. The PSA remains the best way to diagnose prostate cancer as early as possible.
Prostate Cancer Symptoms
If you’re experiencing any of these symptoms, it does not mean that you have prostate cancer. Other health problems can cause any of these symptoms. Still, it’s important to speak with your provider about any symptoms that last longer than two weeks. It could very well be nothing, but it’s best to know for sure what’s going on in your body so that you can get whatever care you may need.
Symptoms of prostate cancer can include the following; though this is not an exhaustive list:
Weak or interrupted (“stop-and-go”) flow of urine
Sudden urge to urinate
Frequent urination (especially at night)
Trouble starting the flow of urine
Trouble emptying the bladder completely
Pain or burning while urinating
Blood in the urine or semen
A pain in the back, hips, or pelvis that doesn’t go away
These symptoms are similar to another non-cancerous condition called benign prostatic hypertrophy (BPH), an enlargement of the prostate that can occur as males age. The prostate may get bigger and block the urethra or bladder, causing trouble urinating or sexual problems. Even though it’s not cancer, patients may still need surgery.
Tests to Diagnose Prostate Cancer
At Siteman, WashU Medicine prostate cancer specialists perform a range of urine, blood, and imaging tests to determine whether high PSA scores indicate a real risk of aggressive prostate cancer.
When our experts do recommend a biopsy, they often use advanced imaging methods to make sure they target the correct area of the prostate.
Urine and blood-based biomarkers
These tests evaluate a patient’s blood and urine for signs of potential prostate cancer. Depending on the results, doctors may decide that a patient’s high PSA score does not indicate cancer.
There are many urine- and blood-based biomarker tests. WashU Medicine prostate cancer specialists at Siteman lead in identifying and assessing the accuracy of biomarkers for the correct diagnosis of prostate cancer and for differentiating aggressive disease from slow-growing disease.
MRI
Magnetic resonance imaging (MRI) scans help the urologist identify which part of the prostate to biopsy and check for signs of cancer in the surrounding tissue.
Clinicians and researchers at Siteman are researching ways to combine biomarkers and MRI scans to predict which patients with high PSA scores have cancer and which of those patients have a more serious form of the condition.
Transrectal ultrasound
During this test, the urologist inserts a finger-sized probe into the rectum to check the prostate. The probe bounces high-energy sound waves (ultrasound) off internal structures to create a picture.
WashU Medicine prostate cancer experts at Siteman have begun to explore the use of newer ultrasound technology that allows for higher-resolution imaging of the prostate, which is available at only a few locations in the world.
Biopsies
There are a few different types of biopsies your physician may order after reviewing your medical history.
MRI fusion-guided biopsy
MRI ultrasound fusion-guided biopsies combine a patient’s MRI scan and ultrasound imaging to pinpoint the suspicious area of the prostate. The imaging detail can help physicians recognize when they can treat cancers with non-surgical methods.
Who should get the UroNav MRI-Guided Biopsy?
Patients with elevated PSA but haven’t had a biopsy.
Patients with history of high PSA but whose conventional biopsy hasn’t revealed cancer.
Patients whose conventional biopsy has led to a diagnosis of small prostate cancer.
What benefits can patients expect from this procedure?
A better biopsy, since conventional biopsies can mischaracterize and underestimate the size of a malignant prostate tumor.
More precise information on the location of the tumor for removal.
Transrectal biopsy
During this procedure, the urologist inserts a thin needle into the rectum through a small ultrasound probe and collects cells from the prostate for examination.
Transperineal biopsy
Although transrectal biopsy is available at many locations, Siteman urologists conduct a high number of transperineal biopsies that go through the skin rather than the rectum. This dramatically reduces the risk of infection and improves the quality of the biopsy.
After a Diagnosis
Once doctors diagnose prostate cancer, they give it a grade on a scale of 2 to 10. The scale indicates how aggressive the cancer is, with 10 being the highest.
Doctors determine the grade, called a Gleason score, based on the tissue samples they collect from the prostate during the biopsy.
Depending on the patient’s PSA level and Gleason score, doctors may need to conduct additional tests to determine if the cancer has spread to other parts of the body.
Conventional staging imaging includes a PET scan, bone scan, or a CT scan.
PET scan: the most commonly used, a PET scan will reveal areas of abnormal cell activity in the body, allowing physicians to detect cancer that has spread to lymph nodes, bones, or other organs.
Bone scan: demonstrates abnormal bone activity, which could indicate prostate cancer that has spread into the bone (in metastatic prostate cancer).
CT scan: takes detailed pictures of organs to determine if the cancer has spread outside the prostate.
Prognosis for Patients with Prostate Cancer
For the most part, the prognosis of prostate cancer is very good. Most patients who get a prostate cancer diagnosis after a PSA screening benefit from finding the disease early. Doctors can either observe the majority of prostate cancers detected this way with active surveillance or eliminate the cancer with a prostatectomy.
For patients with more aggressive disease, prognosis depends on many factors:
The stage of the cancer
Gleason score
PSA level
The patient’s age
The treatment approach – surveillance, surgery, radiation, etc.
Treatment options may also depend on the patient’s general health, expected side effects of treatment, past treatment for prostate cancer, and the wishes of the patient.
At Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine, we diagnose and treat prostate cancer with the most sophisticated imaging techniques, diagnostics, and therapies available. Our multidisciplinary team sees approximately 1,000 new prostate cancer patients a year.
Prostate cancer is the most common type of cancer for males in the U.S.—1 in 8 will develop it during their lifetime. Owing to advances in early diagnosis and effective treatments, most people diagnosed with prostate cancer have a better chance of survival.
Most patients begin to suspect they have prostate cancer after obtaining an elevated PSA level or an abnormal digital rectal examination. The PSA blood test measures the level of prostate-specific antigen in the blood.
Physicians will decide which patients with high PSA levels need biopsies. They also determine which prostate cancer patients need localized treatments for the prostate and nearby tissues, such as surgery or radiation.
Why Choose Siteman
Siteman Cancer Center holds recognition as one of the highest-ranked cancer institutes by the National Cancer Institute (NCI), among peer organizations and by other leading authorities, consistently achieving the highest rankings for cancer care regionally, nationally, and around the globe.
Siteman has led the field in the development of genomic testing for personalized, targeted treatment. We were the first institution to sequence the DNA of a cancer patient. Today, our patients’ genetic information gives us even more insights into their cancer. This helps us better meet every patient’s unique treatment needs.
WashU Medicine researchers investigated DNA-based cancer treatments and began the first clinical trial of a “neoantigen” DNA vaccine for metastatic prostate cancer. This vaccine targets the unique mutations in each patient’s tumor to help the immune system fight these mutations.
They also conducted the world’s largest single-institution prostate cancer screening study with more than 32,000 men and led the NCI-funded PLCO cancer screening trial, which evaluated genetic data from 80,000 men.
Accurate, Customized Diagnostic Techniques
WashU Medicine physicians at Siteman use cutting-edge tests to check each patient’s level of risk and ensure that they receive the correct diagnosis.
We pride ourselves on our advanced use of imaging to assess patient risk, and often pair MRI scans with biopsies to ensure that we find the worst part of the cancer. In fact, we are one of the few centers in the U.S. that have published a number of studies demonstrating the benefit of prostate MRIs as a diagnostic tool. We also have trials for leading-edge imaging methods, such as PSMA and other PET/CT scanning techniques.
WashU Medicine urologists are also working to pair imaging with biomarker tests for maximum accuracy. Biomarkers are traces of disease that can be present in the blood or urine. They assist physicians in gauging the severity of your prostate cancer and can potentially predict how different therapies will work for you. Investigators at Siteman are developing novel “liquid biopsy” tests to determine which patients will respond best to certain prostate cancer drugs.
Refer Your Patient to Siteman Cancer Center
A Siteman care coordinator is the fastest path to referral, consult, or second opinion. Our care coordinators – oncology nurses who help with scheduling and navigation – will guide you from your first call.
WashU Medicine urologists at Siteman know that not every patient with prostate cancer needs treatment. Instead, doctors can carefully track some patients with lower-risk prostate cancer. We call this type of close monitoring active surveillance.
In other patients with prostate cancer, it isn’t necessary to remove the entire prostate. The newest advance in prostate cancer care is focal therapy, which is a method of treating the prostate cancer tumor without major surgery. Focal therapy may involve removing only the cancerous part of the prostate, freezing the tumor, or shrinking the tumor with high-intensity ultrasound.
Radiation therapy can also cure prostate cancer instead of surgery. WashU Medicine physicians at Siteman excel in these techniques.
For patients needing prostate removal, WashU Medicine surgeons and urologists excel in a nerve-sparing radical prostatectomy. This method protects surrounding nerves during the operation. This procedure helps preserve normal urination and sexual function.
WashU Medicine surgeons excel in robotic, laparoscopic, and open (or conventional) prostate removal. They have completed thousands of prostate operations, which makes our team one of the most experienced in the United States. Patients who come to Siteman generally have higher rates of cure and improved physical well-being.
Clinical Trials
WashU Medicine physicians at Siteman are actively involved in clinical trials for prostate cancer. They investigate new technology for accurately diagnosing and effectively treating the disease. Getting your prostate cancer treated at Siteman offers you new diagnostic and treatment options. These methods may be as effective or even better than standard therapies found elsewhere.
As prostate cancer treatment continues to evolve, it is important for you to receive care at a cancer center that offers all treatment options. Siteman offers FDA-approved medications and treatments. They also provide access to the latest therapies for prostate cancer through clinical trials.
Clinical Trials at Siteman Cancer Center
Clinical trials are research studies that help us find new ways to prevent, diagnose, and treat cancer. If you have a rare or complex diagnosis or your treatment path seems uncertain, you might qualify for a clinical trial.
Our team will help you find a study that is right for you. Call us to speak with a Siteman care coordinator.
At Siteman, we understand that excellent cancer care takes a personal touch. Our experienced nurses are specially trained to support cancer patients and will help you cope with your symptoms, treatments, and side effects. We have registered dietitians on staff who can provide guidance about nutrition and suggest ideas for meals and snacks that will taste good as you move through your treatment plan.
In addition, patients and family members who desire mental health care can receive free treatment from our team of skilled cancer psychologists. Social workers are also available to meet with patients.
Start Here. Get the Care You Need.
Our Siteman care coordinators – oncology-trained nurses who help with scheduling, finding the right specialist, and guidance – can help you through the process.
Call us directly or submit a form, and we will call you back.
