Department of Medical Oncology
Atrayee Basu Mallick, MD
Avnish Bhatia, MD
Christina Brus, MD
Andrew E. Chapman, DO, FACP
Jean Hoffman-Censits, MD *
W. Kevin Kelly, DO *
Jianqing Lin, MD *
Michael J. Ramirez, MD
Lewis J. Rose, MD
*Practice Focus: Genitourinary Oncology
For further information contact:
Thomas Jefferson University Hospital
Each year, more than 186,000 American men learn they have this disease. Prostate cancer is the second most common type of cancer among men in this country. Only skin cancer is more common. Risk factors include age over 65 years (the chance of getting prostate cancer increases as you get older), family history of the disease, race (it is more common among black men than any other race), men with certain prostate changes (high-grade prostatic intraepithelial neoplasia (PIN), or certain genome changes.
Prostate cancer forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). Prostate cancer usually occurs in older men.
Stage I: The cancer can't be felt during a digital rectal exam, and it can't be seen on a sonogram. It's found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate. The grade is G1, or the Gleason score is no higher than 4.
Stage II: The tumor is more advanced or a higher grade than Stage I, but the tumor doesn't extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.
Stage III: The tumor extends beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven't spread to the lymph nodes.
Stage IV: The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.
When indicated, a prostatectomy can be performed either laparoscopically or via open surgery. Jefferson physicians were the first in the Delaware Valley to remove the prostate using the robotic daVinci Surgical System.
The brachytherapy program for the treatment of prostate cancer was founded in 1996 and has achieved a national reputation for excellence. Over 18 original papers have been published that further the understanding of this modality. Jefferson is the only hospital in the Philadelphia area to offer the Dose Verification System (DVS) dosimeter, the first implantable dosimeter cleared by the FDA. Two dosimeters, one implanted on each side of the prostate, verify that the patient is receiving the prescribed dose of radiation.
While hormone therapy has been the standard of treatment for advanced prostate cancer for over 60 years, recently we have had good outcomes with androgen ablation through various means for patients with earlier stages of disease. The strongest evidence to date involves the use of hormonal therapy in combination with radiation therapy. Our center was the first in the area to offer sipuleucel-T (Provenge), an exciting new treatment avenue that has been shown in clinical trials to extend survival for patients with advanced prostate cancer.
Reference: National Cancer Institute. http://www.cancer.gov/cancertopics/types/prostate