Prostate Cancer from Detection to Treatment


What is Prostate Cancer?

Prostate cancer begins in the prostate gland - a small gland in men that produces semen. It is one of the most common cancers in men, especially over age 50.

Most prostate cancers grow slowly, but some can be more aggressive.


1. Initial Detection / Screening

Routine Screening
Prostate-specific antigen blood test
Digital rectal exam

Symptoms that may trigger testing
Difficulty urinating
Frequent urination
Weak stream
Blood in urine or semen
Pelvic/back pain


2. Diagnostic Testing

Repeat PSA testing
to confirm persistently high PSA.

Multiparametric MRI
shows suspicious areas in the prostate.

Prostate biopsy
Transrectal ultrasound
MRI-targeted biopsy

Pathology - Determines
Gleason Score
Cancer grade group (1–5)
Localized vs advanced features


3. Staging

Imaging
Bone scan
CT/MRI of pelvis and abdomen
PSMA PET scan

Staging system
Localized (Stage I–II)
Locally advanced (Stage III)
Advanced/metastatic (Stage IV)


4. Treatment Options

Active Surveillance

For low-risk, slow-growing cancers.
Regular PSA tests, MRIs, & repeat biopsies.
Treatment only if cancer progresses.

Surgery

Radical prostatectomy
removal of prostate gland, seminal vesicles, and sometimes lymph nodes.

Open
Laparoscopic
Robot-assisted

Side effects
Urinary incontinence
Erectile dysfunction

Radiation Therapy

External beam radiation therapy.
Brachytherapy

Hormone Therapy - ADT

Lowers testosterone
Used for advanced or high-risk localized cancer
Medications
LHRH agonists/antagonists (leuprolide, degarelix).
Anti-androgens (bicalutamide, enzalutamide).

Chemotherapy

For metastatic castration-resistant prostate cancer
Common drugs
Docetaxel
Cabazitaxel.

Targeted & Novel Therapies

PARP inhibitors
Radiopharmaceuticals
Immunotherapy


5. Palliative & Supportive Care

Pain control for bone metastases
Managing urinary symptoms
Counseling for sexual health, incontinence, psychological support


6. Follow-Up and Survivorship

PSA monitoring:
every 3–6 months after treatment, then annually.

Imaging scans:
if PSA rises or symptoms suggest recurrence.

Lifestyle:
exercise, healthy diet, weight management, avoid smoking.

Long-term monitoring:
recurrence can occur even years later.