Urologic Cancers – Prostate Cancer
Prostate cancer is the most common cancer in men in the United States after skin cancer. About 1 in 8 men receive a prostate cancer diagnosis during their lifetime, and it is a leading cause of cancer death in men, second only to lung cancer.
At Riverstone Urology in Cypress, Dr. Russell Libby evaluates elevated PSA levels, abnormal exams, and prostate cancer diagnoses with a clear focus, early detection, thoughtful use of treatment, and protection of long term quality of life.
What Is Prostate Cancer?
Prostate cancer starts when cells in the prostate grow in an uncontrolled way and form a tumor. The prostate is a small walnut sized gland below the bladder that helps produce semen.
Most Prostate Cancers Are
- Adenocarcinomas, which start in gland cells in the prostate
- Slow growing, especially in early stages
- Confined to the prostate at diagnosis in many men
Some cancers grow faster and spread to lymph nodes, bones, or other organs if not treated.
Symptoms
Early prostate cancer often causes no symptoms at all. Many men learn they have cancer after routine screening with a PSA blood test or digital rectal exam.
As Cancer Grows Or Spreads, Possible Symptoms Include
- Trouble starting or stopping urine flow
- Weak or interrupted urine stream
- Need to urinate often, especially at night
- Burning or pain with urination
- Blood in urine or semen
- New erectile dysfunction
- Pain in the hips, back, or chest
- Weakness or numbness in the legs if cancer reaches the spine
These problems are also common with benign prostate enlargement and infections, so symptoms alone do not prove cancer. They do mean you should get checked.
Risk Factors
You cannot change some risk factors, but you can know them and respond early.
Key Patterns Linked To Higher Risk
Age
- Risk rises with age
- Most prostate cancers are diagnosed after age 65
Family History
- A father, brother, or son with prostate cancer raises your risk
- Several affected relatives or early diagnoses in the family increase concern
Race And Ethnicity
- Black men in the United States and Caribbean have higher rates of prostate cancer and higher death rates from the disease
Other Factors
- Obesity
- Possible links with diet patterns and certain environmental exposures, based on large population studies
Having risk factors does not mean you will develop cancer. Many men with prostate cancer have no clear risk factor other than age.
When To See Dr. Libby
You Should Schedule A Visit With Riverstone Urology If
- Your PSA blood test is higher than expected for your age
- Your doctor feels something abnormal on a prostate exam
- You see blood in your urine or semen
- You have new urinary symptoms that do not improve with simple treatment
- You have strong risk factors and have never discussed screening
Guidelines now encourage a shared decision about screening, where you and your doctor review your risk and preferences before starting or stopping PSA testing.
How Prostate Cancer Is Diagnosed
There Is No Single Test That Tells The Full Story. Diagnosis And Staging Combine Several Steps.
History And Exam
Dr. Libby reviews
- Urinary symptoms and how long they have been present
- Sexual function
- Past PSA values and trends
- Family history and other health conditions
A digital rectal exam helps assess the size and feel of the prostate and look for suspicious nodules or firmness.
PSA Blood Test
PSA, prostate specific antigen, is a protein made by prostate cells. High or rising PSA levels can signal
- Prostate cancer
- Benign prostate enlargement
- Infection, inflammation, or recent procedures
Trends over time, current level, and age all matter when judging PSA results.
Imaging And Targeted Tests
Depending on the situation, evaluation may include
Multiparametric MRI of the prostate
MRI guided or ultrasound guided biopsy of suspicious areas
CT, bone scan, or PET imaging when cancer appears higher risk or PSA is very elevated
Prostate Biopsy
If findings suggest a high chance of cancer, a biopsy removes small cores of tissue from the prostate using a needle. Pathologists check
- Whether cancer is present
- Gleason score and Grade Group, which describe how aggressive the cells look
- How much of each core is involved
This procedure both treats many early tumors and provides the information needed for staging and planning.
This information guides treatment choices.
Staging And Risk Groups
Staging Describes How Far Cancer Has Spread. Key Pieces Include
- Tumor size and whether it is felt on exam
- PSA level
- Gleason score and Grade Group
- Any spread to lymph nodes or distant organs
Based on these details, prostate cancer is grouped into low, intermediate, and high risk categories. These groups help match you with appropriate treatment and follow up intensity.
Treatment Options At Riverstone Urology
There is no single “right” treatment for every man. Many cancers grow slowly and allow time for careful decisions. Others need more prompt, intensive care. Treatment planning always accounts for your cancer features, age, other medical conditions, and personal priorities.
Active Surveillance
For many men with low risk, small volume prostate cancer, active surveillance is a thoughtful choice.
This approach includes
- Regular PSA tests
- Repeat exams
- Periodic imaging and, in some cases, follow-up biopsies
Treatment starts only if there are signs that the cancer is growing or becoming more aggressive. Active surveillance aims to avoid or delay side effects from surgery or radiation in men whose cancer behaves quietly.
Surgery, Radical Prostatectomy
Surgery removes the entire prostate and some nearby tissue and lymph nodes.
Goals
- Remove all visible cancer
- Provide precise staging information
- Give the best chance of long term cure in many localized cases
Modern approaches often use minimally invasive and robotic techniques to improve precision and support recovery. Important nerves and structures that control continence and erections are protected as much as possible, when safe to do so.
Radiation Therapy
Radiation treats cancer by directing focused energy at the prostate. Options vary by case and may include
- External beam radiation therapy
- Internal radiation, brachytherapy, using seeds or temporary catheters
Radiation is a strong choice for many men with localized or locally advanced disease, and is sometimes combined with hormone therapy.
Hormone Therapy, Androgen Deprivation
Prostate cancer cells rely on male hormones, androgens, such as testosterone. Hormone therapy lowers or blocks these hormones to slow or shrink cancer. It often pairs with radiation or treats advanced and metastatic disease.
Common methods
- Medicines that lower testosterone
- Medicines that block hormone action on cancer cells
This close watch lets your team find and treat new tumors while they are still small.
Systemic Therapy For Advanced Disease
If cancer spreads beyond the prostate or returns after local treatment, options expand to include
- Next generation hormone blocking drugs
- Chemotherapy
- Targeted agents and newer combinations
These treatments are usually coordinated with medical oncologists who focus on genitourinary cancers.
Side Effects And Quality Of Life
The Main Potential Side Effects Of Local Treatment Include
- Urinary leakage
- Changes in urinary stream
- Erectile dysfunction
- Changes in ejaculation
Not every man experiences these problems, and many improve over time. Realistic discussion before treatment helps you weigh cancer control against possible impact on daily life.
Long Term Follow Up Addresses
- PSA levels and risk of recurrence
- Bladder and bowel function
- Sexual health
- Emotional wellbeing after a cancer diagnosis
Prostate Cancer Care At Riverstone Urology
At Riverstone Urology In Cypress, Serving The Northwest Houston Region, You Receive
- Clear explanations of your PSA results and exam findings
- Thoughtful use of biopsy, imaging, and genetic information when appropriate
- A balanced review of active surveillance, surgery, radiation, and systemic therapy choices
- Coordination with trusted oncology partners for complex or advanced cases
- Long term follow up that focuses on both cancer control and everyday quality of life
If you have an elevated PSA, an abnormal exam, or a new diagnosis of prostate cancer and want a careful, straightforward review of your options, contact Riverstone Urology to schedule a consultation with Dr. Libby. Early, informed decisions give you the strongest chance to live well during and after prostate cancer treatment.