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Published on August 31, 2018

Prostate Cancer: Screenings, Treatment and Survivorship

Prostate CancerIn this Fox 8 House Call series, Cone Health experts discuss prostate cancer topics, including:

Screening Recommendations

Prostate cancer is the most common form of cancer in men and the second leading cause of cancer death in men. The Prostate-Specific Antigen (PSA) test, widely used to screen men for prostate cancer, measures a protein secreted by the prostate that can become elevated in men who have cancer. While this test has been useful in decreased death rates from prostate cancer, there has been controversy surrounding its routine use due to concerns that some cancers are not lethal and may be overtreated.

Some men may benefit from PSA testing for early detection of prostate cancer more than other men. Typically, men with a life expectancy of at least 10 years benefit the most from screening, whereas men with shorter life expectancies do not. Men at a higher risk of prostate cancer, including men with a first-degree relative who has had prostate cancer (family history) or African-American men, should strongly consider screening.

Not all prostate cancers are now treated aggressively. Many men with slower growing cancers are now managed with active surveillance or monitoring of their condition, reserving aggressive treatment for those men with faster-growing cancers. Other advances include the use of MRI to more accurately detect prostate cancers that are potentially life-threatening. In Greensboro, we are now using MRI/Ultrasound fusion biopsies in many men to help better determine which men have aggressive prostate cancer and which men do not. We also have a dedicated multidisciplinary prostate cancer team to provide multiple experts to assist in personalizing care for the individual patient recognizing that every man’s situation is different.

Les Borden, MD, is a urologist in Greensboro and a member of the Cone Health Medical and Dental Staff.

Advances in Treatment and Side Effects

Prostate cancer is the most common form of cancer in men, which has led to many technological advances in treatment options. While it is a common form of cancer, there is no one-size-fits-all when it comes to treatment. At Cone Health, physicians work with patients to develop a customized treatment plan based on their individual needs.

There are many treatment options for prostate cancer. For men with localized prostate cancer, these include active surveillance, prostatectomy, external radiation therapy and prostate brachytherapy.

  • Active surveillance is an excellent choice for men with low risk disease. With this option, men work with their urologist to carefully track the prostate cancer with lab work and other tests. Additional treatment such as surgery or radiation can be given at any time if the cancer shows signs of progression.
  • Surgery has become a very popular option with the advent of the DaVinci robot. Robotic prostatectomies can be performed through small incisions, and the recovery time is rapid.
  • External radiotherapy can now be given using image-guided intensity modulated radiotherapy, which allows radiation oncologists to pinpoint the location of the prostate and treat it with effective doses of radiation while sparing nearby organs from exposure.
  • Prostate brachytherapy, also known as seed implant, is a minimally invasive outpatient procedure to implant radioactive "seeds" into the prostate gland to kill cancer cells.

The Cone Health Cancer Center has recently adopted the use of SpaceOAR, a polymer gel used during brachytherapy. The gel pushes the rectum away from the radiation of the seeds, reducing the amount delivered to the rectum, resulting in fewer side effects due to treatment.

For men with more advanced or refractory cases, where cancer has spread or doesn’t respond to treatment, Cone Health offers a wide variety of systemic therapies that treat cancer throughout the body. One of the more recent advances offered by Cone Health is a radioactive infusion of Radium-223, which is performed monthly for six doses as an outpatient procedure. Radium-223 has been shown to improve survival with minimal side effects.

A prostate cancer diagnosis can certainly evoke fear and anxiety in an individual, and it is important for patients to become their own advocate when discussing treatment options with their doctor. Cone Health Cancer Center’s radiation oncologists and medical staff collaborate with urologists and other related health care providers throughout the community to develop treatment plans individualized to each patient’s needs.

Matthew Manning, MD, is a radiation oncologist and leading expert on treatment advancements at the Cone Health Cancer Center.

Life After Prostate Cancer

Prostate cancer is the most common form of cancer found in men. Early detection of prostate cancer through the use of screening tools like the prostate-specific antigen (PSA) test has significantly decreased the amount of cancer-related deaths. Through early screening and appropriate treatment, more than 2.9 million American men can now claim to be prostate cancer survivors.

A cancer diagnosis can be a frightening time for anyone, which is why having people around you who support and encourage you can be so essential. For men that have been diagnosed with prostate cancer, whether they have had treatment or not, Cone Health offers a prostate cancer support group. No matter where a man is in his journey, he can come and find other men who have been where they are and who can share in what they are feeling. This group seeks to provide a time for members to meet and talk about their experience with their diagnosis and treatment, and lend emotional support in choosing a treatment method, the physical impact of their treatment choice and the possible impact on their personal relationships.

Spouses can also join the group to meet with other caregivers who can relate to what they’re going through and find encouragement. Groups may also involve a speaker to discuss things like nutrition and treatment options. This group meets on the third Monday of each month from 6 to 7:30 p.m. Dinner is provided to all members.

As part of its dedication to raising cancer awareness throughout the community, and in honor of Prostate Cancer Awareness Month, Cone Health Cancer Center will be offering free prostate cancer screenings. Screenings will be offered from September through October in Greensboro, Reidsville, High Point, Kernersville, Mebane, Madison, Stoney Creek, Brown Summit and Alamance County. To find out when the next screening nearby is, call 336-832-8000 or visit the screenings page on

Robin Bass, BSN, RN, CRNI, is the nurse navigator for the prostate cancer multidisciplinary clinic at the Cone Health Cancer Center.

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