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Prostate Cancer

Prostate Cancer

What Is Prostate Cancer?

Orange County CyberKnife and Radiation Oncology Center are experts in prostate cancer treatment. The prostate is a walnut-sized gland that weighs about 1 ounce and makes a fluid that sustains semen. It surrounds the male bladder and the urethra, which carries urine from the bladder of the body. The rectum is located behind the prostate, and doctors can examine the gland by hand from this area.

Prostate cancer occurs when the formation of abnormal cells in the prostate gland creates a lump. The cells can grow rapidly and sometimes spread to other parts of the body. It is the most common non-skin cancer, affecting 1 in 7 American men.

Our world renowned radiation oncology team and doctors will discuss the range of advanced non-surgical radiation treatment options available to you and the success rates with each type. When caught early, before spreading to other parts of the body, prostate cancer is extremely treatable as shown in the chart below:

Prostate Cancer Survival Rates*
5-Year Survival Rate 10-Year Survival Rate 15-Year Survival Rate
99% 98% 95%

* Percent still living after initial diagnosis, includes all stages of men who die of prostate cancer.

Almost all prostate cancers are considered acinar adenocarcinoma type (90%), meaning it begins in the prostate gland cells, grows slowly, and is unlikely to spread. There are a few subtypes of adenocarcinoma, but they are all treated the same. The other 10% of prostate cancers may be one of six other types of rare cancer and knowledge is limited about the best treatments for these.

Prostate Cancer Risk Factors

There are only a few risk factors that might increase a man’s risk of getting prostate cancer. There are many more factors that researchers think MAY have an impact, while there are others where there is no evidence linking them to prostate cancer. Having one or more risk factors doesn’t mean you’re going to get cancer.

  • Age. As you grow older, your risk of prostate cancer increases. More than 65% of all prostate cancers are diagnosed in men over the age of 65. For men 40 to 59, there is a 1 in 38 chance; for 60 to 69, a 1 in 14 chance; and for those under 40, the disease is unlikely (only 1 in 10,000 chance). The average age of prostate cancer diagnosis is 69 years in the United States. After that, the chance of developing prostate cancer becomes more common than any other cancer in men or women.
  • Race/ethnicity. Though it’s not clear why, if you’re African-American you are more likely to contract prostate cancer and two-and-a-half times more likely to die from it than Caucasian men. Asian-American and Hispanic men are less likely to get prostate cancer compared to non-Hispanic whites. Asian men who live in Asia have the lowest risk.
  • Geography. You may be at greater risk of prostate cancer depending on where you live. If you live north of 40 degrees latitude, you have the highest risk of dying from prostate cancer in the United States. Researchers believe this is because of lack of Vitamin D, caused by diminished sunlight during three months of the year. Prostate cancer is also most common in North America, northwestern Europe, Australia, and the Caribbean islands. It is less common in Asia, Africa, Central America, and South America. The reasons for this are unclear, but may be related to the ability to screen more patients in developed countries. Other lifestyle differences might be important as well. For example, for men in the U.S., the risk of developing prostate cancer is 17%. For men who live in rural China it’s only 2%, but if Chinese men adopt western culture their risk increases substantially.
  • Family history. If you have a father or brother with prostate cancer, you are twice as likely to have the disease. If your family member was diagnosed at less than 55 years old, or if more than two family members were diagnosed, your risk is even greater. This fact seems to show there could be a genetic or inherited factor associated with prostate cancer. Still, most men who have prostate cancer don’t have any family history.
  • Gene changes. Several inherited gene changes seem to raise prostate cancer risk, but they probably account for only a small percentage of cases overall.
  • Other potential risks. Several factors are being studied and some have shown the possibility of having an effect on the risk of prostate cancer, but are inconclusive. These include: diet, obesity, smoking, chemical exposures, prostate inflammation, sexually transmitted diseases, and vasectomy.
  • Myths. Other risk factors are pure myth as they have NOT proven any association with prostate cancer. They include: level of sexual activity, medications (aspirin, statins), alcohol, and Vitamin E.

Contact Us about Prostate Cancer Treatment Today

At Orange County CyberKnife, you’ll find a variety of radiotherapy options to treat both cancerous and non-cancerous tumors throughout the body, including the non-surgical CyberKnife Robotic Radiosurgery system. Find out more about prostate cancer here:

If you have any questions or would like to schedule an appointment, please contact us directly at (714) 962-7100 or reach out to us through our contact page. Our friendly staff is happy to help you get started on your prostate cancer treatment!

Prostate Cancer: Detection & Treatment Options

Diagnosing Prostate Cancer

Most men find out they have prostate cancer after a regular prostate screening test. The American Cancer Society recommends that men discuss screening pros and cons with their doctor to determine if they should have prostate screening. Many men begin having one or more of the screenings after age 50. Typical prostate cancer screenings include:

  • Blood Test. During a check-up, blood may be drawn and tested for the protein PSA (Prostate Specific Antigen). If your PSA is high, your doctor will likely investigate further.  A high PSA test does not always mean cancer. There are other diseases than can cause a higher than normal PSA.
  • Physical Exam. The doctor may also perform a digital rectal examination (DRE) to check for any abnormalities in the gland. A positive result for this exam does not rule out prostate cancer.

If your doctor thinks you might have prostate cancer, based on the initial screenings, he or she may order additional tests to confirm the diagnosis. Those tests may include:

  • Biopsy. This outpatient procedure involves doctors removing small tissue samples from the prostate gland using very thin, hollow needles directed by ultrasound. The cells are sent to a pathologist who finds out if the they are malignant (cancerous) or benign (non-cancerous.)
  • Transrectal ultrasound (TRUS). This is another test that is often ordered if you have a high PSA level or an abnormal DRE result.It views the prostate using a small probe that is lubricated and placed in your rectum. Sound waves from the probe create echoes which are turned into black and white images by a connected computer. The procedure can be completed in a doctor’s office or outpatient clinic and usually takes less than 10 minutes. The test can measure the size of the prostate and may help indicate the best type of treatment.

After these tests, if your doctor believes you have prostate cancer, he or she may order imaging tests to determine the shape and size of the tumor and the extent to which it may or may not have spread to other parts of the body. Orange County CyberKnife has convenient access to an advanced imaging center located within their building, allowing them to plan and monitor the success of tumor treatment. Imaging tests that may be ordered include:

  • PET Bone Scan – If prostate cancer is spread, one of the most likely places to find it is in your bones. This type of scan goes beyond the 3D images provided by a CT scan to show what is happening in your tissue at a cellular level. For this test, you are injected with a small amount of low-level radioactive material, which settles in damaged areas of bone throughout the body. A special camera detects the radioactivity and creates a picture of your skeleton. Using this scan, CyberKnife’s radiation oncologists will develop the best and most focused treatment from the array of advanced technologies at their fingertips for each individual situation.
  • CT Scan – The CT scan will combine many X-ray pictures to make a detailed cross-sectional image of your prostate. A CT scan is more likely to show tumors than a routine X-ray and it can also show more details such as the shape, size, and position of the tumor. CT scans can also show any enlarged lymph nodes that might contain cancer.  Radiation oncologists at Orange County CyberKnife use the Radiology CT scans to monitor growth, size, shape, movement and location of the tumor and surrounding tissues of cancer in patients.
  • MRI Scan – Like CT scans, an MRI can show precise images of the tissue in your prostate. The difference is an MRI uses a magnetic field and pulses of radio wave energy to make the pictures, giving doctors different information about what can be seen.Your prostate MRI, completed at an outside imaging center, is very commonly fused with CT simulation images, completed at Orange County CyberKnife, to help plan your CyberKnife treatment.

Types Of Radiation Therapy For Prostate Cancer

Prostate cancer is 99% treatable when caught early, before the cancer spreads to other parts of the body. Sometimes, based on the age and and type of the cancer, you and your doctor may decide to postpone treatment of prostate cancer, but monitor its development. Oftentimes,  cancer treatment will involve surgery, chemotherapy, and radiation therapy. Orange County CyberKnife is the premier cancer treatment center for many types of radiation therapy, offering a variety of options.

The radiation oncologists at Orange County CyberKnife are uniquely qualified to treat your individual case due to their experience in treating prostate cancer using the most advanced methods. We are also the only comprehensive radiation oncology center in Orange County that offers all of the most advanced, non-surgical treatment options from one convenient center, including: CyberKnife, conventional IMRT, IGRT, HDR brachytherapy, hyperthermia and more. That means our specialists, who are experienced with all of these treatment types, will offer the best treatment option(s) given each patient’s unique situation.

When it comes to treating your prostate cancer with radiation therapy, Orange County Cyberknife and Radiation Oncology Center is your expert choice. The descriptions for your prostate cancer treatment options include:

  • CyberKnife (Stereotactic Body Radiation Therapy, or SBRT) – Orange County Cyberknife was the first comprehensive radiation oncology center in Orange County to offer the CyberKnife, conventional external beam radiation therapies, and brachytherapy for prostate cancer treatments in one comprehensive center. Instead of surgery, the CyberKnife Robotic Radiosurgery System beams high doses of radiation directly to your prostate while you rest on a comfortable treatment couch. It is the most recommended type of dedicated SBRT for Low and Intermediate Risk prostate cases, due to its unique treatment process and accuracy. The flexible, robotic arm of CyberKnife can deliver this radiation directly to the prostate without exposure to the surrounding healthy tissue and organs. Radiation exposure or possible damage through surgery to the bladder, urethra, rectum, or sensitive nerve bundles can result in serious consequences such as incontinence and erectile dysfunction. Unlike other methods of radiation delivery, CyberKnife’s pinpoint precision and constant real-time motion tracking tells the CyberKnife that it is on target on the prostate at all times. Limiting radiation exposure to healthy cells also prevents some of the short and long-term side effects common with conventional radiation treatments and surgery. CyberKnife treatments for the prostate are delivered in four or five short sessions, once per day. Conventional radiation treatments, also offered at Orange County CyberKnife, are given over 25 to 45 days. For many insurance companies, fewer treatments means lower costs – saving patients more money in the long run. CyberKnife provides prostate cancer patients with better outcomes, fewer side effects, more cost-effective treatment, and a convenient treatment schedule.

Low-Intermediate Risk - outlined

  • Traditional External Beam Radiation Therapies
    • Image Guided Radiation Therapy (IGRT) for Prostate Cancer – Orange County Cyberknife and Radiation Oncology Center houses the most advanced equipment including image guided radiation therapy (IGRT) which can track and capture your tumor using high-resolution, three-dimensional images. IGRT is one of the best advancements developed for the gantry designed linear accelerators. Due to gas, and the filling of the bladder and bowels, the prostate can move slightly during treatment. IGRT allows our prostate cancer experts to view and compensate for any prostate movement during treatment, ensuring enhanced accuracy. IGRT provides another tool for our doctors to treat tumors that move with extreme precision.
    • Intensity Modulated Radiation Therapy (IMRT) for Prostate Cancer-  At our center, we determine the best method of treatment given each unique situation. Our prostate cancer experts have compared IMRT to standard or conventional radiation therapy. Due to the increased accuracy of IMRT our doctors can deliver a higher dose of radiation and spare the surrounding tissues of the bowel, bladder, and sensitive nerve bundles. IMRT can also be used if a patient has a returning cancer. Even with prior radiation, IMRT may be a promising option.
    • RapidArc Radiotherapy Technology for Prostate Cancer – With RapidArc Prostate Cancer Treatment, we have combined and enhanced both the IGRT and IMRT, to make this treatment much more precise, giving higher more effective doses, in a shortened treatment time. Patients will still undergo numerous treatments, but each treatment may be shortened from 20 to 30 minutes each to just three to five minutes. Unlike traditional IMRT that requires multiple rotations around the patient or makes repeated stops and starts to treat the tumor from different angles, this volumetric arc therapy delivers precise 3-D doses with a single 360° rotation of the machine. It uses your treatment planning algorithm to simultaneously change the rotation speed, the shape of the treatment aperture, and the delivery dose rate. The shape and position of the tumor are determined from computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) diagnostic studies. This permits improved dose sculpturing over 3-D conformal radiation therapy.
  • 3-D Conformal Radiation Therapy (3-D CRT) for Prostate Cancer – This type of radiotherapy uses 3D images to plan treatment and to deliver a dose of radiation that projects at the best angles for your tumor, avoiding surrounding healthy structures. Usually CT and/or MRI images are used for mapping out the radiation plan. Higher doses of radiation can be sent to cancer cells while much lower doses are received by the healthy tissue. This technology has allowed great improvements in safely treating head and neck tumors to minimize exposure to the spine, eyes, and other important structures.
  • Internal Radiation Therapies
    • High Dose Rate Brachytherapy (HDR) – This extremely precise radiation therapy destroys prostate cancer. It uses an intense source of radiation delivered through temporarily-placed applicators implanted into the tumor site. It is delivered internally via a computer-controlled machine in typically in two to ten convenient treatments. It is pain-free and minimizes the risk of common side effects. The radiation is delivered into the applicators through a wire or cable inserted into a catheter and then removed between treatments. Orange County’s radiation oncologists can vary the position of the wire and the length the radiation is administered to satisfy the shape and need of the cancer. In Interstitial HDR Brachytherapy, often used for prostate cancer, the radiation is delivered directly into tissue.
    • Low Dose Rate Brachytherapy (LDR) – This radiation therapy is similar to its HDR counterpart, except it differs in its treatment delivery and length of treatment. With LDR Brachytherapy, 50 to 100 radioactive ‘seeds’ are implanted permanently into the cancerous tissue and radiation is then delivered to the infected area slowly over the following month or so as the cancerous cells die. Once the seeds emit the radiation, they, too, fade away. To effectively and safely place the seeds, Orange County CyberKnife’s radiation oncologists use a special planning system which uses transrectal ultrasound (TRUS) images to help design and monitor the intended placement of seeds. This one-time treatment may be used to treat a variety of cancers, including cervical, esophageal, head and neck and lung, but it is most often used to treat prostate cancer.
  • Hyperthermia (Thermal therapy or Thermotherapy) – This type of therapy is always used in conjunction with another type, usually radiation or chemotherapy. It focuses on killing cancerous cells by exposing them to extremely high temperatures. Research has proven that this can kill the cancer, even sometimes cells that radiation isn’t reaching, without harming healthy tissues. Hyperthermia may also make some cancer cells more susceptible to destruction from radiation. When hyperthermia and radiation are prescribed together, they are usually given within an hour of each other. Hyperthermia can also enhance the effects of certain anticancer drugs. Ask our Orange County CyberKnife radiation experts about the different types of hyperthermia currently available for your treatment.

H2: Contact Us To Find Out More

We want to make sure you understand all of your treatment options on your first visit to Orange County CyberKnife.  Our team of radiation oncologists are ready to answer all of your questions about our advanced non-surgical and non-invasive radiation therapy systems available. Read what other patients say about our cancer care. Call us today at (714) 962-7100 to schedule your appointment.

Use these links to find out more about prostate cancer:

Prostate Cancer: Types & Stages

Because your prostate is so near vital primary structures, you want to make sure that your treatment specialists are experienced and knowledgeable. The radiation oncology specialists at Orange County CyberKnife are equipped to develop an effective prostate cancer treatment plan for you that minimizes the risk to these surrounding structures, based on the type and stages of your cancer. Orange County CyberKnife is the premier cancer treatment center of Southern California and Orange County, with a comprehensive array of radiation procedures.

Since 90% of prostate cancer is considered one type, the treatment options for early detected prostate cancer are the same.

Types Of Prostate Cancer

Your doctor will be able to tell the type of prostate cancer you have by taking samples of the cancerous tumor from your prostate during a biopsy. A pathologist can distinguish between the different types of cells by examining them through a microscope.

  1. Acinar Adenocarcinoma. This is, by far, the most common type of prostate cancer, encompassing 90% of all prostate cancers in the U.S. It starts in the gland cells of the prostate. Many of these cells grow slowly, but a few can progress more rapidly. There are other types of adenocarcinoma, which include atrophic, foamy, colloid and signet ring carcinoma. They are all treated in the same way as acinar adenocarcinoma. So if you are told you have any of these types, all the information in our prostate cancer section will still apply to you.
  2. Rare Prostate Cancer Types. The other 10% of rare prostate cancers could be one of the following types below. Because they are so rare, there is less known about how they develop and their treatment.
    • Ductal adenocarcinoma. Starting in the cells that line the ducts of the prostate gland, this cancer grows and spreads more quickly than acinar adenocarcinoma. Sometimes men are in the advanced stages by the time it is diagnosed, with poor. It represents 0.4% to 0.8% of all prostate cancers and is associated with a poor prognosis. r chance of recovery.
    • Transitional cell (urothelial cancer). This type of prostate cancer starts in the cells that line the urethra. Transitional cell cancer of the prostate may spread into the bladder entrance and into nearby tissues. More commonly, this type of cancer may start in the bladder and spread into the prostate.
    • Squamous cell cancer. This type starts from the flat cells covering the prostate gland, called squamous cells. Squamous cell prostate cancer tends to grow and spread more quickly than adenocarcinoma, so it may be advanced when diagnosed.
    • Carcinoid of the prostate. Carcinoid tumors start from cells of the neuroendocrine system, which is made up of specialized nerve and gland cells. These tumors are very rare and seem to be slowly growing.
    • Small cell cancer. This is also a type of neuroendocrine tumour and is made up of small round cells. You may not have a raised PSA (prostate specific antigen) test, so it’s harder to find early and may be advanced when diagnosed.
    • Sarcoma and sarcomatoid cancer Sarcomas start from muscle cells. They often grow quite quickly. The most common type of prostate sarcoma in adults is leiomyosarcoma. It tends to occur in men between the ages of 35 and 60. Sarcomatoid cancers have a mixture of sarcoma and adenocarcinoma cells.

Stages Of Prostate Cancer

Identifying the stages of prostate cancer is important to help determine treatment type and prognosis. The stages of prostate cancer, like other cancers, correspond with the methodology TNM – tumor, node, metastasis.

  1. Tumor – The larger the primary tumor or abnormal growth, the more serious.
  2. Node – The more lymph nodes that have cancerous cells, the more serious the cancer.
  3. Metastasis – Serious stages involve the spreading of cancer to other parts of the body.

Doctors assign levels for each of the above factors and then combine these levels into stages. They stages of prostate cancer are:

  • Stage I – This is a non-invasive cancer found only in the prostate when the disease is so small it can’t be detected with a digital rectal exam (DRE) and isn’t seen in imaging. The tumor is smaller than one-half of one lobe of the prostate. Your PSA is less than 10.
  • Stage II – The tumor is still restricted to inside the prostate, but has grown some.
    • Stage IIa – The tumor encompasses between one-half of one lobe and two lobes.
    • Stage IIb – The tumor encompasses both lobes of the prostate.
  • Stage III – In Stage III, the cancer has just barely spread outside the prostate to nearby tissues, like the seminal vesicles. It has not spread to lymph nodes or metastasized to a distant tissue.
  • Stage IV – In this stage, the cancer has metastasized outside the tissue, affecting other parts of the body including lymph nodes, the bones, liver, or lungs.
  • Recurrent – This stage of cancer is used when the cancer returns to the originally infected place after treatment. Once that happens, doctors run more tests to establish a current stage.

Call Us Today To Find Out More

If you or a loved one has been diagnosed with prostate cancer and you still have questions, please give us a call at (714) 962-7100. Our team of internationally renowned radiation oncologists at Orange County CyberKnife are ready to work with you on a treatment plan to meet your individual needs. Our Southern California cancer treatment center is equipped with the latest radiosurgery and radiotherapy equipment to best reach and destroy cancerous cells, including the CyberKnife Robotic Radiosurgery system. Use these links to find out more about prostate cancer:

Prostate Cancer – Frequently Asked Questions

Have Another Question You’d Like Us To Answer? Contact Us Today

Please contact us today at (714) 962-7100 for a free, phone consultation. We are here to help you by answering your questions and discussing treatment options. Our staff of highly-trained oncologists looks forward to working with you to provide an individualized treatment plan to meet your needs.

Q. Can I prevent prostate cancer?

Answer :

There are no definite ways to prevent prostate cancer, but maintaining a healthy lifestyle with a healthy diet and exercise can help reduce the risk of getting the disease.

Q. Can prostate cancer be cured?

Answer :

Yes. The cure rate for prostate cancer is very high because almost all men are diagnosed in the early stages. Most men diagnosed in the early stages are disease-free after five, ten and 15 years.

Q. How is prostate cancer treated?

Answer :

There are several different treatment options for prostate cancer, including surgery, radiation therapy, hormone therapy and chemotherapy. You also may treat prostate cancer with a combination of these, used in conjunction with each other or at different times, depending on how advanced the cancer is. Once you consult with your urologist, a radiation oncologist and a medical oncologist, you’ll be able to compile the most successful treatments available.

Q. How do I decide which radiation treatment is best for me?

Answer :

After you are diagnosed with prostate cancer, contact Orange County CyberKnife and schedule your first consultation. We will meet with you to evaluate your specific situation and explain the various treatment types available to you. We are the only comprehensive radiation oncology center in Orange County to offer the most advanced CyberKnife, external beam radiation therapy, HDR brachytherapy and hyperthermia treatment options from one outpatient cancer center. No matter what treatment we are using, our radiation oncologists, physicists, and dosimetrists will work as a team to develop the most effective treatment plan for you.

Q. Where do I have to go for treatment?

Answer :

The CyberKnife treatments are offered as an outpatient service at Orange County Cyberknife, which is conveniently located in Fountain Valley, California, just off the 405 at the Brookhurst exit.

Q. What are the side effects of radiation therapy?

Answer :

Side effects of radiation therapy depend on the type. In most cases, patients who have the CyberKnife procedure have few noticeable side effects and are able to resume normal activities soon after treatments. With all radiation treatments there is a potential for: constipation, urinary retention or incontinence, blood in stool, injury to rectal or bladder wall, erectile dysfunction. Discuss your specific case with your Orange County CyberKnife radiation oncologist to make sure you fully understand any potential risks of your treatment.

Q. Will my insurance pay for radiation therapy treatments?

Answer :

Orange County CyberKnife treatments for prostate cancer are approved with Medicare, and a preferred in-network provider with most HMO, IPA and Private Insurances. Our team will verify coverage with your insurance before any consultation or treatments begin.