In recent years there have been enormous developments in prostate cancer diagnosis and treatment. Yet many patients and even their doctors don't know about them. Studies show that it can take 10-15 years for new technologies to be adopted by doctors. Men with prostate cancer don't have time to wait! 

The good news is that they don’t have to; breakthroughs in prostate cancer care are here and available today for men who take the initiative to educate themselves. 

Many men believe that an elevated prostate-specific antigen (PSA) automatically means they have cancer. Many doctors automatically order a biopsy after a high PSA level is detected. The presence of cancer cells doesn't always mean you need a radical prostatectomy or radiation therapy. In fact, the opposite is true. Most men with prostate cancer — up to 85% — don't require such radical interventions, yet most of them end up getting surgery or radiation anyway. 

Here's a safer approach to take after tests show you have an elevated PSA level, but before choosing surgery or radiation. It's based on the very latest medical knowledge and technologies. 

1. Ask your doctor for a DRE (digital rectal exam) to feel for any irregularities, bumps, or elevations, and an ultrasound to measure prostate size. Then…

2. If there is a possible prostate infection, treat with antibiotics. Then…

3. Get a second PSA test. There are a number of factors that can skew PSA numbers, so it's important to repeat the test. If they're elevated again, then…

4. Obtain an Advanced Prostate MRI from a center that has the 3.0 Tesla machine. This is a breakthrough technology that is 85-90% accurate in identifying a cancer mass, even small masses of 5 millimeters. Then...

5. Consider getting a Color Doppler Ultrasound test if there's a center near you that offers it. This test can show you a high-resolution image and pinpoint where cancer is present. If cancer is found, your urologist will then be able to perform a more accurate, targeted biopsy. Then… 

6. If possible, try to obtain a targeted biopsy instead of the typical blind biopsy. Doctors knowledgeable about the advanced prostate MRI and Color Doppler Ultrasound will know about the benefits of a targeted biopsy. Rather than taking random samples as is usually done, your doctor will now be able to guide the biopsy needle to the most suspicious areas, greatly increasing the chance of obtaining highly reliable results. Then...

7. If the targeted biopsy reveals cancer, ask if it would be helpful to obtain a second pathology analysis from a different center or institution. You have nothing to lose from doing this, and labs do make mistakes. Then…

8. Join a prostate cancer support group, where you can obtain valuable information from a patient's point of view. Sometimes these men are better informed about the newest technologies and treatments than doctors. Also, do your own research, searching the internet for information about tests, treatments, benefits and risks. Then…

9. Collect your data and have all your test results and dates in a single table so you can track changes over time. Discuss your results with your doctor and ask as many questions as you need. You'll want to know what treatment your doctor suggests for your type of cancer. If he recommends surgery or radiation therapy, ask if you may speak with the surgeon or radiologist. Then…

10. Consider getting a second opinion. Your urologist is most likely a surgeon, so it's natural for him to have a surgical point of view. Be sure to find out if there are alternatives to surgery or radiation therapy you should consider such as cryotherapy, high-intensity focused ultrasound (HIFU), or laser therapy. Then…

11. Decide on your treatment based on all your test results and the knowledge you've gained. Congratulate yourself for taking an active role in your present and future health, and for making decisions that are well informed and based on the most up-do-date information available.

Note: I'm not just a doctor giving advice. I'm also a patient. I was diagnosed with prostate cancer in 2011 and directed toward surgery or radiation, but after undergoing the newest available tests and conducting dozens of interviews with top doctors, I learned that my test results did not warrant invasive treatment. I could actually see my cancer! It is modest in size, in a safe location, and there is no sign of spread. I am enrolled in active surveillance, repeating the tests and meeting with my doctor regularly. My prostate cancer remains under excellent control without medications.

Learn more about the revolutionary new tests and treatment options, the medical centers that offer them, and resources and answers for men diagnosed with prostate cancer in Prostate Cancer Breakthroughs: New Tests, New Treatments, Better Options (2013), by Jay Cohen MD. 

Photo Credit: Shutterstock.com


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