Prostate Cancer

The Winship prostate cancer and genitourinary cancer teams include urologists, medical oncologists, radiation oncologists, advanced practice nurses and social workers. They work together to provide the most appropriate individualized approach to treating prostate cancer patients.

Our prostate cancer program is located at Winship Cancer Institute (Clifton campus), Emory Saint Joseph's Hospital, Emory University Hospital Midtown and Emory Johns Creek Hospital.

Although the prostate is made up of several cell types, almost all prostate cancers develop in the glandular cells. Cancer of gland cells is known as adenocarcinoma.

Most men will not experience any symptoms of prostate cancer if it is caught early. However, some men do, and these symptoms may include the following:

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Weak or interrupted flow of urine
• Painful or burning urination
• Difficulty in having an erection
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the lower back, hips, or upper thighs

Men who experience any of these symptoms should speak to their doctor.

These are some of the tests that may be used to confirm a diagnosis:

Prostate Specific Antigen (PSA) Tests: a blood test is used to assess the level of PSA in the blood. A higher-than-normal level of PSA might indicate a problem with the prostate, including cancer.

Digital Rectal Exam (DRE): a physician inserts a lubricated, gloved finger into the rectum to feel for abnormalities of the prostate.

An abnormal age-adjusted prostate specific antigen (PSA) test or abnormal digital rectal (DRE) exam is an indication of prostate cancer, but does not mean cancer is present. Abnormal findings should be followed by a biopsy of the prostate cells to determine whether they are in fact cancerous.

Biopsy: a biopsy is a procedure in which a sample of tissue is taken from the prostate and then viewed under a microscope to check for abnormalities.

Prostate Health Index (phi): still being studied, phi is a new, more precise blood test that better distinguishes an aggressive cancer from a low-risk cancer.

Specialty imaging uses powerful modalities to provide for better diagnosis and treatment of various cancers. At Winship, our highly experienced radiologists offer the most advanced imaging available for all phases of prostate cancer including multiparametric (3D) prostate MRI to guide biopsies more precisely. Our radiology program is home to the only PET-MR in Georgia which combines the power of MRI and PET in one machine.

Ask your doctor if specialty imaging may benefit you.

Surgical options:

• Radical Perineal Prostatectomy
• Robotic Prostatectomy
• Open Retropubic Prostatectomy

Radiation therapy options:

• Brachytherapy (internal radiation therapy)
• External beam radiation therapy
• Three-dimensional conformal radiation therapy
• Intensity modulated radiation therapy
• Proton beam therapy

Hormone therapy (also called androgen deprivation therapy) may be used if surgery or radiation is not an option. Chemotherapy is sometimes considered if prostate cancer has spread outside the prostate gland and hormone therapy is no longer effective.

Interventional radiology uses imaging to guide minimally invasive non-surgical procedures such as laser ablation to treat prostate cancer, or prostate artery embolization to treat benign prostate hyperplasia, a non-cancerous enlargement of the prostate.

Nuclear medicine uses radiotracers or radioactive drug therapies to diagnose, evaluate, and treat various diseases including prostate cancer. Winship specialists have pioneered the use of fluciclovine in combination with PET imaging to better plan treatment decisions for patients with recurrent prostate cancer.

Clinical Trials

Through clinical trials, you may have access to treatments for prostate cancer at Winship that are not widely available. Winship specialists were the first in Georgia to use PSMA-targeted PET scans in guiding radiation therapy in clinical trials to better identify spread of disease.

Consider talking with your doctor about participating in a clinical trial at Winship.

Supportive Oncology and Urology Care

In addition to delivering the highest quality medical care, we recognize the importance of the psychological and emotional aspects of living with a cancer diagnosis and of dealing with treatment. Our supportive oncology team address these issues in a timely manner with additional support from counselors, nurse navigators, dietitians and social service professionals.

Additionally we recognize that urinary incontinence and erectile dysfunction can be important factors in prostate cancer survivorship and our team of urology experts offer multiple options to help you manage these conditions. To request an appointment, contact our urology team at (404) 778-4898.

Sexual Recovery

Some men may experience sexual changes after treatment for prostate cancer. Winship experts worked with colleagues from other institutions to create an online, tailored interactive program to support men and their partners on their journey toward sexual recovery after prostate cancer treatment. Visit the Movember Foundation's Sexual Recovery Program website to learn more.