What You Should Know about Prostate Cancer   

What You Should Know about Prostate Cancer

Young man speaking with his doctor about prostate cancer.
Clinical Contributors to this story:
Mark Perlmutter, M.D.
Michael Stifelman, M.D.

Prostate cancer is the second leading cause of cancer death in American men.

According to the American Cancer Society, there will be about 174, 000 new cases of prostate cancer in 2019.

These are staggering statistics. Prostate cancer is a serious disease but early detection and emerging treatments are giving patients new hope for survival. Learn the latest about prostate cancer from experts across Hackensack Meridian Health.

What is Prostate Cancer?

Prostate cancer occurs when there is an abnormal growth on the prostate gland.

The prostate is a gland located between the bladder and the penis – normally the size of a ping-pong ball but can grow to the size of an orange. The prostate secretes fluid that protects and nourishes sperm.

What are the symptoms of Prostate Cancer?

Early stage prostate cancer often has little to no symptoms. Men diagnosed with prostate cancer are usually not aware until they are screened – this is why early detection is important.

When prostate cancer presents symptoms, these symptoms may include:

  • Urinating frequently
  • Painful or burning urination
  • Difficulty having an erection
  • Painful ejaculation
  • Blood in the urine or semen
  • Pressure or pain in the rectum

Who is at risk?

All men are at risk for prostate cancer though some are at an increased risk. The probability of getting prostate cancer increases based on age, race and family history. Learning more about risk factors will help to determine the best time to get screening.


The most common risk factor is age. As men get older, this increases their chance of getting prostate cancer.


African American men are more likely to get prostate cancer than men of other races.

Family History

The strongest risk factor of prostate cancer is family history. Men who have a father, son or brother who had prostate cancer are at an increased risk of getting prostate cancer. Men who also had a mother or sister with the BRCA 1 or BRCA 2 gene mutations (genes linked to breast and cervical cancer) are also at an increased risk.

Prostate Cancer Screening

Early detection is the key to treating prostate cancer. It is recommended that men with a family history of prostate cancer or a mother or sister with the BRACA gene begin screening at age 40. African American men are encouraged to begin screening at age 45, and if there is no family history that puts you at risk, you can delay screening until age 55.

Screening is primarily done by administering the Prostate Specific Antigen (PSA) blood test.  A PSA test measures the level of PSA in the blood – a high level of PSA indicates a potential issue with the prostate, often times it’s an abnormal growth or other noncancerous issues of the prostate. However, if there is an elevated PSA, doctors will do a variety of tests including a biopsy to determine if there is a risk of prostate cancer.

Other tests include a digital rectal exam, specialized blood test and magnetic resonance imaging (MRI). Based on the results, your doctor’s recommended course of action may be a tissue biopsy. This is when multiple small pieces of tissues are removed from the prostate and inspected under a microscope to look for cancer cells. When an MRI is done pre-biopsy and an abnormal area is seen, this area will be targeted during the biopsy.  Sometimes an MRI is done after the biopsy to confirm the diagnosis.

What are my treatment options?

Once the cancer is diagnosed, there are a variety of treatment options available. These may depend on the stage, growth and medical history of the patient.

Available treatment options include:

  • Active Surveillance
  • Surgery
  • Radiation
  • Focal ablation
  • Hormone therapy
  • Chemotherapy
  • Clinical Trials
  • Biological therapy

Diagnosis of prostate cancer does not mean immediate treatment. Because of the side effects associated with treating prostate cancer, men may opt to delay treatment if the cancer is localized and slow growing.

Active Surveillance

According to Mark Perlmutter, M.D. FACS, medical director of urologic oncology for Hackensack Meridian Health Cancer Care in Monmouth and Ocean Counties, “When the cancer is localized and not aggressive, active surveillance is an option we recommend – depending on the patient’s age and overall health.The patient is closely monitored with periodic screenings for any changes or progression.”

Dr. Perlmutter explains that periodic screenings include the PSA blood test, digital rectal exams and a biopsy.

Active surveillance is not to be confused with treatment, this is just a strategy for patients who opt to not be treated immediately, but will initiate treatment if the cancer advances.

Surgical Advancements

Robotic surgery is the most common surgical technique to treat prostate cancer. Many cancer centers have implemented this new advanced technology to help treat men diagnosed with the disease. The John Theurer Cancer Center at Hackensack University Medical Center has implemented the most advanced robotic surgical system – the single port robot, to treat both localized and advanced prostate cancer.

Michael Stifelman, M.D., chair and professor of Urology, co-director of Urologic Oncology and director of Robotic Surgery at Hackensack University Medical Center states that the use of the single port robot in treating his patients has transformed the way surgery is done. “The single port robot allows for a small incision, 1 inch in the belly button for the removal of the prostate and when necessary, the surrounding  lymph nodes.  Because of the high definition magnified 3D view, dexterity and precision, the nerves and structures surrounding the prostate are not damaged in the process, the recovery time is shortened and the risks of complications are reduced.”

Learn about one patient’s journey undergoing robotic surgery with Dr. Stifelman to treat his prostate cancer.

Which treatment is most effective?

“Each diagnosis is different and with a wide variety of treatment options available, we use a personalized approach to determine what works best based on the stage of the cancer, the patient’s age and lifestyle,” says Dr. Perlmutter.

Prostate cancer is a risk for all men as they get older, but with early detection and advanced technology, it can be treated.

Don’t wait for symptoms to get screened, if you are at an increased risk of getting prostate cancer, talk to your doctor about screening options.

Next Steps & Resources:

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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