Prostate Cancer

Prostate cancer screening is important in men ages 50 and up. Some men who have a family history of prostate cancer may benefit from earlier screening depending on the age at which his family member was diagnosed. Most primary care physicians order a PSA (prostate specific antigen) screening test annually with a wellness visit.

Screening PSA is important as prostate cancer is often a silent disease in the early stages. Early detection is important to cure the cancer in the most minimally invasive way possible. Typically, once a PSA is > 4.0ng/dL, it is considered elevated, however there are other factors that need to be evaluated to determine your risk of prostate cancer.

What tools does Dr. Hodgins use to evaluate an elevated PSA?

• Digital rectal exam of the prostate
• Free and Total PSA
• ExoDx urine test
• MRI of the prostate
• Ultrasound guided prostate biopsy
• Uronav prostate biopsy

Dr. Hodgins will discuss your individual risk factors for prostate cancer and recommend the appropriate tests.

What happens next if I am diagnosed with prostate cancer?

• You will have a cancer consultation with Dr. Hodgins at which time she will explain your pathology report, order any additional testing if needed (such as a PSMA PET CT to detect disease outside the prostate or a genomic test to determine the aggressiveness of the cancer) and discuss your personalized options for management.
• Some men with low risk and low volume disease may be a candidate for active surveillance (AS) which is a protocol used to closely monitor the cancer. A PSA blood test is checked every six months with follow up MRI and/or biopsy every 12-18 months to monitor the cancer. Over time, some patients will require a definitive treatment due to progression of disease or desire to move away from AS.
• Depending on your particular situation, some prostate cancers can be cured with radiation treatments such as Cyberknife or brachytherapy. Referral to a radiation oncologist may be recommended if your best treatment option is radiation.
• Robot assisted laparoscopic prostatectomy with the DiVinici system is a treatment for prostate cancer in which the prostate gland, seminal vesicles and sometimes the lymph nodes that drain the prostate are removed. Dr. Hodgins has several highly skilled colleagues who perform this procedure and if this is the right treatment for you, she will refer you for surgery.

There are a number of factors involved in this decision, all of which will be thoroughly discussed with you by Dr. Hodgins in your cancer consultation.