Prostate cancer: a plan matched to your cancer and your goals

Does prostate cancer cause symptoms?

Early on, usually not. Most cases are found because of a rising PSA or an abnormal prostate exam. Weak flow and night trips are far more often caused by an enlarged prostate. Bone pain, blood in the semen or unexplained weight loss can appear later and should be checked.

When should you see a urologist?

Come in when your PSA is high or climbing, when your primary care doctor feels something on exam, or when a biopsy elsewhere has found cancer and you want a plan or a second opinion. Men with a father or brother who had prostate cancer, and Black men, benefit from starting the PSA conversation earlier.

How is prostate cancer confirmed and staged?

We repeat and trend the PSA, examine the prostate and usually order a prostate MRI. If a biopsy is needed, it can be targeted to MRI findings, and transperineal biopsy and micro-ultrasound are among the techniques our physicians use. When cancer is confirmed, a PSMA PET/CT scan can show whether it has spread beyond the prostate, which changes the plan.

Which treatments do we offer?

• Active surveillance for low-risk cancer: scheduled PSA tests, MRI and repeat biopsy instead of immediate treatment.
• Robotic radical prostatectomy to remove the prostate when the cancer is confined to it.
• HIFU (high-intensity focused ultrasound), which uses focused sound energy to treat the cancer, sometimes just part of the gland.
• Radiation and hormone therapy, planned with you when they fit the cancer, including medicines that lower testosterone for advanced disease.

What is recovery like?

After robotic prostatectomy, most men go home with a catheter for a short time, and bladder control returns gradually; pelvic floor therapy speeds that up. Erection recovery takes longer and varies. HIFU recovery is usually shorter. On surveillance there is no recovery at all, just regular checks.

What do patients ask about prostate cancer?

Do I need treatment right away?

Not always. Low-risk prostate cancer is often watched with active surveillance, and treatment starts if tests show the cancer changing.

What is a PSMA PET scan?

An imaging test that lights up prostate cancer cells anywhere in the body. It helps stage newly diagnosed cancer and find cancer that returns after treatment.

Who is HIFU for?

Men whose cancer is limited to the prostate and who want an option other than removing the whole gland or radiation. Our urologists will tell you whether your MRI and biopsy fit.

Will surgery affect bladder control or erections?

Both can be affected for a while. Most men regain bladder control over weeks to months, and erection recovery depends on age, baseline function and the nerves spared.

Can I get a second opinion here?

Yes. Bring your biopsy report, PSA history and any imaging, and our urologists will review your options with you.

Does an enlarged prostate turn into cancer?

No. BPH and prostate cancer are separate conditions, although a man can have both, which is why urinary symptoms are evaluated carefully.

Which of our urologists focus on this?

These physicians list it among their focus areas on their Advanced Urology profiles. You can ask for one by name when you book.

• Dr. Vik Sabarwal, Lawrenceville and Braselton: Prostate Cancer
• Dr. Michael F. Nordsiek, Lawrenceville: Prostate Cancer
• Dr. Hemant Chaparala, Lawrenceville and Braselton: Prostate Cancer, Prostatectomy, High Intensity Focused Ultrasound (HIFU)
• Dr. Nicholas Farber, Braselton: Prostate Cancer

Which of our articles go deeper?

• Does prostate cancer have symptoms?
• Is Vanquish a cure for prostate cancer?
• Lupron vs Orgovyx (relugolix): shots or pills?
• Prostate cancer: is surgery really better than radiation for outcomes?
• Prostate cancer radiation: how long is it, and will I need hormone therapy?
• Prostate cancer: will I need radiation after surgery?
• Relugolix / Orgovyx: what is it?
• Should I have an MRI before a prostate biopsy?

All prostate cancer articles

Where can you be seen for this?

At the Lawrenceville Clinic & Surgery Center on Crown Pointe Way, where testing and outpatient procedures share one building, or at the Braselton Clinic on Old Winder Highway for visits, lab work and follow-ups. Our Oakwood Clinic is opening soon. Call (678) 344-8900 or book online, and see your first visit and what to bring before you come.