Prostatectomy may not be needed for prostate cancer

A high PSA level. A positive biopsy. A treatment recommendation that includes the word “radical”, as in radical prostatectomy. Once a prostate cancer diagnosis sinks in, many men just want to remove it. Now. And that’s a completely valid response. But surgery may not be the only answer. It may not even be the best option for you.

If your doctor has recommended surgery to remove your prostate, or radiation therapy instead of removal, you should be comfortable with the decision. Several steps you can take to feel more confident about your prostate cancer treatment include:

1. Understand your test results. If your diagnosis is based on a traditional prostate cancer biopsy, you may not have the whole story. Because a traditional prostate cancer biopsy takes only six to 12 prostate tissue samples, it’s possible that the results are misrepresenting the extent of your prostate cancer. Fewer prostate tissue samples obtained in a traditional prostate biopsy makes it possible—even likely—that your prostate cancer could be localized in more than just one part of the prostate.

2. Get a second opinion. Having another specialist evaluate your PSA, prostate cancer biopsy results, family history, and other risk factors, will help confirm your diagnosis, and also make sure you are choosing the best possible treatment option for your unique situation. Most physicians are very comfortable with patients obtaining a second opinion because it helps the patients feel confident in the physician’s recommendations. Most insurance companies will pay for a second opinion and your insurance company may even require a second opinion before approving treatment for prostate cancer.

3. Obtain additional diagnostic testing. In addition to the PSA test, there are new tests that measure biomarkers for prostate cancer in the blood and urine. These tests, known as “PC markers,” can help determine the presence, extent and type of prostate cancer present. Not all physicians offer these tests so it’s important to ask for them. In addition, you may be a candidate for an advanced type of prostate biopsy, called 3D mapping biopsy. This prostate cancer biopsy allows physicians to obtain 30 to 90 prostate tissue samples that are used to create a computerized map of your prostate the size and location of any prostate cancer tumors.