Prostate cancer forms in the prostate, the gland below the bladder that makes part of the semen. Early prostate cancer often causes no symptoms at all, which is why many men first meet a urologist because of a PSA result.
Came in with a raised PSA?
A PSA level above the usual range does not mean cancer. An enlarged prostate or prostatitis can raise it too, and what counts as normal shifts with age and personal history. Our urologists weigh the trend across earlier readings, a digital rectal exam, and whether an MRI or biopsy would add useful information.
Symptoms that deserve a visit
- Trouble urinating or a weaker stream
- Needing to urinate often, especially at night
- Red or pink urine, or blood-tinged semen
- New erectile dysfunction
- Discomfort in the pelvis
- Bone pain or weight loss without trying
Most of these are more often caused by something other than cancer. They are still worth checking.
Who is at higher risk
Risk rises with age, especially after 50. A father, brother or son with prostate cancer raises it, as do inherited gene changes such as BRCA1, BRCA2 and HOXB13. Black men are more likely to develop prostate cancer and more likely to have an aggressive form. If any of these apply to you, ask about starting screening earlier.
Staging
Once cancer is confirmed, staging describes the tumor, whether lymph nodes are involved, and whether it has spread (the TNM system). Advanced Urology offers PSMA PET/CT, which helps stage prostate cancer and look for disease when PSA rises after treatment.
Treatment options we discuss
- Active surveillance
- For slow-growing, low-risk cancers: regular PSA tests, exams and occasional biopsies, with treatment started if the cancer changes. It avoids side effects of treatment that may not be needed.
- Surgery
- Radical prostatectomy removes the prostate when cancer is confined to it, often with a robotic, minimally invasive approach. Urinary leakage and erectile dysfunction are possible effects we review with you.
- Focal therapy
- Dr. Vahan Kassabian's practice includes HIFU (high intensity focused ultrasound), which treats a targeted area of the prostate for selected men.
- Radiation
- External beam or implanted seeds, an alternative to surgery for localized or locally advanced cancer.
- Hormone therapy
- Lowers or blocks testosterone, which many prostate cancers need to grow. Often used for advanced cancer or alongside radiation.
- Chemotherapy, immunotherapy and targeted medicines
- For advanced cancer, including medicines aimed at specific gene changes such as BRCA.
- Supportive (palliative) care
- Relief of symptoms such as pain, at any stage and alongside other treatment.
Your team
At Sandy Springs, Vahan Kassabian, MD directs Advanced Urology's prostate center and trained in urologic oncology. Herman Bagga, MD, FACS and Marc Greenstein, DO also see men with prostate cancer and elevated PSA here.
Advanced Urology's page on prostate cancer has more detail.