We Treat
Prostate Cancer
SCRI Oncology Partners brings decades of experience in treating prostate cancer to our patients in Nashville and Middle Tennessee. We use a customized approach, incorporating the most advanced medical oncology therapies at the right time, to treat prostate cancer effectively. Our goal is to support you every step of the way, working diligently to improve your outcome so you can enjoy a healthy and fulfilling life for many years to come.
Our compassionate team of experts also provides our patients with the most advanced prostate cancer therapies by offering access to clinical research trials.
Meet your Prostate Cancer Doctors
What are some of the signs and symptoms of prostate cancer?
The prostate is the organ that sits below the bladder and in front of the rectum – the last part of the intestines. It sits in front of the seminal vesicles, which are the glands that make most of the fluid for semen and where the urethra passes.
Because it usually grows very slowly, prostate cancer is generally curable and sometimes can be observed. However, there are some types of prostate cancer that grow aggressively and can spread quickly, causing a sudden onset of symptoms.
Some common signs and symptoms you need to be aware of may include:
- Urination issues, such as frequent urination, a weak urine stream, difficulty urinating, and pain or burning during urination
- Blood in the urine or semen
- Pain or pressure in the lower back, hips, testicles, rectum, or pelvis
- Recent onset of erectile dysfunction (trouble getting an erection)
- Discomfort when sitting, often due to an enlarged prostate
Many of these symptoms have causes other than prostate cancer, and many of those causes are benign. If you are experiencing a new or concerning symptom, however, it is important to tell your doctor so the cause can be found and treated as soon as possible.
Risk Factors
Staging
Treatment
Clinical Trials
How is prostate cancer diagnosed?
The process of receiving a prostate cancer diagnosis can be overwhelming, but it’s important to remember that you don’t have to face it alone. Our healthcare team is here to support you and guide you through the next steps.
Prostate cancer is typically diagnosed through routine screening, often before any symptoms have appeared. Early detection through screening, such as a digital rectal exam or a blood test to measure prostate-specific antigens (PSA), plays a crucial role in identifying potential issues. If your screening results raise concerns, your physician may recommend further testing, including a prostate biopsy, to confirm the diagnosis.
A prostate biopsy takes several tissue samples from within the prostate to be examined by a pathologist. The two samples that are most different from normal prostate cells will be used to establish a Gleason score. Other tools might be utilized in conjunction, including a transrectal ultrasound or magnetic resonance imaging (MRI). Your urologist will likely review the pathology report with you and discuss next steps. Most men have time to review their options and determine whether surgery is necessary or if other treatments could be used. Request an appointment with our cancer center in Nashville for a consultation on the treatments available to you that can help you delay or avoid surgery.
Risk factors for developing prostate cancer
Researchers have identified several factors that may increase a man’s risk of developing prostate cancer. While some of these risk factors cannot be changed, it is crucial to be aware of them and discuss them with your doctor. Being informed about your risk can help you make decisions about when to begin regular screenings and how to monitor your health proactively. Having one or more risk factors does not guarantee that you will develop prostate cancer, but it’s important to be aware if any of the following apply to you.
- Age is one of the most significant risk factors for prostate cancer. The likelihood of developing prostate cancer increases dramatically as men age, particularly after the age of 50. This makes regular screening especially important for older men to detect any early signs of the disease. Learn more about cancer screening guidelines.
- Race and ethnicity also play a crucial role in the risk of prostate cancer. Studies show that African American men and Caribbean men of African descent are more likely to develop prostate cancer and often at a younger age compared to other groups. Additionally, the cancer tends to be more aggressive or advanced in these populations.
- Family history is another key factor in the risk of prostate cancer. Men with a first-degree relative, such as a father or brother, who has had prostate cancer are twice as likely to develop the disease themselves. This risk increases even more if multiple relatives have been diagnosed. Additionally, inherited genetic mutations, such as those in the BRCA1 or BRCA2 genes, can increase the risk of prostate cancer, as can conditions like Lynch syndrome, which is linked to hereditary gene changes.
- Lifestyle factors also contribute to the risk of developing more aggressive forms of prostate cancer. Diets high in saturated fats, like those found in red meat and dairy, and low in fruits and vegetables can slightly elevate the risk. Obesity is another contributing factor, as is smoking tobacco, which, while not directly linked to an increased risk of developing prostate cancer, has been associated with a higher risk of dying from the disease. Thus, maintaining a healthy lifestyle can be an important aspect of reducing overall risk.
Types of prostate cancer
The most common prostate cancers are adenocarcinomas. There are two different types of adenocarcinoma of the prostate, acinar adenocarcinoma of the prostate and ductal adenocarcinoma of the prostate. The first develops in the gland cells that line the prostate gland and the latter in the cells that line the tubes (ducts) of the prostate gland. Ductal adenocarcinomas tend to grow and spread more quickly than acinar adenocarcinomas.
Most other types of prostate cancer are rare, but can include small cell carcinoma, transitional cell carcinoma, sarcomas and other neuroendocrine tumors (including large cell carcinoma).
Staging
Once you have been diagnosed with prostate cancer, your physician will determine the stage of your cancer to help guide your treatment plan.
Cancer staging refers to the process of determining the extent of cancer in the body, including the size of the tumor and whether it has spread to other areas. Prostate cancer is also given a grade, called a Gleason score, which describes how likely your cancer is to grow and spread. This information is combined to determine the stage of your cancer. Understanding the stage of cancer is crucial for your provider as it helps them assess the severity of the disease, plan the most effective treatment and identify suitable clinical trials that could be potential treatment options. Prostate cancer staging is quite complex. Don’t hesitate to discuss with your provider more to fully understand the state of your disease.
Grade Group as Part of Prostate Cancer Staging
Prostate cancer is categorized into five distinct grades based on the Gleason score, which is determined by the pathologist who analyzes your biopsy samples. The score reflects how closely the cancer cells resemble healthy cells when viewed under a microscope.
Healthy-looking tissues are typically slow-growing, earning them a lower grade that is often referred to as “well differentiated.” Tissues that appear less healthy and more aggressive are assigned a higher grade, called “poorly differentiated.”
Gleason scores range from 2 to 10. To calculate this score, the pathologist examines the two most common patterns in the sample. The more abnormal the cells appear, the higher the score, which is based on a scale of 1 to 5. These two numbers are combined to determine your Gleason score. Gleason scores of 6 or greater are often considered cancer.
Stage I
- The tumor is half the size of the prostate or smaller, and the cancer cells are well-differentiated, which means they look like healthy cells.
- Men with cancer in this stage generally have low PSA levels and have a Gleason score of 6 or less.
Stage II
- The tumor is small and found only in the prostate but may have an increased risk of growth. PSA levels are medium.
- There are three different versions of Stage II cancers, labeled A, B, or C depending on their PSA levels, Gleason scores, and how differentiated the cancer cells are.
Stage III
- The tumor is characterized by high PSA levels, a growing tumor or a high grade. These cancers are more likely to grow and spread.
- Stage IIIA cancers have spread from the prostate to nearby tissues.
- Stage IIIB cancers have spread into nearby structures like the bladder or rectum.
- Stage IIIC cancer cells are poorly differentiated with a Gleason score of 9 or 10.
Stage IV
- The cancer spread outside of the prostate and may have any grade or level of PSA.
- Stage IVA cancers have spread to lymph nodes in the same region as the prostate.
- Stage IVB cancers have spread to distant lymph nodes, other parts of the body or to the bones.
Grade Group as Part of Prostate Cancer Staging
In prostate cancer stages 1 through 3, the oncologist will consider the PSA test results as part of staging. If the PSA level is between 10 and 20, it is considered medium risk, while a PSA level above 20 is considered high.
Stage I
- The tumor is half the size of the prostate or smaller, and the cancer cells are well-differentiated, which means they look like healthy cells.
- Men with cancer in this stage generally have low PSA levels and have a Gleason score of 6 or less.
Stage II
- The tumor is small and found only in the prostate but may have an increased risk of growth. PSA levels are medium.
- There are three different versions of Stage II cancers, labeled A, B, or C depending on their PSA levels, Gleason scores, and how differentiated the cancer cells are.
Stage III
- The tumor is characterized by high PSA levels, a growing tumor or a high grade. These cancers are more likely to grow and spread.
- Stage IIIA cancers have spread from the prostate to nearby tissues.
- Stage IIIB cancers have spread into nearby structures like the bladder or rectum.
- Stage IIIC cancer cells are poorly differentiated with a Gleason score of 9 or 10.
Stage IV
- The cancer spread outside of the prostate and may have any grade or level of PSA.
- Stage IVA cancers have spread to lymph nodes in the same region as the prostate.
- Stage IVB cancers have spread to distant lymph nodes, other parts of the body or to the bones.
How can prostate cancer be treated?
If you were diagnosed with prostate cancer, the SCRI Oncology Partners team will work with you to develop a treatment plan that best fits your cancer, overall needs, and personal preferences. It’s often helpful to have this discussion before deciding to have a prostatectomy (surgery to remove the prostate). However, even if you’ve had surgery, it’s still important to talk with an oncologist about what they can do to lower the likelihood of prostate cancer coming back.
Your risk group will affect the treatments the oncologist considers necessary.
Prostate Cancer Risk Groups
Prostate cancer doctors often tailor treatment plans based on how likely a person’s cancer is to grow beyond the prostate. The higher the chance of growth or spread, the sooner treatment usually starts. Risk is grouped into three main categories based on PSA levels, digital rectal exam (DRE) findings, and biopsy results:
Low Risk
These cancers are small, low-grade, and confined to the prostate, which means they tend to grow slowly. PSA is under 10, symptoms are uncommon, and the chance of spreading outside the prostate is low. Some men fall into a “very low” category, particularly when a tumor can’t be felt during an exam or if previous biopsies show little or no cancer.
Intermediate Risk
In this group, tumors are still limited to the prostate, but the PSA level is higher (between 10 and 20), and the cancer cells are more active (Grade Group 2 or 3). This category is often divided into two subsets:
Favorable: Slower-growing tumors with a lower chance of spreading
Unfavorable: Tumors that are more likely to grow or spread quickly
High Risk
These tumors show signs of potentially spreading beyond the prostate, with a PSA level above 20 and higher-grade cells (Grade Group 4 or 5). If the cancer extends into nearby structures, such as the seminal vesicles, bladder, or rectum, or if multiple biopsy samples show high-grade disease, it is considered very high risk.
At SRCI Oncology Partners, your prostate care team will use these risk levels to guide treatment decisions and timing. For example, low-risk patients often benefit from active surveillance, while higher-risk cancers typically require earlier treatment.
Prostate Cancer Treatment Options
Active Surveillance
If you were diagnosed with prostate cancer, the SCRI Oncology Partners team will work with you to develop a treatment plan that best fits your cancer, overall needs, and personal preferences. It’s often helpful to have this discussion before deciding to have a prostatectomy (surgery to remove the prostate). However, even if you’ve had surgery, it’s still important to talk with an oncologist about what they can do to lower the likelihood of prostate cancer coming back.
Your risk group will affect the treatments the oncologist considers necessary.
Surgery
When prostate cancer is found early and hasn’t spread beyond the prostate, your urologist may suggest surgery. The most common type of surgery is called a radical prostatectomy. During this procedure, the entire prostate gland is removed, and occasionally some nearby tissue as well, to ensure all the cancer cells are taken care of. This approach helps to effectively treat cancer and gives you the best chance for a healthy future. We recommend meeting with an oncologist as well to discuss all of your options and treatment planning.
Radiation therapy
Radiation therapy may be used in combination with surgery or on is own to slow the growth of the cancer, treat symptoms or treat remaining cells. There are three main types of radiation therapy used for prostate cancer, external beam radiation and internal radiation.
Immunotherapy
One of the exciting new treatments for cancer in select patients is immunotherapy. This approach uses special drugs alongside other prostate cancer treatments to help your own immune system better recognize and fight off cancer cells. By working with specific proteins in your immune system, immunotherapy boosts your body’s natural defenses, making it even more effective at tackling cancer.
Targeted Therapy
Targeted therapy is designed to recognize and precisely attack cancer cells with certain abnormal proteins or genetic changes. In prostate cancer, one of the most effective targeted therapies is called PARP inhibitors. These drugs block PARP enzymes, which play a key role in repairing DNA. By blocking these enzymes, PARP inhibitors prevent cancer cells from repairing themselves, particularly in prostate tumors that have mutations such as BRCA1 or BRCA2. Before treatment, your physician will likely test for DNA repair gene mutations. Targeted therapies continue to be an ongoing part of clinical research studies.
Chemotherapy
Chemotherapy is usually only used when the cancer has spread beyond the prostate gland and isn’t responding to hormone therapy. With chemotherapy, anti-cancer drugs travel through your bloodstream to reach and target cancer cells wherever they might be in your body. This approach can be very effective in controlling the spread of cancer and improving your overall health.
Radiation therapy
Radiation therapy may be used in combination with surgery or on its own to slow the growth of the cancer, treat symptoms, or treat remaining cells. There a few types of radiation therapy used for prostate cancer: external beam radiation, brachytherapy seed implantation, and proton therapy.
Prostate cancer clinical trials in Nashville
Today’s clinical trials are tomorrow’s treatment options. A clinical trial can help determine if a drug shows a better way of treating a particular cancer or condition. At SCRI Oncology Partners, we are committed to offering all phases of the latest clinical trials for prostate cancer. This is part of our commitment to improving outcomes and ensuring access to cutting-edge scientific advancements for our patients and the community.
If you are looking for a local oncologist in Nashville, Tennessee and are interested in participating in a clinical trial for prostate cancer through our collaboration with Sarah Cannon Research Institute (SCRI), a global leader in oncology research, the first step is to talk to our healthcare team.
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We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.
We’re here when you need us
If you were recently diagnosed or would like a second opinion, request an appointment with one of our experienced cancer doctors right here in Nashville.