Prostate Cancer

Prostate cancer is the most common non-skin cancer among American men. About one in six American men will be faced with the diagnosis of prostate cancer during their lifetime. UC Davis Health provides multidisciplinary care for men with all stages of prostate cancer. Our prostate cancer program has an internationally respected team of urologic oncologists, backed by more than 25 research scientists and able to access a large clinical trials network. For men with prostate cancer, this combination means opportunities for the latest treatment advances, early diagnostic approaches and prevention strategies that may not be readily available elsewhere.

Who should have a prostate exam?

• The American Urological Association recommends getting a baseline PSA test, along with a physical exam of the prostate known as a digital rectal exam, at age 40
• Men with a family history of prostate cancer, such as a father or brother

The Prostate-Specific Antigen (PSA) test 

• PSA is an enzyme produced by the prostate gland that may enter the blood stream. Men with prostate cancer often have elevated levels of serum PSA, which correlate with the extent of cancer spread.
• Normal PSA values are less than 3.0 ng/ml
• Repeated PSA values greater than 3.0 ng/ml should be evaluated by a urologist
• Normal levels can vary with age so what is abnormal at 40 may well be normal at 70

Surgery  — radical prostatectomy for localized disease

Robotic prostatectomy — a minimally invasive, laparoscopic approach

Radiation therapy — external beam radiation or brachytherapy for localized disease

Hormone therapy — used to treat metastatic disease (cancer that has spread beyond the prostate gland), as well high-risk localized disease

Chemotherapy — added to enhance the effectiveness of other therapies for localized and metastatic disease

Active surveillance — combined with secondary chemoprevention

The choice of treatment depends on many factors, including how fast the cancer is growing, how far it has spread and the patient's age and health. Weighing the benefits against the potential side-effects of treatments is an important consideration, and helps patients and their physicians develop individualized treatment programs.

In every case, the goal of therapy is to cure prostate cancer while maximizing a man's quality of life. Preventing and treating erectile dysfunction in men with prostate cancer is an area of special emphasis and expertise for the Department of Urologic Surgery’s physician team.

Because each patient’s case is different, a detailed discussion with your UC Davis urologist and other cancer experts will help clarify the risks and benefits of various tests and treatment options.

Focal therapy is a minimally-invasive option offered to some men with prostate cancer. This technology ablates prostate tissue by focusing energy such as high-intensity ultrasound (HIFU), laser, or cryotherapy to the affected area, causing localized destruction of the cells in the gland without damaging the healthy surrounding tissue. Focused ultrasound, for example, works in the same way as rays of sunlight that pass through a magnifying glass and are concentrated at a single point, equally causing a significant temperature to rise around the focal point. Real-time imaging allows for precise local ablation in one session under general anesthesia, repeatable, if necessary, with a low risk of side effects such as incontinence and erectile dysfunction. The patients' quality of life is preserved with minimal time away from work and leisure activities. This is an outpatient procedure - the patient will be discharged and allowed to return home shortly after the procedure. Typical follow-up will include PSA testing at three months, six months, and one year, as well as an MRI image and potentially follow-up biopsies at one year to evaluate the result.

Marc Dall'Era, M.D.
Professor and Interim Chair

Thenappan (Thenu) Chandrasekar, M.D.
Associate Professor

Philip Hsiao, M.D.
Assistant Professor