From Jeffrey Grass, MD, a radiation oncologist with OHC and one of OHC's team of experts in the use of CyberKnife for prostate cancer, answers some of the most common questions men ask about prostate cancer and treatment.

March 1, 2019

Q: What are the signs of prostate cancer?

A: Early prostate cancer usually causes no symptoms. Some advanced prostate cancers can slow or weaken your urinary stream or make you need to urinate more often, especially at night. But non-cancerous diseases of the prostate cause these symptoms more often. Contact your doctor if you experience any of these symptoms:

  • Weak or interrupted flow of urine
  • Frequent urination (especially at night)
  • Trouble urinating
  • Pain or burning during urination
  • Blood in the urine or semen
  • A pain in the back, hips, or pelvis that doesn’t go away

Q: How do you test for prostate cancer?

A: Two most common tests are a digital rectal exam (DRE) and a prostate specific antigen (PSA).

DRE is a test in which the doctor inserts a gloved, lubricated finger into a man’s rectum and feels the surface of the prostate through the bowel wall for any irregularities.

There is controversy about using the PSA test to look for prostate cancer in men with no symptoms of the disease. On the one hand, the PSA test is useful for detecting early-stage prostate cancer, especially in men with many risk factors, which helps some men get the treatment they need before the cancer grows and spreads. On the other hand, PSA screening finds conditions that are not cancer, such as BPH, in addition to very-slow-growing prostate cancers that would never threaten a man’s life. As a result, screening for prostate cancer with PSA may mean that some men have surgery and other treatments that may not be needed, which can cause side effects and seriously affect a man’s quality of life.

The American Society of Clinical Oncologists (ASCO) recommends that men with no symptoms of prostate cancer not receive PSA screening if they are expected to live less than 10 years. For men expected to live longer than 10 years, ASCO recommends that they talk with their doctors to find out if the test is appropriate for them.

Q: When should I start getting regular check-ups for it?

A: Everyone is different so we always suggest that you talk with your doctor to determine what’s best for you based on your medical history, current health and your family’s medical history.

Q: If I have an enlarged prostate, does that automatically mean cancer?

A: No. It could be benign prostatic hyperplasia (BPH), non-cancerous abnormal cell growth or inflammation of the prostate.

Q: What if it is cancer?

A: If you are diagnosed with prostate cancer, your treatment will depend on a number of factors including how early your cancer was found, how fast it’s growing, if it has spread, and your general health. Some common treatments include:

  • Watchful waiting is common for early-stage prostate cancers. Your doctor will simply monitor your symptoms over time before choosing a treatment.
  • Radiation therapy uses high-energy particles to kill cancer cells. This can be done outside the body (external beam radiation) or inside the body (brachytherapy).
  • Hormone therapy, in injectable or oral forms, is used in men with advanced prostate cancer to shrink and slow the growth of tumors. It’s sometimes used in combination with radiation therapy.
  • Surgery involves removal of the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. There are a number of ways the radical prostatectomy procedure can be performed, all of which should be discussed with your physician.

Q: Why should I choose OHC for my treatment?

A: At OHC, we assemble a team of experts to plan your care – and you are at the center of that team. The team may include a radiation oncologist, medical oncologist, urologist, nurse navigator, and other clinical and non-clinician team members.

Together, OHC and The Urology Group offer many men diagnosed with prostate cancer stereotactic body radiotherapy using a Cyberknife, one of the most advanced treatments used for prostate cancer. CyberKnife (which isn’t a knife) is nonsurgical, painless radiation technology that can reduce or eliminate certain lesions and tumors, many previously considered inoperable. Here in Cincinnati, CyberKnife has been used for nearly five years to treat men with early stage prostate cancer.

Image-guided cameras locate the position of the prostate and radiation remains focused on the target throughout the procedure. This allows the CyberKnife to compensate for gland movement during treatment and avoid the adjacent bladder and bowel. CyberKnife treatments can be accomplished by an OHC radiation oncologist in just five visits, and the side effects may be less than other forms of radiation used to treat prostate cancer.

As always, our OHC doctors and staff are with you through your entire journey, not just during tests and visits. We’re with you from the first time we talk on the phone until you no longer need our services. That’s our goal: to provide you with the support, strength and services you need so you can focus on beating cancer. For more information about prostate cancer and treatments, visit

Sources: OHC, the National Cancer Institute and the American Society of Clinical Oncologists

Comments (9)

8 responses to “Commonly Asked Questions About Prostate Cancer”

  1. Sarah Cummings says:

    Thanks for answering some of the big questions that people want to know about the prior symptoms and how to get the proper treatment about this condition. Thumbs up for you!

    • OHC says:

      Thank you Sarah. It’s our mission to provide information about different types of cancer and treatment options, so people can make the best decisions about their health.

  2. Caden Dahl says:

    It’s good that you listed the signs of prostate cancer as for those that are older, they should know. I don’t think that I have any of these symptoms but it wouldn’t be a bad idea to get myself checked out. It would be best to go to a professional for this as they would have a good idea of what to look for.

    • OHC says:

      Thank you for your message! It’s always good to be proactive about your health. You can ask your primary care doctor about various screenings, including prostate, and together you can determine which you should have and how often.

  3. Rose Hocutt says:

    What if you have a progressive prostate cancer and had axtandi oral treatment and it made you very very sick what what els can be done the xtandi brought the cancer down from 5 to 0.39 if its that low wich is about gone do you have to still take treatments please I want to know

    • OHC says:

      Dear Rose,

      Thank you for your message. We would be happy to discuss the situation and determine the best course of action. Although we don’t provide medical advice over the internet, you can contact us and schedule an appointment to talk with one of our doctors. This will allow us to meticulously review the chart and recommend next steps. You can contact us at 1-888-649-4800 to schedule an appointment. You can also request an appointment through this web site and one of our team members will contact you to schedule an appointment. Thank you.


  4. Sam Li says:

    I appreciate what you said about watchful waiting when it comes to prostate cancer. No matter the type of cancer, proper treatment should be sought out. If I were to have cancer, I would seek out treatment from a reliable doctor.

    • OHC says:

      Thank you for your message and your interest in our blog on prostate cancer. We understand that the term “watchful waiting” is sometimes misinterpreted to mean nothing is being done, when in fact a man is still being closely monitored. Some cancer doctors no longer use this term due to this misunderstanding.

      At OHC, our nationally recognized team of cancer experts follow the evidenced-based medical guidelines set forth by the National Comprehensive Cancer Network (NCCN). This includes watchful waiting, also known as active surveillance. You can learn more about active surveillance from this NCCN downloadable brochure: If you still have questions about prostate cancer, please feel free to call us at 1-800-710-4674. Thank you.

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