From screening to diagnosis to treatment, we’re changing everything about prostate cancer.

When you hear “it’s prostate cancer,” you may feel like everything changes.

But Cleveland Clinic is changing everything about prostate cancer — including your outlook. From screening to diagnosis to treatment, our breakthroughs are improving care for men everywhere. Read on to learn more about smarter screening, more effective monitoring, better biopsies, and breakthrough therapies, or listen to our podcast, Smarter Screening, Better Biopsies, and Breakthrough Treatments for Prostate Cancer.

Smarter screening

Most prostate tumors grow slowly and don’t spread. But some can spread unless you stop them early — even before you have symptoms.

To catch prostate cancer early and reduce your risk of dying from it, you should have screenings at:
  • Age 50 for most men.
  • Age 40-45 for men at higher risk of getting prostate cancer. This includes men with African ancestry, certain genetic mutations or a family history of some cancers.
Screenings include a digital rectal exam and a prostate-specific antigen (PSA) blood test. A high score on the PSA test usually is because of a benign (not cancer) enlarged prostate. But it also can be a sign of prostate cancer.

A PSA test is not very good at distinguishing the difference between cancer and not cancer — or between cancer that needs treatment and cancer that can just be watched. So, Cleveland Clinic helped create a new, more accurate blood test called IsoPSA®.

The IsoPSA test detects changes in PSA molecules instead of just measuring how much PSA is in your blood. That means the test is better at telling whether you have a prostate cancer that may need treatment or not.

Many men who used to be recommended for a biopsy after their PSA test may no longer need one. In fact, one study found that prostate biopsies recommended on the basis of PSA alone were avoided in 50% of men who had the IsoPSA test.

Cleveland Clinic became the first medical center to offer the IsoPSA test to patients in 2020.

More effective monitoring  

Sometimes the best treatment for prostate cancer isn’t treatment at all, but active surveillance. That’s when you have regular monitoring to make sure your cancer is staying small.

Active surveillance allows you to delay — and maybe even avoid — treatments like surgery and radiation, which can cause urinary, sexual and rectal side effects.

The strategy is safe and effective for patients with low-risk, slow-growing tumors. To better identify these patients, Cleveland Clinic helped develop the Oncotype DX® Genomic Prostate Score. This test evaluates genes in prostate tumor cells. These genes can indicate how aggressive a cancer tumor is.

This genomic test can be done on the same tissue used for your biopsy. It can predict how likely your cancer is to spread even 20 years from now. Better understanding your individual risk reveals whether you need treatment right away or just active surveillance.

Download our free prostate cancer treatment guide

One in nine men will receive a prostate cancer diagnosis during his lifetime. In its early stages, the disease rarely causes symptoms, but you may experience certain warning signs as it progresses. Here’s what to be on the lookout for.

Better biopsies

A biopsy is when your doctor takes cells from your prostate to be examined in a lab. Studying these cells under a microscope is the only way to diagnose prostate cancer.

Most of the time, prostate biopsies are done through your rectum. But Cleveland Clinic now offers a new technique, transperineal biopsy, which goes through your skin. An ultrasound shows your doctor just where to place the biopsy needle, guided by an MRI of the prostate.

This type of biopsy is more precise than the standard technique. It also allows doctors to remove cells from areas of your prostate that are hard to access through your rectum. You may have less pain after transperineal biopsy, and there is a lower risk of infection.

Focal One® High-Intensity Focused Ultrasound

Breakthrough therapies 

If your prostate cancer needs more than monitoring, Cleveland Clinic offers the most innovative treatments. In addition to standard surgery, brachytherapy and radiation therapy, we treat prostate cancer with breakthrough therapies, such as:

Focal One® high-intensity focused ultrasound. This procedure uses high-intensity sound waves to destroy a cancer tumor. It’s delivered through a rectal ultrasound probe. There are no incisions. Most patients need no pain medication after treatment. And there are fewer side effects than with radiation therapy or prostate removal.

Prostate-Specific Membrane Antigen (PSMA) targeted therapy. Found on the surface of prostate cells, PSMA can be a useful biomarker of prostate cancer. PSMA PET (positron emission tomography) uses a radioactive tracer to locate and attach to PSMA proteins, making prostate cancer visible through PET imaging. This approach can be used in conjunction with CT or MRI scans to help physicians accurately stage a patient’s extent of disease, which can lead to more personalized treatment for each individual.

Breakthrough therapies & Photo Kaouk
  • Outpatient prostate removal. Cleveland Clinic was the first in the U.S. to remove a patient’s prostate robotically through a single incision. Most patients having this single-port robotic procedure go home a few hours after surgery. Recovery time is shorter than with standard prostate removal. Most patients feel fine with over-the-counter pain medication or none at all. While not all patients can have single-port robotic surgery, even those who have prostate removal by standard techniques typically go home the same or next day.
  • Partial prostate removal. This new type of surgery removes only the part of the prostate that has the cancer tumor. By leaving the healthy part in place, patients have fewer urinary and sexual symptoms than with standard prostate removal. This procedure is so new that there are no long-term studies on how effectively it controls prostate cancer, but early results are promising in select patients.

Yes, it’s safe to see your doctor again

COVID-19 has changed a lot about how you live, including how you go to the doctor. Although COVID-19 is still around and still contagious, Cleveland Clinic has taken steps to allow you to return safely for care.