There are numerous excellent medical research institutions and hospitals which specialize in the diagnosis and treatment of prostate cancer. I can speak first-hand about one of them, namely Johns Hopkins in Baltimore, MD. Each year, the U.S. News and World Report magazine ranks medical institutions according to their specialty and for the past fifteen years at least, Johns Hopkins Urology has been ranked #1. I can also personally attest to their expertise, care and knowledge since I have had successful surgeries at Hopkins as far back as the 1990’s. Hopkins publishes their Johns Hopkins Health Alerts covering a multitude of disciplines including urology and prostate cancer. To any man who has questions about prostate health and cancer, I would recommend their reference entitled “Choosing the Right Treatment for your Prostate Cancer.” I can personally recommend the knowledge and expertise of the chief author, Dr. Jacek Mostwin as well as his colleagues, among them Dr. H. Ballentine Carter.
In addition to commercial materials as described above, Johns Hopkins also publishes their Prostate Disorders Health Alerts to which one can subscribe electronically. Their recent December 19th, 2012 issue described four (4) categories of prostate cancer risk as defined by the National Comprehensive Cancer Network. These categories range from very low risk, to low, intermediate and high risk. The categories are based upon the stage of the cancer, prostate-specific antigen (PSA) and PSA density values, Gleason scores and the percentage of cancerous prostate cores as detected by biopsies. Guidelines for possible management scenarios are also provided for the four classification categories. The December 13th, 2012 issue of the Hopkins Prostate Disorders Health Alert describes four (4) common misconceptions about prostate cancer. These misconceptions are related to “normal” PSA values and the presence or absence of prostate cancer and potential negative side effects of prostate biopsies including the spread of the cancer and erectile dysfunction.
Androgen-deprivation (hormone therapy) for advanced prostate cancer is accompanied by several risks, among them osteoporosis and loss of bone mineral density which may result in fractures. For such men, Johns Hopkins (in their January 3rd, 2013 Health Alert) recommends annual bone-density scanning with dual-energy X-ray absorptiometry (DEXA scanning). If osteoporosis is indicated, treatment with bisphosphonates (such as Fosamax or Reclast) or a new drug that blocks the formation of a protein that causes bone to break down (Prolia) may be prescribed.