The prostate is a secondary sexual organ exclusive to males which secretes products such as a protein known as prostate-specific antigen (PSA). Though females do not have prostates, they do have similar organs which also produce this PSA protein. The prostate is typically the size of an apricot, and it is located beneath the bladder and surrounds the upper urethra. Its position in front of the rectum makes the prostate accessible to touch during rectal examination. The prostate functions in conjunction with another pair of secondary sexual organs known as seminal vesicles to produce the liquid portion of semen. Despite this inclusion in processes of intercourse, the role of the prostate in human fertility remains debatable. The position of the prostate deep within the pelvis makes surgical access difficult.

Elevated levels of PSA are common in ejaculate, though the level of PSA which leaks from the prostate into the bloodstream is typically low. The level of PSA in the bloodstream is indicative of the probability for developing prostate cancer, and higher levels are associated with higher probability. Specific conditions such as infections or use of certain medications can affect the level of PSA without increasing the probability of prostate cancer. As such, each patient must be evaluated individually in order to interpret the credibility of a PSA level. Though PSA levels can be indicative of cancer, they are not a sure warning sign; this is why an additional test called a biopsy is required to diagnose prostate cancer.

During a biopsy, sample cores are taken from the prostate to be fixed in formaldehyde and stained to identify sections which represent different regions of the prostate. These cores are then examined through microscopy to identify cancer, infection, inflammation, or other distinguishable abnormalities. A biopsy core is only a sample of a prostate, and as such results are not always a definite representation of the condition of the prostate. While a biopsy which reveals cancer can be considered a definite source of diagnosis, absence of cancer in a biopsy does not always indicate absence of cancer in the prostate. Biopsy results are also subject to the interpretation of the biopsy cores, and for this reason communication between Dr. Gholami and your pathologist can ensure an accurate and impartial interpretation. The pathologist will prepare a report for Dr. Gholami which will explain the nature of cores sampled in the biopsy. If cancer is detected this report will include the grade of the cancer as well as the proportion of the core involved. This report should also describe any abnormalities visible in the biopsy cores. Even biopsies which are negative for prostate cancer should note these abnormalities, as they could lead to future cancer diagnoses.

Prostate cancer is described by two separate classifications. The first classification, the grade of prostate cancer, pertains to the shape of cancer cells. Prostate cancer cells vary in shape when viewed under a microscope, and these shapes have been categorized and numbered by a Dr. Donald Gleason. The Gleason score of prostate cancer is the sum of two of the most common shapes of cancer cells. The least aggressive of these cells is labeled 2, while the most aggressive is labeled 10. The Gleason score of prostate cancer determines how aggressive the cancer appears to the pathologist, and it is important in allowing Dr. Gholami to pair his patient with the most effective therapy available. The second classification, or stage of prostate cancer, simply indicates the extent of growth of the cancer.

Patients who should consider DVP as therapy for prostate cancer should have very good health with a life expectancy exceeding 10 years. They should also have cancers which are localized to the prostate gland. Other variables to consider for patients considering LRP include PSA, biopsy results, previous treatments for prostate cancer, weight, smoking history, other illnesses, and current medication regimens.