Urologic Cancers

About Prostate Cancer

Prostate cancer is among the most frequently diagnosed cancers in men, especially after age 50, with approximately 60% of cases occurring in men age 65 and older. Key risk factors include advancing age, family history, genetic predisposition, and race, with Black men experiencing higher incidence and mortality rates. The disease develops when abnormal cells grow uncontrollably within the prostate, often without early warning signs. In many cases, the disease does not cause symptoms in the earliest stages. However, when symptoms do appear, they may include:

• Changes in urination
• Pelvic or lower back discomfort
• Sexual dysfunction
• Bone pain (more advanced disease)
• Loss of appetite
• Weight loss
• Painful ejaculation
• Blood in the urine (hematuria)

Screening and Early Detection

As with other forms of cancer, early detection is crucial when it comes to prostate cancer. To identify risk and disease presence as early as possible, your Mount Sinai urologist will guide you in deciding whether prostate-specific antigen (PSA) testing or digital rectal exams (DREs) are appropriate based on age, family history, and other individual risk factors. When slow-growing cancers are detected, we take a careful, measured approach, balancing early intervention with strategies such as active surveillance to avoid unnecessary treatment and their side effects.

Diagnosis and Staging

At Mount Sinai, we use advanced imaging, biopsy techniques, and expert pathology to assess the presence, location, and aggressiveness of prostate cancer. Diagnostic approaches may include:

• Advanced MRI imaging when appropriate
• Ultrasound-guided MRI fusion targeted biopsy techniques
• Comprehensive pathology review to characterize tumor behavior

Together, these insights allow the Mount Sinai team – often led by a urologist – to evaluate each case from multiple perspectives, improving the precision of diagnosis and treatment planning. With this thorough evaluation, we create personalized treatment strategies that align with each patient’s medical needs, lifestyle, and treatment goals.

Comprehensive, Personalized Treatment Options

While low-risk prostate cancers are typically monitored through active surveillance, higher-risk or more aggressive cancers may require more proactive strategies. Our urology team works in collaboration with other members of the Mount Sinai Comprehensive Cancer Center to determine which treatments to apply, such as:

• Surgery – Your Mount Sinai urologist will use advanced techniques, including robotic-assisted prostatectomy, designed to remove the prostate with precision while preserving urinary control and sexual function.
• High intensity focused ultrasound (HIFU) – This can be offered in select cases of low-risk prostate cancer to selectively destroy prostate cancer cells while sparing surrounding healthy tissue. This approach minimizes side effects of incontinence and erectile dysfunction.
• Radiation therapy – Our team of radiation oncologists use targeted tissue-sparing radiation therapy, including external beam radiation and brachytherapy, which precisely delivers radiation to destroy cancer cells while sparing surrounding tissue.
• Hormone therapy – Your urologist and medical oncologist may suggest hormone treatments to slow or stop cancer growth by reducing or blocking hormones that fuel prostate cancer.

Additionally, patients with advanced prostate cancer may be eligible to participate in clinical trials that explore emerging therapies and new approaches to treatment. Clinical trials at Mount Sinai are tightly regulated scientific studies designed to evaluate whether new treatments are safe and effective compared with standard care. Mount Sinai’s urologic cancer experts serve as investigators for both Phase II clinical trials, which evaluate the effectiveness of promising new approaches, and Phase III clinical trials, which compare new treatments with existing standards of care. Participation in these studies may provide Mount Sinai patients with access to innovative options as part of their overall care planning. With the opening of the Braman Comprehensive Cancer Center, we will also offer a second-opinion multidisciplinary prostate cancer clinic. This program brings together a team of specialists—including a urologist, medical oncologist, and radiation oncologist—under one roof to provide comprehensive evaluations and personalized treatment plans.

Support During and After Treatment

Care from Mount Sinai does not end when treatment for prostate cancer is over. Survivorship programs and specialized support services address our patients’ physical, emotional, and practical issues, such as erectile dysfunction, urinary incontinence, and fatigue. Our urology program offers medical, procedural, and rehabilitative solutions to help manage these side effects and support a lasting recovery. Patients may also benefit from:

• Patient navigation services – Mount Sinai’s certified oncology navigators assist with the coordination of care, appointments, referrals, insurance questions, and practical needs throughout the treatment journey.
• Counseling and social work support – Licensed social workers and counselors help patients and caregivers address emotional, financial, and practical concerns, including referrals to community resources, advance care planning assistance, transportation support, and at-home care options.
• Nutritional services – Our registered dietitians offer personalized nutrition counseling to help patients maintain strength, manage side effects, and support overall well-being during treatment.
• Integrative therapies – Complementary therapies such as mindfulness, gentle movement, meditation, and aromatherapy enhance quality of life during and after treatment.
• Music therapy and pet therapy – Therapeutic music sessions and certified animal visits help reduce stress and improve mood during and after the treatment journey.
• Educational resources and support groups – Educational materials, support groups, and survivorship programs address emotional wellness, coping strategies, and long-term health.