The Middlesex Health Cancer Center specializes in diagnosing and treating prostate cancer with state-of-the-art biopsy technology and sophisticated surgical techniques. 

Prostate cancer is the second-most common cancer in men. However, the condition has very few symptoms until it's advanced. Regular screenings like blood tests and rectal exams help find prostate cancer early when it's most treatable. Survival rates continue to rise with improved screening, detection, and treatment.

The prostate gland is located at the base of the bladder, near the front of the rectum. The gland secretes some of the fluids that are present in semen. It also helps control bladder function. Prostate cancer starts when cells in this gland grow out of control.

Diagnosing prostate cancer commonly involves a few different tests, including a full physical exam, blood work, and an ultrasound or an MRI. Once cancer is suspected, your doctor may order a biopsy of the tissue to look for cancer cells under the microscope.

No two patients or their treatment plans are alike. This is particularly true for prostate cancer, where care may range from active monitoring only to aggressive treatment, depending on the cancer's biology and the patient's overall health. This is why, at Middlesex Health, we take a highly personalized approach to your prostate cancer care.

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Early-stage prostate cancer usually does not cause noticeable symptoms. This makes early detection - which is key to successful treatment - more difficult. Therefore, prostate cancer screening is very important.

At Middlesex Health, we recommend that men begin prostate cancer screening at the following ages:

  • Men with Higher Risk: Begin yearly screenings at 40 years old
  • Men with Normal Risk: Begin yearly screenings at 70 years old

There are many different recommendations for prostate cancer screening from organizations such as the American Cancer Society, American Medical Association, American Urological Association, and the National Comprehensive Cancer Network. There is also debate over the benefits of screening. The most important step you can take is to discuss screening with your doctors and determine the best plan based on your health and risk level.

Most people with prostate cancer do not have symptoms until the disease is in its later stages. Symptoms may include:

  • Decreased urine flow
  • The feeling of not fully emptying your bladder
  • Needing to get up often during the night to urinate
  • Blood in the urine
  • Swelling of the penis, scrotum, legs and feet
  • Difficulty getting an erection
  • Pain in the hips, thighs, and lower back

Many diseases of the male urinary tract have similar symptoms. If you are experiencing any of the above, please contact your doctor.

Early detection of cancer can be key to successful treatment, so it is important to understand what increases your risk of prostate cancer. Current research has shown that key risk factors include:

  • Family History: This is the most important risk factor for prostate cancer. Men with one first-degree relative (a father or brother) with prostate cancer have twice the risk of developing prostate cancer. Men with two or three first-degree relatives with prostate cancer have five and eleven times the risk (respectively).
  • Age: The risk of prostate cancer increases as men age. After age 50, 30% of men will be diagnosed with prostate cancer. After age 80, this number increases to 60-70%.
  • Race and Ethnicity: African-American men have a 70% higher risk of having prostate cancer. They are also more likely to be diagnosed with prostate cancer at higher stages. 

Prostate cancer screening and diagnosis takes place using a combination of tests, including:

  • PSA (Prostate-Specific Antigen): A test to determine the level of this protein in the blood. It is produced by healthy and cancerous prostate cells, and it is often elevated in men with prostate cancer.
  • DRE (Digital Rectal Exam): A test in which your doctor inserts a gloved, lubricated finger into the rectum to feel the prostate, which lies in front of the rectum.

Advanced Diagnostic Technology

When diagnosed early, most cancers can be treated successfully. This is especially true for prostate cancer, where survival rates are significantly higher when the cancer is still localized to the prostate. 
That is why Muddlesex Helth has invested in advanced diagnostic technology, which allows us to detect prostate cancer in its earliest stages.

A prostate MRI is a noninvasive imaging test that uses a powerful magnetic field, radiofrequency pulses, and a computer to create detailed pictures of your prostate gland and surrounding tissues. One of the primary uses of a prostate MRI is to assess the extent and aggressiveness of prostate cancer and determine whether it has spread beyond the prostate gland.

This scan uses a special camera to take PET and CT scans. The scan uses a radioactive tracer called Pylarify, which helps cancer cells show up more clearly in the images.

Middlesex Health offers UroNav, an innovative way to do prostate biopsies. UroNav combines regular ultrasound images with MRI images taken before the biopsy. This creates clear pictures of the prostate and possible cancers. 
With UroNav, doctors can take biopsy samples from specific spots, which reduces the number of biopsies needed for diagnosis. 
Unlike traditional biopsies that use only ultrasound images to guide the needle and choose which parts of the prostate to sample, UroNav's MRI-guided biopsy is much more precise. This lowers the chance of missing a cancer and needing extra biopsies. UroNav reduces patients' stress and pain by making the process more targeted.

Treatment Options

There are many ways prostate cancer can be treated, and the evidence-based plan your doctors choose is based on a number of factors: type of cancer, grade and stage of the cancer, your overall health, and your treatment preferences.

If your prostate cancer is determined to be low-risk, the best course of action may be to postpone treatment and watch carefully to see if the disease progresses.

What is a low-risk cancer?

A low-risk prostate cancer either grows very slowly or not at all. It is not an aggressive form of prostate cancer. 

What is the benefit of postponing treatment?

In cases of low-risk cancer, treatment may be postponed in order to avoid over-treatment. Some patients can avoid surgery or radiation altogether. 

What if my prostate cancer starts to advance/progress?

Your doctor will closely monitor your cancer. If there are changes, which would show up in repeat PSA testing, DRE testing, or biopsies, your doctor will develop an appropriate treatment plan.

Is there scientific evidence supporting this approach? 

Yes, the American Urological Association and the National Comprehensive Cancer Network recommend active surveillance in carefully selected cases.

Two common surgical procedures are used to treat prostate cancer. 
Radical Prostatectomy 
This procedure involves the removal of the prostate gland. This surgery is an option for treating cancer that's confined to the prostate. It's sometimes used to treat advanced prostate cancer in combination with other treatments. 
At Middlesex Health, our expert surgeons have the training and expertise necessary to perform da Vinci® Robot-assisted prostate surgery, which allows our surgeons to be incredibly precise. This means that the delicate nerves near the prostate can be preserved so that you can maintain as much urinary control and sexual function as possible.
The da Vinci® surgical system includes a powerful, high-definition camera that gives the doctor crystal clear 3D images of the surgical area. The ability to see fine anatomical details is key to nerve preservation.
Your physician will review your treatment options and determine whether you are a good candidate for robot-assisted surgery. 
Orchiectomy, or surgical removal of the testicles, is also an option for men with advanced disease who do not want long-term medical therapy. Because testicles produce the body's testosterone, their removal immediately causes hormone levels to drop.


Over the last several years, there have been significant advances in the use of medical oncology for Prostate Cancer. Medical therapies are often used in conjunction with other treatments, like radiation and surgery, to ensure the best possibilities for remission and recovery. 

Medical therapies we offer for prostate cancer include:

Hormone therapy

This treatment interferes with the effects of testosterone. Testosterone helps prostate cancer cells grow, so interfering with testosterone production helps kill the tumor.


The use of drugs to kill or slow the growth of rapidly multiplying cancer cells.


Immunotherapy for prostate cancer works by helping a patient's own immune system fight back against cancer cells. For example, one immune therapy approved by the FDA is a vaccine called sipuleucel-T (Provenge), which spurs a patient's immune system to attack prostate cancer cells.

The main types of radiation therapy used for prostate cancer are:
External Beam Radiation (ERBT)
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier-stage cancers or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.

Radiopharmaceuticals are drugs that contain radioactive elements. They are injected into a vein and travel through the blood to reach cancer cells that have spread to other parts of the body. These drugs then give off radiation that kills the cancer cells
All treatment options have side effects. Your doctor will discuss the best treatment option for you and your lifestyle. 
Understanding Prostate Cancer Stages and Risk Groups

After a patient is diagnosed with prostate cancer, doctors will try to figure out if it has spread and, if so, how far. This process is called staging. The stage of prostate cancer describes how much cancer is in the body. It helps determine how severe the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

Doctors consider several factors when determining the stage of your prostate cancer, but there are two key measurements. 

PSA Level: Prostate-specific antigen (PSA) is a protein made by both normal cells and cancer cells in the prostate gland. Most men without prostate cancer have PSA levels under 4 ng/mL of blood. When prostate cancer develops, the PSA level often goes above 4. Men with a PSA level between 4 and 10 have a 1 in 4 chance of prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.

Gleason Score: This score is based on how much the cancer looks like healthy tissue when viewed under a microscope. Tumors with a Gleason score of 6 or less are less aggressive and generally look more like healthy tissue. Tumors with a Gleason score of 8 or more are more aggressive and are likely to grow and spread to other parts of the body. They look less like healthy tissue.

Once prostate cancer has been identified, our team will further sort your cancer into one of five risk categories based on your Gleason score, PSA level, and other factors. Your recommended treatment plan may differ based on the risk category assigned to your cancer. 

Very low: These prostate cancers are small, not felt on exam, can only be found in a small area of the prostate, and have not grown outside the prostate. They usually grow very slowly and are unlikely ever to cause any symptoms or other health problems.

Low: Prostate cancers in this group have not yet grown outside of the prostate but are slightly larger than very-low-risk cancers.

Intermediate: This group of prostate cancers can be felt on an exam or seen on an imaging test. The cancer might be found in more than half of one side of the prostate or on both sides of the prostate. Additional classifications split the intermediate-risk group into favorable and unfavorable categories.

High: Prostate cancers in this group have grown outside the prostate. They have a Gleason score of 8 to 10 or a PSA level of over 20. 

Very high: These prostate cancers have a high risk of the tumor growing, returning, or spreading to the nearby lymph nodes. 


2 Specialty Care Locations

1Middlesex Health Cancer Center - Middletown

536 Saybrook Road
Middletown, CT 06457
Office Hours
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
Middlesex Health Cancer Center - Middletown

2Middlesex Health Cancer Center - Westbrook

250 Flat Rock Place
Westbrook, CT 06498
Office Hours
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
8:00 AM - 4:00 PM
Middlesex Health Cancer Center - Westbrook