Keith Kowalczyk, MD, Urologist and Robotic Surgeon

Prostate cancer is one of the most common cancers in men, with approximately one in eight men receiving a diagnosis at some point in their lives. Fortunately, early diagnosis and a broad range of effective treatments have contributed to positive outcomes with fewer long-term side effects. As one of the leading teams in the Washington, D.C. and Maryland region, we at MedStar Health dedicate ourselves to helping patients find the most suitable prostate cancer treatment. Our team of seasoned experts from various medical specialties is committed to improving prostate cancer outcomes. We offer the latest technology and techniques in robotic and minimally invasive surgery, radiation, and medical oncology, under the stewardship of some of the region's most experienced surgeons and oncologists. Our multidisciplinary care team also includes nurses, social workers, genetic counselors, and nutritionists, among others, who work in unison to support patients and their families during their journey toward health. Our strategic partnership with the Georgetown Lombardi Comprehensive Cancer Center, the region's only National Cancer Institute-designated comprehensive cancer center, ensures patients benefit from ground-breaking research and clinical trials, leading to more effective, personalized treatments. Prostate cancer often remains symptomless in its early stages, growing slowly and silently. As the disease progresses, however, symptoms such as urination problems, frequent pain in the lower back, hips, or upper thighs, difficulty maintaining erections, loss of appetite, and weight can manifest. Importantly, some of these symptoms could be linked to other conditions, such as infection or prostate enlargement. Therefore, it's essential to consult your primary care doctor or urologist promptly if you experience any of these signs. If you do not have a primary care provider or urologist, use our Find a Doctor tool to find a provider.  Understanding your risk factors is also crucial for early detection. If you're over 50, African-American, have a family history of prostate or breast cancer, carry a BRCA gene, or are obese, you may be at a higher risk. Regular screening through a prostate-specific antigen (PSA) test is crucial if you're at high risk. Prostate cancer screening is not a one-size-fits-all approach. Some men will develop prostate cancer in their lifetime, but the disease affects every man differently, and often, it doesn't become life-threatening. Therefore, understanding the importance of early detection is key, as it offers more treatment options. At MedStar Health, we use various methods for prostate cancer screening, including a blood test measuring prostate-specific antigen (PSA) levels and a digital rectal examination (DRE). This simple procedure allows your provider to detect any lumps on the prostate. Talk to your primary care provider or urologist to find out if a PSA test is right for you. If you don’t have a provider, use our Find a Doctor tool to find one that fits your needs. If your PSA levels are high, we understand this can trigger anxiety. That's why we rely on advanced detection tools to determine if cancer is present and assess its extent quickly. Our diagnostic techniques include prostate biopsy, Gleason scores, biomarker profiling, and PSMA PET imaging. Click here to learn more about prostate cancer diagnosis techniques.  We offer comprehensive treatment options tailored to every case of prostate cancer, ranging from watchful waiting for slow-growing cancers to aggressive interventions for faster-growing ones. Our treatments prioritize minimizing and managing possible side effects, using advanced methods such as robotic surgeries and targeted therapies that spare healthy tissue and nerves. Our treatment plans may include surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapy, hormone therapy, and radiopharmaceutical drugs. All our treatments aim to deliver the highest level of precision and care with the least impact on the patient's quality of life. To learn more about treatment options, click here. Watch our Facebook Live broadcast below with Dr. Kowalczyk and Dr. Randolph-Jackson to learn more about prostate cancer: At MedStar Health, we strive to provide expert cancer care that doesn't only focus on the disease but also respects the patient's dignity and compassion. With multiple locations throughout the region, patients have easy access to top-tier cancer specialists and high-quality care. Furthermore, our partnership with the Georgetown Lombardi Comprehensive Cancer Center gives our patients access to clinical trials, often leading to breakthroughs in cancer care. Prostate cancer is a journey, and we're here to ensure you're not walking it alone. We're proud of our unmatched experience, and above all, we're honored to treat you with the dignity, respect, and compassion you deserve.

Prostate cancer is one of the most common forms of cancer in the United States.  The American Cancer Society estimates that there are 268,490 men diagnosed with prostate cancer in 2022. Although many men diagnosed with prostate cancer never experience symptoms or need treatment, more advanced cases can be fatal. The difference in life or death hinges on when the disease is detected. Early detection is key to beating any form of cancer, and a prostate-specific antigen (PSA) test is a simple and quick way to screen for prostate cancer, especially if you have certain risk factors. A PSA test is a blood test that catches signs of prostate cancer early. It can be completed in your primary care provider's office or at a local lab within 15 minutes, just like any other blood test. You don't need to fast before a prostate cancer screening, but you may want to avoid biking or sexual activity for 24 hours before the test. Most major health insurances cover one annual screening for prostate cancer. If you have urologic symptoms, you may be covered for follow-up tests, as needed. While the test itself is simple, it's important to have an expert interpret the results because they're not always straightforward. A PSA screening can detect high prostate-specific antigen (PSA) levels, but an elevated level doesn't always mean you will develop prostate cancer. Inflammation or enlargement of the prostate can also cause elevated PSA. If your PSA level is high, you should meet with an experienced urologist to discuss your results and next steps. When you get a prostate cancer screening, you increase your chances of catching something early when it's easy to treat. Prostate cancer grows slowly over time, and most men with the disease don't know they have it because they don't have any symptoms. When it comes to cancer, knowing is better than not knowing, and a PSA test can ensure you receive timely treatment if you need it. Survival rates are high for early-stage prostate cancer, as 95 percent of men who get early treatment are alive at the five-year mark. If you wait to get a PSA test, you increase your risk of allowing prostate cancer to progress. When the disease becomes advanced, the five-year survival rate drops to about 30 percent. Watch our Facebook Live below to learn more about prostate cancer screenings: A risk factor is something that increases the likelihood that you will develop a disease. While every man is at risk for developing prostate cancer, there is a greater chance you will develop the disease if you: Are over 50 years old Are African American Have a family history Carry the BRCA1 and BRCA2 mutations, the same genetic mutation that increases the risk of breast cancer in women Smoke Are obese Whether you have an average risk or a higher risk, you should talk to your doctor about if and when you need a prostate cancer screening. Men who have a father or brother who was diagnosed with prostate cancer may benefit from a screening every year, starting at the age of 50. If your risk of the disease is considered low, you may only need a prostate cancer screening every other year. You do not need to get a PSA test if you are over the age of 70 or if you have a life expectancy of fewer than 10 years, although it's always best to confirm with your healthcare provider. Health disparities exist for African American men who have a much higher prostate cancer mortality rate than White men. While you may not be able to control the social or economic drivers of health inequities, you can choose to get informed on the disease and schedule a prostate cancer screening every year to increase your chance of catching it early when it's easily treated. Pick a consistent time of year every year to schedule your screening, like football season, to help you remember. Click to Tweet If your PSA level is elevated, you should always have a follow-up appointment with your primary care physician. You may also want to consult with a urologist who can provide a second opinion. A urologist is trained to interpret PSA results and can determine if any next steps are needed, such as a biopsy. When you meet with a urologist to discuss your results, you can expect them to: Ask about your medical history Inquire about your family history of the disease Conduct a digital rectal exam Explain the pros and cons of additional screening, if necessary Offer options for next steps Many men have elevated PSA levels but not everyone needs prostate cancer treatment. Because the disease typically grows slowly, some men benefit from active surveillance. Typically, urologists diagnose prostate cancer after a referral from a primary care provider. Different ages and cancer stages benefit from different treatment approaches, and your doctor will discuss which may be right for you. As one of the most comprehensive prostate cancer centers in the region, we have an experienced multidisciplinary team at your service. We not only offer the full array of treatment options, we’re also leading new discoveries in prostate cancer care that are resulting in excellent prognoses for our patients. Our goal is always to cure your cancer, and we also want to protect your quality of life. We do this by offering a range of treatment options that will achieve the best possible outcome. In most cases, younger men with a 30-year life expectancy will opt for surgery, which may involve robotic-assisted technology. This minimally-invasive approach involves less pain and recovery time than traditional surgery, but it's only as good as the surgeon using it. When your surgery is performed by an experienced surgeon, your risk of side effects, like incontinence or erectile dysfunction, is much lower. At MedStar Georgetown Cancer Institute, our surgeons have performed over 4,000 robot-assisted prostatectomies, making us some of the most experienced in the region when it comes to treating prostate cancer. Older men may benefit from radiation instead of surgery. We've pioneered advances in radiation treatment as well, as one of the first in the country to use CyberKnife® radiation to treat prostate cancer. CyberKnife offers many benefits over traditional radiation because it's faster, requires fewer sessions, and is more effective. CyberKnife also treats prostate cancer with millimeter accuracy in just 5 treatments compared to 40 treatments necessary for conventional radiation therapy.  If you need a second opinion on your PSA level after screening for prostate cancer, you'll benefit from our team approach and broad experience. At the MedStar Georgetown Cancer Institute, our cancer team involves experts from a variety of disciplines, including urologists, medical oncologists, radiation oncologists, and others who work closely together to evaluate which treatment option will benefit you the most. We treat more patients for prostate cancer than most health systems in the region, so you can trust that we have the tools and the experience necessary to care for you. Don't let the fear of a prostate cancer diagnosis keep you from getting a prostate cancer screening. Talk to your doctor about getting your PSA checked early so that you can seek timely treatment, if necessary, and continue doing the things you love while you're in the prime of your life.

If you have been diagnosed with prostate cancer, surgery might be the best treatment for you, especially in younger men less than 65 years old who have higher risk disease and overall good health. But, before you undergo an operation, you need to feel confident that you are using a surgeon you can trust.Read on to learn what factors you should consider, as well as what you should avoid, when choosing the right prostate surgeon.Factors You Should ConsiderWhen it comes to choosing a prostate surgeon, experience is the primary concern. While there is no "magic number" of years a doctor needs to have practiced necessarily, one who has performed prostate surgery hundreds of times is better able to put your mind at ease than someone who does not perform prostate cancer surgery very often. A doctor who has had extra fellowship training focusing on prostate cancer treatment is beneficial, too.Additionally, a multidisciplinary team can help you get the best treatment. Since the decision between surgery and radiation is not always black and white for patients, the surgeon you choose should offer a consultation with a radiation oncologist to determine if radiation is the better option.Red Flags to AvoidFirst and foremost, avoid a surgeon who seems to push or market the surgery they offer. Also, if they say they can do the surgery tomorrow or next week, it’s probably because they are not very busy and don’t do many surgeries.It is always wise to ask the doctor about patient outcomes. If the surgeon cannot answer or doesn’t know, this is a concern. It indicates that they do not engage with patients enough during their journey beyond treatment, and are not following their own outcomes. In short, these surgeons simply can’t know what they don’t know. Similarly, if you meet with a doctor who quotes outcomes that seem too good to be true, they probably are.For example, if a surgeon claims that 95 percent of all patients have no trouble with erectile function after surgery, he is probably not giving you an honest or realistic picture of typical outcomes, or outcomes specific to your condition. They may only be considering young men with low-risk disease and good preoperative erectile function, who also have bilateral nerve sparing to preserve erections.These patients realistically only consist of about half of men seeking treatment.Why Your Prostate Surgeon Choice MattersProstate cancer surgery is not a procedure that can be done well by just any surgeon, especially when it comes to preserving your long-term health. Nearly any urologist can remove the prostate safely, but there may be side effects that reduce quality of life in the long run. For example, surgery can not only affect erectile function, but it can also disturb urinary function, depending on the surgeon’s skill.So don't let the pressure of a prostate cancer diagnosis rush you through this decision-making process; take your time and make the right choice. See as many practitioners as you can to explore all of your treatment options and gather as much information as possible before you get prostate cancer treatment.Also, remember that there is a lot of misinformation about prostate cancer out there. For example, a common misconception heard in our clinics is: “I didn’t think prostate cancer could kill me."This is simply not true, as it remains the second leading cause of cancer death in men. It is, however, generally slow-growing if caught in time. So there is time to make the correct decision for you, which may even be no treatment at all.While prostate cancers may be slow-growing — which is why you don’t need to make a treatment decision in one day — avoiding treatment altogether is not recommended without expert guidance and input from a trained doctor or surgeon. At the same time, some low-risk cases require no treatment at all. So do your research and be mindful of your choice in prostate surgeon, and you'll increase your chances of positive outcomes.