Thank you for your patience and we apologize for the inconvenience.
Our hold times may be longer than usual as our team is currently undergoing a transition and training to serve you better.
For faster service, we encourage you to use our patient portal to message your care team, request appointments, or access health information anytime.
Thank you for your patience and we apologize for the inconvenience.
Our hold times may be longer than usual as our team is currently undergoing a transition and training to serve you better.
For faster service, we encourage you to use our patient portal to message your care team, request appointments, or access health information anytime.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
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  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
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Your Definitive Guide to Integrated Prostate Cancer Care in Dallas-Fort Worth

The First Step Towards Clarity and Control

Navigating a Prostate Cancer Diagnosis with DFW’s Leading Experts

At Urology Partners of North Texas (UPNT), we provide truly cohesive cancer care. Our team of board-certified urologists and leading radiation oncologists from Texas Cancer Specialists work together under one roof, guiding you with a unified treatment plan on the path to wellness.

Schedule a Confidential Consultation
step-to-clarity

Making Sense of Your Diagnosis: A Step-by-Step Guide

Receiving a prostate cancer diagnosis involves a series of tests and results that can be confusing. Our first goal is to eliminate that confusion and walk you through what each part of your diagnosis truly means.

The First Clue: The PSA Blood Test

Prostate-Specific Antigen (PSA) is a protein made by the prostate gland. Normally, very little PSA enters the bloodstream. But when the structure of the prostate is disrupted—whether by inflammation, BPH, or cancer—the PSA molecule leaks into the blood. The higher the number, the greater the leak and the greater the risk that something serious is going on.
What is considered a high PSA?
  • While there’s no universal cutoff, a PSA level greater than 2.5 ng/mL often warrants further discussion and evaluation, especially if it’s rising over time. Your UPNT physician will consider your age, prostate size, and PSA velocity to determine next steps.
Important Note
  • An elevated PSA doesn’t always mean cancer. Many benign conditions like prostatitis or BPH can cause it to rise. But it is a signal that a closer look is needed.

Next Step: The Prostate MRI

Before proceeding to biopsy, we often order a prostate MRI—a high-definition scan that maps the prostate and highlights any suspicious areas. This imaging step is crucial in determining whether a biopsy is even necessary and, if so, where to target it.

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Confirming the Diagnosis: The MRI Fusion Biopsy Advantage

If the MRI identifies concerning areas, the next step is a biopsy. At UPNT, we use MRI Fusion Biopsy, which combines the MRI image with real-time ultrasound—much like GPS. This allows your physician to target specific suspicious zones rather than randomly sampling the gland, reducing uncertainty and the need for repeat procedures.

The Pathologist’s Report: Understanding Your Gleason Score and Grade Group

After the biopsy, a pathologist examines the cells under a microscope. They assign each sample a Gleason pattern ranging from 3 to 5 (we no longer use 1 or 2). The two most common patterns are then added together to form a Gleason score.
  • For example, if the most common pattern is a 3 and the second most common is a 4, your score is Gleason 3+4 = 7.
  • To simplify things further, Gleason scores are grouped into Grade Groups:

Grade Group

Gleason Score

What It Means

1

3+3=6

Low-grade (slow-growing)

2

3+4=7

Intermediate (favorable)

3

4+3=7

Intermediate (less favorable)

4

8

High-grade

5

9–10

Most aggressive
This grade gives your care team insight into how aggressive the cancer is and helps determine which treatment options are appropriate.

Understanding Clinical vs Pathological Staging

Prostate cancer is staged using the TNM system, which describes how far the cancer has spread. But here’s where it gets confusing — there are actually two kinds of TNM stages:

Type

When It’s Used

How It’s Determined

Clinical Stage (cT, cN, cM)

Before treatment (based on PSA, rectal exam, imaging, biopsy)

What we think the cancer looks like before surgery or radiation

Pathological Stage (pT, pN)

After prostate is removed (prostatectomy)

What we know after examining the tissue under the microscope
Example:
  • Before surgery: You might be staged T1c if the cancer was found only from a high PSA (not felt or seen).
  • After surgery: You’ll be re-staged as T2 or higher based on what was actually found in the prostate.
Once the prostate is removed, T1 staging is no longer used — it’s a clinical-only category.

Simplified TNM Staging (in plain language)

Prostate cancer is staged using the TNM system, which describes how far the cancer has spread. But here’s where it gets confusing — there are actually two kinds of TNM stages:

Stage

What It Means

In Plain English

T1

Tumor is small and can’t be felt or seen on scans.

Found only because of a high PSA or during surgery for BPH.

T1a

Tiny spot found during BPH surgery (≤5% of tissue).

Accidental find.

T1b

Larger amount found during BPH surgery (>5%).

Still accidental, but more serious.

T1c

Found on biopsy due to high PSA, no lump on exam.

Most common way prostate cancer is diagnosed today.

Note:

T1 is only used before treatment. After surgery, staging starts at T2 or higher.

T2

Cancer is inside the prostate.

Localized and still contained.

T2a

Involves less than half of one side of the prostate.

Small and one-sided.

T2b

Involves more than half of one side.

Bigger, still one-sided.

T2c

Involves both sides of the prostate.

Cancer is throughout the prostate.

T3

Cancer has spread beyond the prostate.

Locally advanced.

T3a

Grown just outside the capsule.

Pushed through the wall.

T3b

Spread to seminal vesicles.

Into reproductive structures

T4

Invading nearby organs (e.g., bladder, rectum).

Advanced local disease.

N0 / N1

N = Nodes. N0 = no spread. N1 = spread to pelvic lymph nodes.

M0 / M1

M = Metastasis. M0 = no spread. M1 = spread to bones/organs.

Why This Matters:

  • Clinical stage helps us plan treatment before surgery.
  • Pathological stage gives us the full picture after surgery.
  • Together with your PSA and Gleason score, this system helps determine if your cancer is low-risk, intermediate-risk, or high-risk — and how aggressive we need to be.

Staging Your Cancer: Determining Extent of Disease

Once cancer is confirmed, the next step is staging—determining whether the cancer is confined to the prostate or has spread beyond it.
staging-of-cancer
We use two key imaging tools:
  • Prostate MRI: This helps identify whether the cancer has grown through the prostate capsule or involves surrounding structures.
  • PSMA PET Scan: For men with high-risk or recurrent disease, this scan is the most sensitive and specific method for finding metastases.

Understanding the TNM System

  • To provide a standardized classification, prostate cancer is staged using the TNM system:
  • T (Tumor): Indicates how far the primary tumor has spread
    • T2 = confined to prostate
    • T3 = spread through the capsule
  • N (Nodes): Indicates lymph node involvement
    • N0 = no nodal involvement
    • N1 = cancer in pelvic lymph nodes
  • M (Metastasis): Indicates spread to other organs
    • M0 = no distant spread
    • M1 = metastases found (often bones or distant lymph nodes)
By combining Gleason score, PSA, and TNM stage, we can classify your cancer as low-, intermediate-, or high-risk—and tailor treatment accordingly.

The UPNT Advantage: Cohesive Cancer Care Under One Roof

At UPNT, we believe that cancer care should not be fragmented. Our integrated model ensures that urologists and radiation oncologists from Texas Cancer Specialists work side-by-side, reviewing each case in real time to provide the most effective treatment strategy.
  • Integrated Teamwork: From diagnosis to treatment, our unified care team makes decisions together—eliminating delays and miscommunication.
  • On-Site Radiation Centers: Our comprehensive radiation centers in Arlington and Fort Worth, operated by Texas Cancer Specialists, deliver cutting-edge therapy using IMRT and image guidance.
  • Unbiased Recommendations: Because we offer every major treatment option, your care plan is built around what’s best for you—not just what’s available.
  • Leaders in Salvage Therapy: For patients experiencing recurrence, our collaborative team specializes in advanced salvage techniques that offer renewed hope for cure.

A Full Spectrum of Advanced Treatment Options

Radiation Therapy

Radiation remains one of the most effective non-invasive treatments for prostate cancer. Our Texas Cancer Specialists radiation oncologists offer the most advanced options available:

  • IMRT (Intensity-Modulated Radiation Therapy):
    This computer-guided treatment delivers radiation precisely to the prostate while sparing nearby structures like the bladder and rectum. It’s ideal for curing cancer while preserving quality of life.
radial-therapy
surgical-focal-therapies

Surgical & Focal Therapies

Our urologists are fellowship-trained and experienced in a wide array of surgical and focal therapies:
  • da Vinci® Robotic Prostatectomy:
    Minimally invasive surgery that offers precision, faster recovery, and a lower risk of complications such as incontinence or erectile dysfunction.
  • Cryoablation (Cryosurgery):
    A minimally invasive option that uses targeted freezing to destroy cancerous tissue. Often used in primary treatment or in salvage settings.
  • NanoKnife® (Irreversible Electroporation):
    A focal therapy that uses electrical pulses to destroy cancer cells without heat or radiation. Ideal for select localized tumors where preserving surrounding nerve tissue is a top priority.
  • Active Surveillance:
    For men with low-grade disease, active surveillance avoids unnecessary treatment while closely monitoring for signs of progression with regular PSA tests, MRIs, and follow-up biopsies.

Hope for Recurrent Cancer: Integrated Salvage Therapies

A recurrence does not mean the end. Our team at UPNT is highly skilled in providing salvage therapy that targets and destroys residual or returning cancer while preserving your function and dignity.
Salvage IMRT:
  • Delivered by our own radiation oncologists, salvage IMRT can effectively target recurrent disease after surgery with minimal impact on surrounding organs.
Salvage Cryoablation:
  • This is a valuable option for recurrence following radiation and is performed by our experienced urologists under image guidance for precision.
Salvage Nanoknife
  • For patients with a local prostate cancer recurrence on one side or one zone of the prostate, IRE - Irreversible Electroporation is an excellent choice to minimize side effects but destroy the cancer.

Meet Your Expert Care Team

Your care at UPNT isn’t managed by a committee—it’s led by a collaborative, compassionate group of specialists who work together daily.

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Stories of Hope: Our Patients’ Journeys

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John Doe
John DoeCEO
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Take the First Step Today

We’re here to provide clarity, confidence, and compassion—starting from your first visit. Whether you’re looking for a second opinion or ready to take action, our team will walk with you every step of the way.

  • Or fill out the form below and our patient coordinator will be in touch.
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Frequently Asked Questions

Is prostate cancer hereditary?
Yes. Men with a first-degree relative (father, brother, or son) diagnosed at a young age are at significantly higher risk. Let your doctor know your family history.
Whole-gland therapy (like surgery or full radiation) treats the entire prostate. Focal therapy (like NanoKnife or HIFU) targets only the cancerous area.
We’ll verify your insurance, get pre-authorizations if needed, and walk you through all financial aspects so there are no surprises.
Most patients go home the next day. You’ll have a catheter for about a week and start walking immediately. We guide you through recovery, including bladder control and sexual function.

Final Words

You deserve a team that sees the full picture—combining cutting-edge tools with compassionate, expert care. At UPNT, we’ve built that team. From diagnosis to recovery, we walk with you, fight for you, and help you move forward with confidence.

This is your journey—but you don’t have to walk it alone. Let’s take the next step together.

Your peace of mind matters just as much as your treatment plan—and we’re here to help you find both.

final-words
Dr. Weber Chuang will be retiring from medical practice effective September 26, 2025. To ensure that your medical care continues seamlessly, your ongoing care will be transitioned to another physician within our practice. You may schedule appointments directly by contacting our office at 866-367-8768 or via your patient portal. Your medical records will remain securely within the practice, so there is no additional step required on your part unless you wish to request a transfer elsewhere.
Dr. Weber Chuang will be retiring from medical practice effective September 26, 2025.
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