Prostate Cancer
Prostate cancer is the most common malignancy in males. Asymptomatic
men who have nothing abnormal on physical examination may test positive for prostate cancer with an elevated PSA blood test.
Thankfully, we have a full array of treatment choices to control and cure this disease.
Patients with
prostate cancer are generally grouped into low, intermediate and high risk depending on the level of PSA, the clinical stage,
and Gleason score (pathology). Low risk patients have a higher chance of achieving long term disease control compared to higher
risk patients.
Treatment options for low risk patients: watchful waiting, radical surgery
(if less then age 70), definitive external beam therapy, definitive brachytherapy.
Treatment options
for intermediate risk patients: radical surgery (if less then age 70), definitive external beam therapy, definitive brachytherapy,
and combination external beam therapy with brachytherapy. Hormones may be added prior to or along with radiation therapy.
Treatment option for high risk patients: definitive external beam therapy, combination external
beam therapy with brachytherapy. Patients with high risk disease should receive hormones prior to and along with radiation
treatments.
The referring urologist along with the radiation oncologist will help guide patients in
their choice of treatments.
Terk Oncology is the only free standing facility in New York City to offer
Brachytherapy and External Beam Therapy in an outpatient facility.
Rapid Arc IMRT/IGRT is an advanced
technique utilized at Terk Oncology. This technique allows for maximal sparing of normal tissues while achieving excellent
coverage of the prostate. With Rapid Arc, the treatment is delivered in less than 2 minutes which allows for less organ motion.
Additionally, there is less total body radiation dose delivered. With this technique, the prostate is visualized prior to
therapy to make sure the set up is perfect before to each treatment.
Brachytherapy is a minimally
invasive treatment whereby radioactive seeds are placed into the prostate. This is an outpatient procedure performed in our
office under general anesthesia.
Risk Factors
The risk factors for prostate
cancer include:
- Family history of prostate cancer
- Race (African American males have a higher risk)
- Age (being over 65)
Symptoms
Prostate cancer is usually asymptomatic
and is often found either because of an elevated PSA or because of a finding during a rectal examination. Patients with prostate
cancer often have BPH (benign prostatic hypertrophy) and associated urinary symptoms which can include weak stream, difficulty
urinating, and pain or burning during urination.
Diagnosis
Patients that have
an elevated PSA and/or a suspicious physical exam finding have prostate biopsies performed. Multiple prostate biopsies are
obtained via an ultrasound guided needle, through the rectum.
Staging
In patients
with intermediate or high risk prostate cancer, testing includes CT of the Abdomen/Pelvis and bone scan.
PROSTATE CANCER
