Learn about prostate cancer treatment
options
Let's take a closer look at the most common
cancer in American men, prostate cancer. 1 man in 6 will be diagnosed with
prostate cancer in his lifetime. You need to know your options: There is a lot
to think about when choosing the best way to treat or manage your prostate
cancer. You should always get a second opinion, especially if you have many
treatments to choose from. Prostate cancer is a complex disease, and doctors may
differ in their opinions about the best treatment options. You will want to
weigh the benefits of each treatment against its drawbacks, side effects, and
risks.
RADIATION TREATMENT
There are several radiation options for the
treatment of prostate cancer.
1.
External
beam radiation therapy involves focusing a beam of ionizing radiation to the
tumor while sparing the surrounding tissue. Treatments are given Monday through
Friday and last less than 30 minutes.
2.
Dimensional
Conformal Radiotherapy (3D-CRT) is a method of treatment delivery that combines
multiple radiation treatment fields using 3-Dimensional computer planning to
produce a high-dose area of radiation that conforms to the shape of the area to
be treated.
3.
Intensity
modulated radiation therapy (IMRT) is an advanced form of 3D-CRT that modifies
the intensity or strength of each radiation beam. It utilizes a sophisticated
system of treatment delivery that allows a precise adjustment of the radiation
beam intensity to the tissue within the target area while minimizing effects on
surrounding tissue.
4.
IGRT or
Image Guided Radiation Therapy is another technology that can also be used to
ensure better targeting of daily radiation treatments.
5.
The Newest
Technique is Stereotactic body radiation therapy (SBRT) is a specialized form
of 3D-CRT that delivers high doses of radiation over a period of five to ten
days.
6.
Brachytherapy refers to the technique of
implanting small radioactive sources directly into the prostate gland. This
procedure takes place under anesthesia, usually in the operating room.
Brachytherapy is generally used only in men with early stage prostate cancer
that is relatively slow growing. There are two methods of delivering this type
of radiation to prostate cancer:
SURGERY
A surgical approach toward the treatment of
prostate cancer is called a prostatectomy. There are several prostatectomy
options:
1.
Radical Retropubic Prostatectomy: The most common type of prostatectomy
involves making an incision in the abdomen and removal of the prostate from
behind the pubic bone.
2.
Nerve-sparing prostatectomy: The surgeon cuts very close to the edges of the prostate. Care is
taken to spare the nerves responsible for erections that run alongside the
prostate. In cases when the nerves cannot be spared it may be possible to
perform a surgical grafting procedure.
3.
Laparoscopic Radical Prostatectomy (LRP): minimal invasive surgery. Very
small incisions are made in the abdomen, into which the surgeon inserts narrow instruments
fitted with cameras (laparoscope) and/or surgical tools, allowing the surgeon
to visualize and operate on the internal structures without cutting open the
entire abdomen.
Side effects of prostatectomy%u2028 include
urinary incontinence (stress and total), erectile dysfunction (ED) and
impotence, and post-operative complications.
HORMONE THERAPY
is also called androgen deprivation therapy
(ADT) or androgen suppression therapy. Often hormone therapy will be used in
addition to other treatment. It may consist of a combination of injections and
oral tablets. Therapy typically begins at least two months prior to
radiotherapy and may be recommended for up to three years depending on the
clinical situation.
ACTIVE SURVEILLANCE
The concept of active surveillance, or
watchful waiting means watching the patient closely with regular PSA tests and
digital rectal exams every 3 to 6 months. Transrectal ultrasound-guided
prostate biopsies may be done every year as well. Treatment is started if the
cancer seems to be growing or getting worse, based on either a rising PSA, a
change in the rectal exam, or biopsy results.
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