Choosing the Right Prostate Cancer Treatment

What’s the Right Prostate Cancer Treatment for Me?

prostate cancer treatmentThere are many things to consider when trying to choose the prostate cancer treatment that is right for you.

Most men diagnosed with prostate cancer haven’t had the disease spread beyond the gland and may be classified as low risk. Others may have more advanced stages of the disease and will be considered intermediate or high risk.

Doctors use the serum PSA test and the Gleason score to help decide which type of prostate cancer they are dealing with. Treatment options vary depending on these factors and more.

Dr. Farshid Dayyani details what these factors are and how you can use them to find the correct prostate cancer treatment for you.

Transcript

Dr. Farshid Dayyani: When a man is newly diagnosed with prostate cancer there are a few options you can choose from. In terms of treatment which factors should be considered before deciding on treatment, the majority of men are diagnosed with what we call localized prostate cancer meaning that cancer has not spread beyond the gland while some of them might live forever and never die of the cancer. Even without treatments others will have much more aggressive disease and will need to be more aggressive treatment up front in order to stratify the patient and different risk categories. To guide them through treatment we have used clinical parameters such as the serum PSA the Gleason score which is found under biopsy results as well as the extent clinically through rectal exam
and imaging to building prognostications system that will guide our treatment based on these three factors we have pieces with low risk of disease progression intermediate and high-risk. For patients with very low risk, active surveillance is actually a recommended modality meaning are close follow-up serial psh X and repeat biopsies and treatment at the time of disease progression. Patients who have
low-risk disease can choose in selected cases between active surveillance or treatment with radiation or radical prostatectomy patients with intermediate great disease probably should not observe and the silent treatment with either radiation or surgery and if the choose to undergo radiation therapy, should be treated with six months of hormone deprivation therapy high-risk patient, meaning those who are
at the highest risk for progression and the task to seize up should either under undergo prostetectomy or if they choose to have radiation therapy will combine this with two to three years of androgen deprivation. How to choose between surgery or radiation will depend on the patient profile if the patient is not good, a good surgical candidate because of other core morbid conditions he has such as heart disease diabetes or advanced age then treatment is likely to be radiation with or without hormone deprivation a younger fifth patient for example in his fifties was no other medical issues and a very aggressive disease might probably benefit more from up-front surgery the side effects associated with radiation and surgery are explained by the technique and I will explain to you in a second. With surgery the main goal for quality of life is to try to preserve the nerve bundles that mediates sexual function so for the surgeon who performs this procedure the question is can I preserve the nerve
bundle safely meaning without leaving any disease behind this should be discussed with the patient prior to the procedure based on the risk level the search you will also entail removal of lymph nodes in the pelvis which might cause some problems down the road such as edema if the so called urinary sphincter muscle is affected during the surgery the patient might suffer from incontinence after the surgery most of these a side effects will improve over time by about two years after surgery depending on what study will look at thirty to fifty percent of patients will have some decrease of these functions although they are not very severe it’s important to know that for example sickle cell dysfunction can be treated with implants and medication so a counseling the patient is very important to know that we are able to control most of the side effects patients who elect to undergo radiation will have more acute side effects such as irritable bowel that is in the radiation field and is a manifested by up frequent bowel movements urgency and sometimes also a rectal bleeding but again these are acute side effects and most of them resolve over the first one to two years the urinary symptoms that patients who undergo radiation experience are explained by what we call the radiation cystitis so it’s more the irritation of the
blather rather than are interaction with the sphincter muscle so again they will have emergency
meaning they have to go to the bathroom a lot have some burning sensation but this over time will improve as well sexual dysfunction on the other hand is a side effect there will develop over time and the increased typically over the first one or two years in patients who undergo radiation but if you look at two years in most studies there is not a major difference in terms of long-term side effects of surgery of this radiation in the majority of men so other medical problems as mentioned earlier will help guide the decision-making.


This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided on this site solely at your own risk. If you have any concerns about your health, please consult with a physician.

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