Prostate Cancer Treatment
About the prostate
The prostate is a gland in the male reproductive system located in front of the rectum and underneath the urinary bladder. The size of the prostate varies with age. It is usually the size of a walnut, but it can become larger as men get older. The prostate creates the fluids that shield and feed the sperm cells in semen, producing semen with more liquidity. Located behind the prostate gland are the seminal vesicles that create most of the fluid for semen. The urethra, which goes through the center of the prostrate delivers semen and urine out of the body through the penis.
There are many types of cells found in the prostate, but nearly all prostate cancers grow from the gland cells. Gland cells make the prostate fluid that is added to the semen. The medical term for a cancer that starts in gland cells is adenocarcinoma.
Most prostate cancers grow slowly, although sometimes the prostate cancer can grow quickly and spread to other parts of the body. It has been discovered through autopsy studies that many men who died from other causes also had prostate cancer but it never affected them during their lives and they and their doctors never knew they had prostate cancer.
Prostate cancer can sometimes cause pain, difficulty with urination, and problems during sexual intercourse, which might include erectile dysfunction. There also may be other symptoms that can develop during other stages of prostate cancer.
Knowing how far the cancer has spread, referred to as the staging process is very important part of evaluating prostate cancer. By determining the stage, our cancer doctors can prescribe the best course of cancer treatment needed. The most important distinction made by any staging system is whether or not the cancer is still confined to the prostate or if it has spread to other parts of the body.
The only way to confirm a diagnosis of prostate cancer is through a prostate biopsy. During a prostate biopsy, the pathologist will study the samples under a microscope. If cancer is present, the pathologist will identify the grade of the tumor. The grade will tell us how large the tumor is and how fast it could possibly grow by comparing the normal tissue and the tissue from the tumor. The Gleason system is used to grade prostate tumors from 2 to 10, where a Gleason score of 10 indicates the most irregularities. The pathologist assigns a number from 1 to 5 for the most common pattern observed under the microscope, and then does the same for the second-most-common pattern. The sum of these two numbers is the Gleason score.
Signs and symptoms
Early prostate cancer usually causes no symptoms. Often it is diagnosed during the workup for an elevated PSA noticed during a routine checkup. Symptoms can include:
• Frequent urination – including increased urination at night
• Difficulty during urination such as starting or continuing a steady stream
• Blood found in the urine
• Pain during urination
Age and family history are the most common factors of prostate cancer. The average age at the time of diagnosis is over 65 years.
Prostate Cancer Screening and Treatment
Prostate cancer screening is important, especially if you have a family history of prostate cancer. Screening for prostate cancer to find unsuspected cancers includes a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE) to assess the size and feel of the prostate. If screening exams indicate the possible presence of cancer, follow-up may be required. Follow-up tests may include a biopsy, with cell samples taken for closer study.
Treatment for prostate cancer can include a number of options, including taking a wait-and-see approach while monitoring tumor progress and symptoms and surgery. Other options include:
• Prostate Seed Implantation – This outpatient procedure involves the placement of tiny radioactive “seeds” into the prostate cancer tumor site. The seeds deliver a low dose of radiation to the cancer cells while slowly disintegrating over time. This minimally invasive procedure only takes about an hour to complete and has proven very successful in treating tumors in their earlier phases.
• High Dose Radiation Therapy (HDR or Temporary Brachytherapy) – This is another form of internal radiation that involves the temporary placement of higher-dose radioactive seeds into the prostate. A hospital stay is involved, during which a template is fitted into the area to be treated. The initial treatment is generally two or three times following again about two weeks later.
• External Beam Radiation – This therapy involves the use of daily radiation treatments, five days a week, for generally seven to eight weeks. These painless sessions only last a few minutes. The primary target is the prostate gland itself. Intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), and 3D conformal radiation therapy enable more precise targeting of the tumor to spare nearby tissue.
• Combination Seed/EBR – This therapy is conducted in advanced stages of prostate cancer for those at risk for a spread of the disease. It involves the use of both seed implants and external beam radiation.
• Hormonal Therapy – This therapy may be used in conjunction with others if a tumor is large. It is designed to suppress, eliminate or add particular hormones to the body to slow or stop the growth and/or spread of cancer.
Which cancer treatment options are best depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors are age, general health, and patient views about potential treatments and their possible side-effects.
Choice Cancer Care suggests working very closely with our doctors and oncologists to determine the best prostate cancer treatment for you and your lifestyle. The average life expectancy with men who have been diagnosed with prostate cancer has increased due to advances in the treatment of prostate cancer.
Choice Cancer Care’s Dr. Gregory Echt is also the founder and lead surgeon at the Prostate Seed Institute. Through this affiliated practice, Dr. Echt and his colleagues are dedicated to providing men with the most effective prostate cancer treatment options available. Dr. Echt prefers using Prostate Seed Implants to treat men whenever this method is an advisable option. Less invasive than a radical prostatectomy, implants have been proven highly effective over the course of more than 15 years of use. Dr. Echt has personally treated more than 5,000 men with seed implant therapy and has also overseen more than 10,000 cases where External Beam Radiation was used to battle prostate cancer.
To learn more about prostate cancer treatment options, visit the Prostate Seed Institute’s website.