Radiation Therapy For Prostate Cancer
Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the prostate cancer and other factors, radiation therapy might be used:
- As the first treatment for cancer that is still just in the prostate gland and is low grade. Cure rates for men with these types of cancers are about the same as those for men treated with radical prostatectomy.
- As part of the first treatment for cancers that have grown outside the prostate gland and into nearby tissues.
- If the cancer is not removed completely or comes back in the area of the prostate after surgery.
- If the cancer is advanced, to help keep the cancer under control for as long as possible and to help prevent or relieve symptoms.
Prostate Cancer Treatment Stages
Success rate for treating prostate cancer will depend on the stage of the cancer and how far the cancer has spread. There is a labeling system of T-1 through T-4 which indicates how far the cancer has spread from itâs original site and the size of the cancer.
Ablatherm® HIFU is an appropriate treatment option for essentially any male who has prostate cancer which can be cured by any other means. The stages of cancer of the prostate are:
T-1 Prostate cancer
This is a cancer which has no signs or symptoms and is totally unsuspected.
The prostate feels normal to the physician on rectal exam. The cancer is detected either by an elevated Prostatic Specific Antigen blood test and subsequent biopsies or by examination of tissue removed during treatment of an enlarged prostate. This tumor can be cured by surgery, radiation, and Ablatherm® HIFU.
T-3 Prostate cancer
This is a tumor that has spread outside the prostate capsule and may have reached the seminal vesicles. This tumor is not curable by surgery, radiation, or HIFU.
T-2 Prostate cancer
This is a tumor which is suspected on rectal exam.
One or both lobes of the prostate have areas of firmness and biopsies reveal the cancer. The PSA is also usually elevated.
This tumor can be cured by surgery, radiation, and Ablatherm® HIFU.
T-4 Prostate cancer
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Does Msk Offer Proton Therapy For Prostate Cancer
Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.
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Tools To Help You Decide
The Predict Prostate tool can help you decide between monitoring and more radical treatment. It is for men whose prostate cancer hasnt spread.
It cant tell you exactly what is going to happen in the future, but it gives you an idea about the differences in survival between the different treatment options. The tool works less well for men with a very high PSA or those with a fast growing or large tumour.
To be able to use the tool you need to know the following about your cancer:
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A Large Role For Radiation Therapy
People diagnosed with localized prostate cancerthat is, disease that hasnt spread outside the prostate regionhave many potential treatment options, depending on the stage and grade . Some may have surgery alone. Others may only have radiation therapy.
And some may have a combination of the two. This often happens when theres concern that surgery hadnt removed all the tumor tissue. Or, if someones prostate-specific antigen levels start to rise months or years after surgery, radiation therapy may be recommended even if imaging hasnt been able to identify tumor growth.
Hypofractionated radiation therapy is already an accepted treatment option for some people undergoing radiation therapy alone to treat prostate cancer. But whether this type of radiation therapy is appropriate for use after surgery has been unclear.
When radiation is used after surgery, its delivered to a larger area of the body, including sensitive areas in the bladder and rectum, Dr. Buyyounouski explained. This raises the possibility that the higher doses used in hypofractionation may cause long-term side effects that could outweigh the benefit of two fewer weeks of treatment for these patients.
And a lot of people do have some urinary complications after surgery, said Dr. Citrin. So even a small increase in urinary or bowel symptoms that persist after treatment with one regimen versus the other could be quite impactful in terms of quality of life.
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Impact Of Age On Treatment
The rising number of men diagnosed with prostate cancer is a result of increasing life expectancy as well as the current practice of screening by prostate-specific antigen blood tests. Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making. Although organ-confined disease can be cured by radical prostatectomy and full-dose local radiation therapy, treatment options for advanced- stage disease remain palliative. They include active surveillance, or watchful waiting, early versus delayed hormonal therapy to control disease progression, and continuous or intermittent androgen deprivation. Observational studies of older men with early stage disease have suggested conservative management as a viable option.,
Chodak and associates evaluated 828 men who were managed expectantly in a series of nonrandomized trials. Median follow-up was approximately 6.5 years. Patients with poorly differentiated cancers had a 10-fold increased risk of death from prostate cancer as compared with men showing highly differentiated prostate cancer. A 5-year disease-specific survival of only 34% was found in men with poorly differentiated prostate cancer. In contrast a 5-year disease-specific survival of 87% was described in men with well-or moderately differentiated cancers.
Treatment Options For Prostate Cancer To Consider
Almost 90% of prostate cancer diagnoses are delivered at early stages. In these cases, there is plenty of room for doctors and their patients to discuss and address the situation at a steady pace.
Depending on the circumstances, doctors can call for monitoring the development of the tumor without taking any actionable steps. In the absence of harmful symptoms or a swift change in the progression of the disease, doctors usually incline towards prudent measures.
Given the slow progression of prostate tumors, it can take even years before medical specialists decide on a pragmatic approach. The moment the symptoms of prostate cancer start superseding the possible treatment side effects and affect the quality of life, a care plan is set into motion.
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Heres What You Should Know About This Treatment Option
Men who get diagnosed with prostate cancer have several options to choose from for their next step. Many men with slow-growing, low-risk cancer follow active surveillance, a wait-and-see approach that monitors the cancer for changes.
But if the cancer shows higher risk or has already begun to spread, other treatments are recommended. There are two options: surgery to remove the prostate or radiation to destroy the cancer cells.
Studies comparing these two approaches demonstrate no advantage of one over the other with respect to cancer control. Your path will depend on factors like your current health, the specifics of your cancer, and personal preference. Yet for many men, radiation can be the better option.
“Its much more precise than the traditional radiation used for other kinds of cancer, and research also has found that long-term quality of life is often better, with fewer adverse health effects compared to surgery,” says Dr. Anthony DAmico, a radiation oncologist with Harvard-affiliated Dana-Farber Cancer Institute and Brigham and Womens Hospital.
There are two main ways to deliver radiation to the prostate: external beam radiation and brachytherapy.
Dr Samadi Shares Why Prostate Surgery Is Better Than Radiation For Younger Patients
Choosing between the many variants of surgery or radiation, in case of prostate cancer, is a difficult decision. Often, doctors are biased towards the treatment they feel theyre more experienced in. Our discussion with Dr. David Samadi aims at making light of his stance as to why prostatectomy is his preferred course of action. His website prostatecancer911.com takes issue with all the treatment options and the advantages and disadvantages that each of them entail.
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Radiopharmaceuticals That Target Psma
Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.
Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.
This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.
This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.
Possible side effects
Some of the more common side effects of this drug include:
This drug can lower blood cell counts:
- A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
- A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
- A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.
This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.
Promising Prostate Cancer Drug Hints At Improved Immunotherapy
Immunotherapy is a promising cancer treatment, but getting it to work against solid tumors is proving difficult. A new study has not only identified a drug thats effective against solid tumors, but may have uncovered a reason that immunotherapy often fails.
The human immune system is a powerful weapon, but cancer does a good job of hiding from it and creating an environment around itself that keeps immune cells out. Immunotherapy is an emerging treatment that allows scientists to supercharge the immune system against cancer, and while its had some success against things like melanoma and leukemia, the technique hasnt translated well to solid tumors.
But new research into a drug that helps treat prostate cancer might have uncovered a mechanism for immunotherapys patchy record, and point to a way to fix it. Scientists at Washington University in St. Louis started out by testing a drug compound called -9b, which in previous studies had proven promising against cancer. Since the drug is known to block a gene called ACK1, the team engineered mice to completely lack this gene and investigated how well they responded to cancer.
The research was published in the journal Nature Communications.
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Can Chemotherapy Cure Metastatic Prostate Cancer
Metastatic prostate cancer takes place when cancer cells have reached other organs, distant from the prostate gland. It takes its name from the verb metastasize which means to spread to other parts of the body through means of blood, lymphatic vessels, or membranous surfaces.
At this stage, there is currently no cure to reverse a metastatic phase. That being said, doctors are focusing on various strategies in order to prolong life expectancy.
For cases of metastatic prostate cancer, medical specialists are steering away from surgical procedures. Instead, they are likely to pursue other care plans that involve less invasive treatments, such as hormone therapy, immunotherapy, chemotherapy or even clinical trials. Therefore, patients who suffer from metastatic prostate cancer are usually undergoing sessions of chemotherapy in view of diminishing the symptoms rather than curing cancer.
After Prostate Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Prostate Or To Other Parts Of The Body
The process used to find out if cancer has spread within theprostate or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnoseprostate cancer are often also used to stage the disease. In prostate cancer, staging tests may not be done unless the patient has symptoms or signs that the cancer has spread, such as bone pain, a high PSA level, or a high Gleason score.
The following tests and procedures also may be used in the staging process:
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Image Guided Radiation Therapy
In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.
In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.
Calypso is another form of IGRT where the prostate can be tracked during the treatment.
Movember: What Treatments Are Available For Prostate Cancer
You might be seeing more than the usual amount of facial hair sightings this month as men celebrate Movember and No-Shave November to raise awareness for health issues such as prostate cancer, the second most common cancer in the United States for men after skin cancer.
Prostate cancer survival rates are high when detected and treated early among the highest of all cancers. However, diagnosis and developing a treatment plan can be complicated because it requires the collaboration of physicians from different specialties.
MultiCares urology and oncology teams have partnered to improve the patient experience and offer innovative diagnostic and treatment options for prostate cancer. We dive into the different options below.
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Prostate Cancer: Radiation Therapy
Radiation therapy, also called X-ray therapy, uses high levels of radiation to kill prostate cancer cells or keep them from growing and dividing while minimizing damage to healthy cells.
Radiation can be given from a machine outside the body and directed at the prostate . Or a surgeon can place radioactive materials into the tumor . These radioactive materials can be temporary or permanent.
Helping People Imagine Their Future
The hardest thing we can do as physicians is help patients envision their future selves, Dr. Buyyounouski said. So patient-reported outcomes are very helpful, because you can tell patients exactly what side effects people had, and the frequency and bother of those side effects at points in time.
For many, he added, the trade-off in more side effects right after treatment will be worth it for a shorter treatment duration.
Unless youve been a patient, its hard for folks to imagine all the things that need to happen for somebody to go and get treatment every for weeks, Dr. Buyyounouski said.
Theres transportation costs, gas, parking, co-pays. And there are costs associated with the things youre not doing, like time away from work or responsibilities at home. Its more than just the medical bills.
I think people are itching to shorten the treatment because there are a lot of patients for whom its a barrier to getting treatment. And radiation therapy is a potentially curative treatment, added Dr. Citrin. So, making it easier for patients without increasing the long-term side effects is a huge win.
However, a less-intensive standard course of radiation will still likely appeal to some people, she added, especially if they are experiencing ongoing side effects from surgery.
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Are Other Tests Needed
A doctor will not generally recommend further treatment after a single PSA test result. They will typically monitor a persons PSA levels over time to see whether they are rising.
PSA testing is only one way to check a persons health after having a prostatectomy. A doctor may use an imaging test to look for a tumor or a growing number of cancer cells.
They are also likely to ask the individual about any possible symptoms that could suggest that prostate cancer has returned.
Age The Younger People Survive
People above the age of 55 are very unlikely to survive prostate cancer. Only 7% of diagnosed prostrate cancer die within the first five years. Studies show that the risk of getting prostate cancer increases with age, and the speed at which cancer spreads grows exponentially too. People younger than the age of 40 rarely contract prostate cancer, and when they do, almost all of them are cured easily.
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How To Know When Prostate Cancer Is Cured
As a general rule, doctors consider that their patients are outside any risk of cancer recurrence when the PSA levels remain within normal limits for 5 years. Anything below 4.0 is considered a normal PSA reading.
Once the recommended treatment for prostate cancer reaches an end and the results are favorable, doctors dont rush into labeling the outcome as cured prostate cancer. Instead, they resort to the term remission to indicate that any sign of cancer is gone for the time being.
However, cancer cells can return even after successful treatments. This is why the American Cancer Society urges men to accept annual screenings whether they experience prostate cancer symptoms or not.