Treatment Of Prostate Cancer Using Surgery
The surgical removal of prostate cancer is called radical prostatectomy. This type of surgery can be conducted using the traditional method of cutting an incision at the abdomen to remove cancer. There is however a less invasive method know as laparoscopic which is the use of a robotic system. The best thing about this type of surgery is that the robot requires less cutting and hence quick recovery and minimal complications.
Surgery today has evolved nowadays because of the use of advanced machines that aims at preserving as many healthy tissues as possible. In prostate cancer treatment high precision is paramount for better results. This is the main reason why there is the use of computer-controlled surgical equipment. This is designed to give surgeons higher precision while conducting the surgery. Doing this allows patients to have better recovery and avoid cases of erectile dysfunctions.
Considering Prostate Cancer Treatment Options
For most men diagnosed with prostate cancer, the cancer is found while it’s still at an early stage — it’s small and has not spread beyond the prostate gland. These men often have several treatment options to consider.
Not every man with prostate cancer needs to be treated right away. If you have early-stage prostate cancer, there are many factors such as your age and general health, and the likelihood that the cancer will cause problems for you to consider before deciding what to do. You should also think about the possible side effects of treatment and how likely they are to bother you. Some men, for example, may want to avoid possible side effects such as incontinence or erection problems for as long as possible. Other men are less concerned about these side effects and more concerned about removing or destroying the cancer.
If you’re older or have other serious health problems and your cancer is slow growing , you might find it helpful to think of prostate cancer as a chronic disease that will probably not lead to your death but may cause symptoms you want to avoid. You may think more about watchful waiting or active surveillance, and less about treatments that are likely to cause major side effects, such as radiation and surgery. Of course, age itself is not necessarily the best reason for your choice. Many men are in good mental and physical shape at age 70, while some younger men may not be as healthy.
Brachytherapy For Prostate Cancer
Brachytherapy is a form of internal radiation therapy. With this type of therapy, radiation is delivered to the prostate tumor inside the body via a catheter or another implantable device.
High-dose rate brachytherapy uses radioactive Iridium-192 to deliver high doses of radiation to the prostate tumor. Treatments are short, sometimes requiring as few as five sessions. Brachytherapy radiation more tightly surrounds the tissues were targeting, which may help spare normal tissues.
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Are There Complications Or Side Effects Of Prostate Cancer Surgery
Similar to radiation therapy for the treatment of prostate cancer erectile dysfunction and urinary problems are the main side effects experienced. It is however important to note that according to research conducted on men who have undergone these two types of surgeries, those who had radical prostatectomy had higher urinary inconsistencies and erectile dysfunction compared to those who had radiation therapy.
This however should not worry you because a large number of men reported having an improvement of these side effects in about 6 months after the surgery. Bowel issues are however minimum for men who have undergone radical prostatectomy.
Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
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What Is The Success Rate Of Radiation Therapy For Prostate Cancer
Radiation therapy is highly effective for treating prostate cancer. In a 2017 , researchers compared the effectiveness of brachytherapy and external beam radiation in men with high-risk prostate cancer. Five years after treatment, 89% of men given brachytherapy and 84% of men given external beam radiation had no signs of cancer.
What Are The Different Types Of Radiation Treatment For Prostate Cancer
Three types of radiation therapy are used to treat prostate cancer.
Brachytherapy involves inserting radioactive pellets into your prostate. External beam radiation involves aiming radiation at your prostate from an external device. Radiopharmaceuticals involve taking radioactive medication through an intravenous line that travels through your bloodstream.
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Side Effects Of Prostate Radiation
Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.
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Shorter Course Of Post
WEDNESDAY, Oct. 27, 2021
After prostate cancer surgery, men can safely undergo fewer radiation treatments at higher doses, a new clinical trial shows.
Researchers found that the shorter regimen given over five weeks, instead of seven did not raise patients odds of lasting side effects.
Safety has been a major concern because when patients have fewer radiation treatments, the daily dose needs to be higher, explained Dr. Neha Vapiwala, a radiation oncologist who was not involved in the study.
But the new findings offer level-one evidence that a shorter course can be delivered safely, said Vapiwala, a professor at the University of Pennsylvania, in Philadelphia.
Prostate cancer is a highly treatable disease. In the United States, the 10-year survival rate stands at 98%, according to the American Society for Radiation Oncology. That means the impact of treatment choices on mens quality of life is particularly critical.
A shorter course of radiation is obviously appealing for its convenience. The new study was designed to find out whether fewer treatments would come at the expense of lasting side effects.
According to lead researcher Dr. Mark Buyyounouski, Preserving quality of life was a major priority when testing the shorter treatment course. It is important for patients to know that accepting a more convenient treatment doesnt mean they have to compromise on quality of life.
More information
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Can Surgery And Radiation Be Used Together
If both surgery and radiation are in the treatment plan for prostate cancer, surgery is usually done before radiation. Radiation may be given to the area around the prostate after removal to help reduce the risk of cancer returning.
This is often done proactively in people in whom staging after surgery shows high-grade disease with a high risk for recurrence.
Other Robotic Prostatectomy Surgery Considerations
There are some other factors that I will look into in deciding if a patient is a good fit for surgery.
One of those factors is your weight. If you are really obese, then this can make the surgery difficult for a couple reasons. First of all, it can be technically challenging if there is a lot of fatty tissue in the body for a variety of reasons.
Additionally, for patients who are morbidly obese, it can make it technically risky from an anesthesia perspective, meaning that it may be hard to manage your breathing mechanics while you are off to sleep.
When we do this surgery, we position you with your legs in the air and your head towards the ground. All the weight from your belly can make it hard to breathe in that position, which is why for some people due to their weight I will not offer surgery as an option.
Another technical factor that I will consider is your prior medical/surgical history.
If you have had surgeries and/or radiation in your belly in the past for any reason, this can lead to added scar tissue formation, which can make the technical aspects of getting exposure to the prostate difficult.
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How Prostate Cancer Staging And Risk Stratification Affect Treatment Options
Your treatment choices are determined by several factors, including your cancers stage, aggressiveness and assigned risk stratification . Your age and current general health condition may also affect your choices.
Prostate cancer staging
Prostate cancer staging determines whether the cancer is confined to the prostate gland or whether theres evidence of metastasis, meaning its spread to other areas of the body.
Tools and methods to determine staging may include the prostate-specific antigen test, the digital rectal examination , the Gleason score and the American Joint Committee on Cancer TNM system, which provides information on the tumor, lymph node involvement and metastasis of a cancer. Imaging tests, such as a PET/CT scan, may also help determine your cancers stage.
The four stages of prostate cancer are subdivided into more precise categories, but we generally refer to three groups that indicate how far the cancer has spread:
Localized, meaning theres no indication that the cancer has spread beyond the prostate
Regional, meaning theres evidence of cancer cells in nearby lymph nodes or tissue
Distant, meaning theres evidence the cancer has spread to other organs or body parts farther from the prostate
Almost 90 percent of prostate cancers are diagnosed at the localized or regional stage. The five-year relative survival rate for men diagnosed with prostate cancer at these stages is nearly 100 percent.
Prostate cancer risk assessment
What Are The Risks Of Radiation Treatment
However, like surgery, radiation therapies often cause side effects. In particular, radiation may cause severe damage to healthy cells and tissues near the prostate area.
These problems are different for each patient, depending on the radiation dose and your general health. Common side effects are detailed below.
- Erectile dysfunction
- Radiation therapy may cause you to experience erection problems, possibly impotence. After a few years, the erectile dysfunction rates in men treated with radiotherapy is similar to that after surgery. Radiation-induced erection problems usually develop over time. This delayed erectile problem is contrary to the presentation after surgery, where erection problems occur immediately and improve over time.
- Concerning different types of radiation therapy for prostate cancer, studies comparing rates of erection problems in brachytherapy and external beam radiation reported conflicting results.
- Some studies found that erection problems are lower after brachytherapy compared to external beam radiation. Other studies have found that rates were not different between ways of delivering radiotherapy.
- Urinary incontinence
- Severe urinary problems are not common in radiation therapy. Nevertheless, you may experience frequent urination and symptoms of an irritated prostate. Urinary issues tend to improve over time, with most men making a full recovery.
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Prostate Cancer Surgery Vs Prostate Cancer Radiation
After being diagnosed with prostate cancer, many men are confused about their treatment options. They probably wonder: Do I go for radiation? Do I go for surgery? Well-intended people may give certain suggestions or recommendations. But, because prostate cancer may be a life threat, prostate cancer patients need to have accurate, scientific information about their options.
Dr. David Samadi, prostate cancer expert, highlights the benefits of robotic prostatectomy surgery over radiation for prostate cancer. A study from Memorial Sloan Kettering showed a 65 percent reduced risk of prostate cancer metastasis after surgery compared to radiation.
Also, there is an analysis of more than a dozen studies which shows that prostate cancer patients do better with surgery versus radiotherapy, especially for men who have localized prostate cancer.
Patients who were treated with radiation over surgery were twice as likely to die from prostate cancer than those treated by surgery. As with any cancer, surgery is the first line of treatment.
Which Treatment Is Best For You
The exact type of treatment that is best for you can depend upon many factors, such as the stage of the cancer, where in the prostate the cancer is located, and individual factors. These are all taken into account by the treating healthcare team when creating a personalized treatment plan.
When you meet with your healthcare provider, they will give you the options that will be the most effective in treating your case of prostate cancer.
For stage 1 prostate cancer, treatment may include:
- Watchful waiting or active surveillance
- Hormone therapy
- Radical prostatectomy with pelvic lymphadenectomy
- Radiation after surgery
- Transurethral resection of the prostate
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Some Things To Consider When Choosing Among Treatments
Before deciding on treatment, here are some questions you may want to ask yourself:
- Are you the type of person who needs to do something about your cancer, even if it might result in serious side effects?
- Would you be comfortable with watchful waiting or active surveillance, even if it means you might have more anxiety and need more frequent follow-up appointments in the future?
- Do you need to know right away whether your doctor was able to get all of the cancer out ? Or are you comfortable with not knowing the results of treatment for a while if it means not having to have surgery?
- Do you prefer to go with the newest technology , which might have some advantages? Or do you prefer to go with better proven treatments that doctors might have more experience with?
- Which potential treatment side effects might be most distressing to you?
- How important for you are issues like the amount of time spent in treatment or recovery?
- If your initial treatment is not successful, what would your options be at that point?
Many men find it very stressful to have to choose between treatment options, and are very fearful they will choose the âwrongâ one. In many cases, there is no single best option, so itâs important to take your time and decide which option is right for you.
Comparison Of The Leading Techniques Of Rp And Ebrt: Rarp Versus Vmat
A retrospective study has recently been published in Radiotherapy & Oncology, which reports comparative outcomes of RARP and VMAT, as the leading respective techniques of RP and EBRT . RARP is a novel, gold standard, surgical procedure for localized PC using the da Vinci Surgical System and has been reported to reduce blood loss complications and positive surgical margin rates, resulting in improved safety and feasibility . VMAT represents a sophisticated EBRT technique based on rotational IMRT, which delivers a highly conformal beam from a rotating radiation source to the target while avoiding risky organs such as the rectum in a short time, by computerized optimization. VMAT has been reported to reduce complications and improve oncological outcomes .
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Coping With The Side Effects
The side effects of both surgery and radiation can vary from mild to more severe and potentially significantly impact someones life.
The side effects of urinary and bowel problems can be distressing. There are ways to help manage these, such as with pelvic floor exercise, bladder training, and incontinence products. Other coping strategies include:
- Urinating every few hours
- Limiting caffeine intake
- Talking to your healthcare team about any medications or other interventions that may be helpful
Sexual dysfunction related to prostate cancer treatment can also be an unwelcome side effect. Helpful ways to cope with this can include:
- Having open communication with your partner
- Prioritizing activities for the day and taking breaks as needed
Can Prostate Cancer Recur After Surgery How To Detect It
Prostate cancer can occur in tissues that are positioned locally next to the seminal vesicles or prostate. This cancer tends to have a negative impact on the surrounding lymph nodes outside that area and in the pelvis.
This type of cancer can spread to the tissues located right next to the prostate including the muscles that help in controlling the urination or affect the walls of the pelvis. This cancer can also travel through your blood stream and impact on your bones as well as other organs.
In this article, we will discuss this cancer recurrence, biochemical recurrence of prostate cancer, and signs of prostate cancer along with the treatment which is most effective.
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What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery
I would rather have surgery.
I would rather have radiation.
I am more concerned about the risks of radiation than I am about risks from surgery.
I am more concerned about the risks of surgery than I am about the risks from radiation.
I’m not worried about the higher risks of erection problems in the first few years after surgery.
I don’t want to risk having erection problems in the first few years after surgery.
How We Approach Prostate Cancer Treatment At Ctca
When you come to CTCA for a diagnostic consultation or second opinion, your case is reviewed by a multidisciplinary team of genitourinary cancer experts before you arrive for your first appointment. This care team may include a medical oncologist, a urologist or urologic oncologist and a radiation oncologist.
If we determine you need additional diagnostic evaluations, such as imaging or genomic testing, we schedule those procedures for you before your arrival.
Well also schedule appointments for you with our integrative care providers, who work to prevent and manage side effects of cancer and its treatment.
Together, we develop a treatment plan thats based on your unique needsusually within two to three days. Our goal is to give you and your caregivers a clear understanding of your options to empower you to make an informed decision about your care.
At CTCA, we strive to treat our patients as we would want our own loved ones to be treated: with compassion, dignity and respect. Its the basis of our foundation, and we call it the Mother Standard® of care.
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