Prostate cancer is a very common malignancy identified in nearly 190,000 men in the U.S. annually. It is important to understand that prostate cancer can be slow-growing in some men and aggressive in others, and therefore can behave differently in each patient. It is a cancer that often lacks respect because, for the majority of men, it is a low-risk malignancy that does not require treatment. Unfortunately, 30,000 men die annually in the United States from prostate cancer. Further complicating the diagnosis is the current controversy regarding the benefits of PSA screening for prostate cancer because many men may be unnecessarily treated for the disease without benefit of an increase in lifespan and subsequently have lifelong side effects.
Explore Your Options for Prostate Cancer Treatment Thoroughly
Men should seek an understanding of their illness and treatment options prior to making a decision regarding treatment. It is imperative for men newly diagnosed with prostate cancer to seek out the opinion of a urologist-surgeon, radiation oncologist, and medical oncologist, as well as the opinion of their primary physician so that a well-balanced, consensus opinion of several experts can be considered prior to undergoing treatment. This process can take a month or longer but will serve the patient well in understanding the risk of their prostate cancer and the benefits and side effects that can accompany treatment.
Additionally Lawrence Cancer Center created the PSA – “Prostate cancer Support Advocates” support group which meets on a monthly basis. This group of men includes a spectrum of patients who meet for educational lectures and share their treatment decisions and experiences with those who are recently diagnosed.
Prostate Cancer Treatment Options
Treatment options can include watchful waiting, prostatectomy, radiation therapy alone, or a combination of surgery followed by radiation, or radiation with hormone therapy. For patients who choose treatment with radiation therapy, Lawrence Cancer Center offers IMRT – intensity-modulated radiation therapy with daily image guidance. Low and intermediate prostate cancer patients are typically treated in 5 sessions over two weeks. Patients with higher risk prostate cancer with higher risk of lymph node involvement are typically treated in 28 sessions. Patients who have completed surgery but require radiation due to PSA recurrence are typically treated in 40 sessions over 8 weeks.
Beware the Bells & Whistles Approach
Patients should be cautious of doctors, radiation oncologists, and urologists, who insist or push patients to receive care at other locations in Kansas City for “bells and whistles” or claims of “unique team expertise”. These physicians may try to create a sense of fear or doubt in patients who choose to have their treatments elsewhere. Typically these doctors have their own productivity at heart more than concerns for the patients’ driving inconvenience and expense.
Radiation Vs. Surgery for Prostate Cancer
During the consultation with a radiation oncologist, you will have your pathology report reviewed and risk of cancer progression explained. We will explain the options for treatment with an emphasis on radiation therapy. The process of treatment, probability of cure, and potential side effects will be reviewed in detail. The advantages of radiation therapy over surgery include the non-invasive treatment option with equal benefit for cure with very low risk of incontinence or impotence. While radiation therapy is daily and inconvenient, it allows patients the ability to continue to work, exercise and engage in sexual activity during the course of treatment. Frequently, patients feel enlightened with information following the consultation.
A new option in the treatment of low and intermediate-risk prostate cancer can be delivered in five treatments. This compares with a historical treatment lasting approximately eight weeks or 40 treatment sessions. For patients with some intermediate and high-risk prostate cancers, they can now be treated in 28 treatments or approximately 5 1/2 weeks.
Stereotactic Body Radiotherapy Offers Faster Prostate Treatment
Stereotactic body radiotherapy is the treatment of low and some intermediate prostate cancers in five sessions. It is extremely convenient and long-term studies now show that it has equal effectiveness at curing prostate cancer and equal side effects to that of traditional treatment. Men sometimes travel to Kansas City for eight weeks unaware that this extremely convenient therapy is available in Lawrence. It utilizes the placement of three small markers in the prostate and a total of five sessions lasting no more than 30 minutes per treatment.