Prostate Cancer Awareness Part II: Treatment Options
Treatment options depend on the likelihood of cancer spreading or the amount that has already occurred; the age, and the overall condition of the patient. An elderly patient with a type of prostate cancer that is very slow growing (low Gleason Score) and few or no symptoms may be a candidate for active surveillance. Tests are performed to evaluate the spread of the cancer. No treatment is actually started at the time of diagnosis.
“Since prostate cancer can be very slow growing, there is no reason to subject the patient to aggressive procedures and painful treatment if it’s not necessary,” said Strickland. Radiation Therapy
Radiation therapy is used for the treatment of some types of prostate cancer. External radiation therapy sends radiation toward the cancer, while internal radiation therapy is the placement of a radioactive substance inside the prostate near the cancer. The risk of bladder or rectal cancer increases if radiation therapy is used. Impotence and urinary problems may also occur.Hormone Therapy
Hormone therapy is another type of cancer treatment that removes or blocks hormone action. Male sex hormones can cause prostate cancer to grow, so blocking them starves the cancer cells. Men may experience hot flashes, impaired sexual function, loss of desire for sex and weakened bones.Biologic Therapy
Biologic therapy uses the patient’s own immune system to fight cancer. This treatment is used for cancer that has metastasized.
With robotic-assisted surgery, prostate removal and dissection of lymph nodes has gained popularity. Robotic-assisted surgery decreases pain and length of disability, allowing patients in many instances to get back to activities as soon as two to four weeks.
John Strickland, MD, along with several of his partners at Kansas City Urology Care, have been performing robotic prostatectomy since 2003. The goal of every surgery is to remove the cancer, while maintaining urinary continence and erectile function following surgical recovery. The da Vinci™ allows the surgeons to be more successful with nerve sparing techniques required for post-surgical urinary continence and preservation of erectile function.
No two patients are the same, so each patient has to be evaluated individually.
“We complete a full work-up to determine the care options and review them with the patient and their family,” said Strickland. “We want them to understand the risk and reward ratio of whatever care they choose to receive.”
As patients present for prostate evaluation, many are found to be normal. Each patient with an elevated PSA is screened. Infection and inflammation also elevate PSA levels, but an elevated PSA level cannot be ignored. If cancer is found to be the cause, the type of cancer and treatment options are evaluated individually.
Less than 24 hours after his robotic-assisted surgery, one patient said, “I have no pain, can feel my incisions only slightly, and have been up walking around a lot.”
Robotic surgery is not ideal for everyone. Patients are encouraged to discuss a treatment plan with their physician to determine the best option.