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Other Treatment Options 2017-08-24T03:54:18+00:00

Other Treatment Options

The Big Picture: Other Options

Historically, localized prostate cancer has been treated in one of three ways — surgically, with radiation, or observation. Men diagnosed with prostate cancer that have a Gleason score of 6-7 have been in a confusing, gray area in which the risks and benefits of these more aggressive (and passive) treatment options have come into question. With the introduction of focal therapy for prostate cancer, an alternative treatment to the traditional methods is available. Focal laser ablation (FLA) is a quick, minimally-invasive procedure that is designed to target only the cancerous cells and destroy them while sparing the healthy prostate tissue. The goal of focal laser ablation is to eliminate many of the adverse effects of more aggressive treatments while still destroying the cancer.

Historically, localized prostate cancer has been treated in one of three ways — surgically, with radiation, or observation. Men diagnosed with prostate cancer that have a Gleason score of 6-7 have been in a confusing, gray area in which the risks and benefits of these more aggressive (and passive) treatment options have come into question. With the introduction of focal therapy for prostate cancer, an alternative treatment to the traditional methods is available. Focal laser ablation (FLA) is a quick, minimally-invasive procedure that is designed to target only the cancerous cells and destroy them while sparing the healthy prostate tissue. The goal of focal laser ablation is to eliminate many of the adverse effects of more aggressive treatments while still destroying the cancer.

Active Surveillance

  • Typically recommended for men with a Gleason score, equal or less than 6, older men, or men with other serious health concerns

  • Monitor serial PSA (prostate specific antigen) levels and perform a DRE (digital rectal exam) every 3-6 months

  • Possible repeat biopsy every 12-24 months

  • MRI surveillance as needed

Surgery

  • Most common treatment

  • Radical prostatectomy: Removes the entire prostate gland and surrounding tissue

  • Open Surgery: Removes the prostate from an incision in the lower abdomen

  • Robot Assisted Laparoscopic: A minimally-invasive procedure in which a video camera and surgical tools are operated by a physician controlling a robot. There is less blood loss and a shorter hospital stay with this surgical technique.

  • May remove lymph nodes

  • Urinary catheter for 1-3 weeks after surgery

  • Risks of erectile dysfunction (ED), urinary and bowel incontinence

External Beam Radiation (EBR)/ Brachytherapy

  • Brachytherapy for Gleason 6 or less places tiny radioactive seeds in prostate close to tumor and left permanently

  • EBR for more advanced disease involves radiation to the entire tumor and some surrounding tissue

  • Usually reserved for patients with significant comorbid medical illnesses or patients older than 70

  • Side effects include fatigue and loss of energy, skin reactions, high risk of ED, bowel and urinary incontinence

Hormone Therapy

  • Blocks testosterone production which reduces size and growth

  • Commonly used with late stage tumors and a Gleason score higher than 8

  • Used for metastasis, often in conjunction with other therapies

  • Shrinking cancer before surgery

  • If surgery or radiation is not possible

To learn more about these treatment options, visit American Cancer Society.
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