Prostate Cancer Treatment
Your team of specialists in medical oncology, surgery, radiation oncology, radiology and pathology will work together to assess your best course of prostate cancer treatment. That will involve the creation of a coordinated plan, staging the disease and designing a personalized treatment plan consistent with the highest standards of care. Your treatment will be tailored to your specific type of prostate cancer, and it may involve a combination of surgery, radiation and chemotherapy.
Much will be determined on the stage of your disease and your Gleason score. Because prostate cancer is a very slow growing cancer, your WellStar physician may recommend something called “watchful waiting,” or “expectant management” of your disease.
If your cancer is confined to the prostate gland, and if your Gleason score is low, you may want to consider watchful waiting, which involves no surgical treatment or radiation, but only testing at certain intervals to discern your PSA levels. This is a highly personal decision, and your WellStar physician is prepared to discuss this decision process with you.
Prostate Cancer Surgery
WellStar offers some of the best prostate cancer surgeons in the nation, critically important when determining your treatment options. Because the prostate gland lies so close to nerve bundles and muscles which affect urination and sexual function, it is extremely important to have an expert comprise your treatment team.
You may have different surgical options, depending on the location of your tumor and whether it has spread.
A procedure known as a radical prostatectomy is the most frequently performed surgery for prostate cancer. In that procedure, the WellStar surgeon will remove your prostate gland. He may also remove nearby lymph nodes if they, too, have cancer cells.
Today, you may have a choice about whether you choose robotic surgery, generally less invasive, or more traditional prostatectomy. Outcomes for both are comparable, studies show, and in both, your prostate gland will be removed. Your WellStar physician is ready to discuss your options with you and understands that this decision can be difficult.
He or she also will encourage you to discuss your surgical options with your partner. WellStar physicians are extremely capable and adept at sparing nerve bundles and nearby muscles. This is extremely important, as an important goal of prostate surgery is for a man to maintain sexual and bladder function.
The first and most effective treatment for patients in stopping the spread of prostate cancer is testosterone blocking therapy. This can be accomplished through the removal of the testicles or regular injections of medication. Prostate cancer is fueled in part by testosterone. Thus, by removing certain hormones or blocking their action is useful in treating some prostate cancers. There are several different drugs that work in a variety of ways to block the production of testosterone. These drugs may have side effects such as hot flashes, impaired sexual functions and a loss of interest in sex. Your WellStar physician can discuss any concerns you have about this type of therapy and whether you are a candidate for it.
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Chemotherapy has a role in prostate cancer if the disease has spread beyond the prostate and becomes resistant to testosterone blocking drugs.
Radiation or more commonly, Cyberknife, can be used to cure some early stage patients who are not candidates for surgery.
There are two types of radiation therapy to discuss with your WellStar physician if you have prostate cancer. External beam radiation involves a machine outside the body sending radiation toward the cancer. There is also a process called internal radiation to treat prostate cancer. Internal radiation, sometimes called brachytherapy, involves radioactive “seeds,” wires or sometimes needles being surgically inserted into the body and left there. Once inside, the seeds will emit radiation directly to the prostate.
At WellStar, radiation is administered by radiation oncologists in consultation with medical oncologists and surgeons. And several innovative radiation therapies are offered, including two found to be extremely effective against difficult cases of prostate cancer:
- Intensity Modulated Radiation Therapy (IMRT) allows modulation of radiation across the tumor, while sparing healthy surrounding tissue.
- The CyberKnife, a highly-advanced form of non-invasive radiation therapy that allows treatment of cancer that previously was inoperable or complex. WellStar is the first health system in Georgia to offer the CyberKnife.
Your WellStar physician has experience in all forms of radiation therapy for prostate cancer and will guide you to the best decision for you.