Stages and Prevention of Prostate Cancer | Dr Meenu Walia | DNB Medical Oncologist

Stages of Prostate Cancer

There are two types of staging for prostate cancer

1. The clinical stage is based on the results of tests done before surgery, which includes DRE, biopsy, x-rays, CT and/or MRI scans, and bone scans. X-rays, bone scans, CT scans, and MRI scans may not always be needed. They are recommended based on the level of serum PSA; the size of the cancer, which includes its grade and volume; and the clinical stage of the cancer.
2. The pathologic stage is based on information found during surgery, plus the laboratory results, referred to as pathology, of the prostate tissue removed during surgery. The surgery often includes the removal of the entire prostate and some lymph nodes.

Prevention of Prostate Cancer

Tumour Board Evaluation

* Treatment approaches for prostate cancer range from prostate removal surgery, called prostatectomy, to non-surgical treatments such as radiation, Brachytherapy and hormone therapy. The choice of prostate cancer treatment depends on factors such as how fast the cancer is growing, how much it has spread, the age and overall health.

* Men whose cancer is detected while confined to the prostate gland have an excellent chance for successful treatment with minimal or short-term side effects.

* Oncologists at Dr. Meenu Walia see several thousand men who have prostate cancer each year. That experience helps them to guide patients toward the most appropriate treatment approach. We take great care to ensure patients understand the benefits and risks associated with each treatment option.

Surgery

* Surgery is the mainstay of prostate cancer treatment. As a single treatment method – meaning that no radiation, chemotherapy or additional treatment is anticipated – surgery is an effective way to treat cancer confined to the prostate gland.

* Our Surgical Oncologists use great care and proven techniques to remove the prostate (radical prostatectomy) while making every effort to spare the muscles and nerve bundles that control urination and sexual function.

External Beam Radiation Therapy

* Radiation therapy uses high-powered beams or other radiation to kill cancer cells. Cancer cells are generally more sensitive to the harmful effects of radiation compared to normal tissues. Radiation may be used to treat most stages of prostate cancer, with or without surgery, depending on each patient’s overall health and cancer severity.

* Dr. Meenu Walia oncologists have developed a method that uses special imaging devices to precisely track the internal movement of the prostate while daily radiation beam treatments are administered. Intensity modulated radiation therapy (IMRT) uses gold markers implanted in the prostate to allow radiologists to precisely guide radiation beams toward their intended target, reducing radiation exposure to the rectum and bladder. IMRT safely delivers more radiation to the prostate while sparing surrounding tissue, resulting in increased cure rates.

Radiation after Surgery

* Radiation therapy is also commonly used after surgery to treat the prostate bed (the area formerly containing the prostate). Pathologists examine the removed prostate under a microscope to determine whether any cancer cells possibly may not have been completely removed via surgery. If suspected traces of cancer are thought to remain, additional radiation therapy may be administered at some point following surgery.

* Post-surgical radiation treatments reduce the chances of recurrence. Treatment usually begins within two to three months following surgery and lasts for six to seven weeks. Radiation therapy may also be administered if the PSA level rises after surgery. At all times, the patient is considered to be a member of the treatment team and is involved in decision making.

Brachytherapy Radiation

* Brachytherapy involves the implantation of rice-sized radioactive seeds into the prostate to destroy the cancer. In Permanent Prostate Brachytherapy, implanted seeds are left in place, but their radioactivity decreases over time.

Hormone Therapy

* When advanced prostate cancer can’t be treated through surgery or other means, hormone therapy is an option. Hormone therapy reduces the supply of male sex hormones that make prostate cancers grow faster. In most cases, hormone therapy is not a cure but may help control prostate cancer. This can be done by surgery (Removal of both testis) or injection Goserelin to be taken life long.

Expectant Management

* Expectant Management may be an option for men over 70, those in poor health, or men whose cancer is small and slow growing. (Expectant management was formerly referred to as watchful waiting.)