Prostate
Cancer
According to Cancer Research UK, more than 36,000 men in the UK are diagnosed
with prostate cancer each year. It differs from most other cancers in the body,
because small areas of cancer within the prostate are very common and may stay
dormant for many years.
The Facts:
- Prostate cancer is the most common
cancer in males in the UK and the second leading cause of
male cancer deaths.
- It is most common among men between
the ages of 60 and 80.
- Known risk factors for prostate
cancer include age, race and family history.
- The early stages of prostate cancer
generally show no symptoms.
- When the tumour becomes more advanced,
patients may experience a weak urinary stream, the inability
to urinate, interruption of urinary stream, frequent urination
(especially at night), pain or burning during urination,
and blood in the urine. It is important, however to remember
that these symptoms are not specific and may be a result
of benign prostatic enlargement.
Treatment Options for
Prostate Cancer
There are numerous treatments for localised prostate cancer and each has its
own benefits and drawbacks. Patients and their physicians must weigh many factors
when determining the best treatment option. Age, Gleason score (measures aggressiveness),
PSA, lifestyle and quality of life all may be factors in the equation of finding
the optimal treatment. Treatments available include:
- High intensity focused ultrasound
(HIFU)
- Radical prostatectomy
- Radiation therapy
- Hormone therapy
- Cryotherapy
Some patients are choosing no treatment at all, called watchful waiting or
active surveillance, because of the effects on quality of life after treatment.
The treatment modalities are described below in more detail.
HIFU with the Sonablate is a minimally invasive treatment option for prostate
cancer that uses a transrectal probe to focus ultrasound waves in the prostate.
At a very precise and targeted location, the temperature is rapidly elevated
which causes tissue destruction. During HIFU typically the entire prostate
is treated or ablated. In most cases, HIFU with the Sonablate takes between
two to four hours and is a day case. A catheter is inserted during the procedure
that is worn for two to three weeks. It is an out-patient, non-surgical,
radiation-free procedure that you
can truly walk away from.
A radical prostatectomy is surgery to remove the entire prostate gland and
some of the tissue around it and may be done by open or laparoscopic surgery.
An open prostatectomy may take two to four hours, and a laparoscopic prostatectomy
may take up to eight hours. The procedure is usually performed under general
anesthesia and requires a hospital stay and catheterisation.
There are two primary types of radiation therapy: External Beam Radiation Therapy
(“EBRT”) and brachytherapy or seed implants. EBRT is usually recommended for
men with a prostate volume less than 60 grams and involves several weeks of
radiation directed at the cancer from outside of the body. Brachytherapy is
radiation therapy transmitted by tiny radioactive pellets placed inside the
prostate.
Hormone therapy, also known as androgen deprivation therapy or androgen suppression
therapy aims to reduce the levels of male hormones, such as testosterone, in
the body. Lowering these hormone levels can shrink prostate cancer tumors or
slow the growth. However, hormone therapy is a palliative treatment and does
not cure prostate cancer, and carries a risk of side effects such as decreased
mental acuity, fatigue, weight gain, depression, anemia, osteoporosis, anemia
and loss of muscle mass.
Cryotherapy, also known as cryosurgery or cryoablation, is a minimally invasive
procedure that involves freezing the cells in the prostate to bring about destruction
or elimination. Cold gases are passed through needles that are placed in the
prostate, creating ice balls that destroy the gland. The procedure is ultrasound
guided by a physician and is usually performed under spinal, epidural, or general
anesthesia. Side effects from cryotherapy may include swelling, erectile dysfunction,
incontinence and rectal fistula.
Again, the information provided is for
general information purposes only and is not intended to replace
sound professional medical advice and care. All treatment options,
potential outcomes and complications should be discussed with
a qualified health care provider. Please see the potential
side effects section of the website for a complete list of
possible complications from the HIFU procedure.
