NEW OPTIONS IN PROSTATE CANCER

TREATMENTPresented by

Triangle Urology Associates, P.A.

PROSTATE CANCER:The #1 cancer in males

• Second leading cause of cancer related deaths among men

• 1 out of 6 men has a chance of developing prostate cancerin his lifetime

• Majority of cases occur after age 65

EARLY DETECTION IS KEY

• Disease has “silent” progression in early stages

• 21% of cases are discovered after disease is advanced

• If detected early, cure rate is nearly 100%

PROSTATE ANATOMY

• Walnut-sized gland below the bladder

• Surrounds the urethra

PROSTATE CANCER WARNING SIGNS

• Weak or interrupted urine stream

• Difficulty urinating/frequent urination

• Painful/burning urination

• Blood in urine

• Pain in back, hips, pelvis

• Often no symptoms at all!

DIAGNOSING PROSTATE CANCER

• Digital Rectal Exam (“DRE”)

• Prostate Specific Antigen (“PSA”) blood test

• Screening (DRE, PSA) is recommended:– Annually for men 50+ years

– At age 40 for higher risk patients (African-American,

– Family history of prostate cancer)

• Elevated PSA levels suggest possible presence of cancer, gland enlargement or infection

IF PSA OR DRE IS ABNORMAL

• Additional tests may be done to confirm presence of cancer:

– Imaging of the prostate (ultrasound, MRI, CT)– Needle biopsy - small tissue sample

obtained with a needle and analyzed in lab

AFTER THE DIAGNOSIS

• Grading the tumor

• Staging the cancer

• Considering a treatment plan

GRADING THE TUMOR

• Determines how fast the tumor is growing

• Rated on a “Gleason Scale” of 2-10

• Most localized prostate cancers are low-to-intermediate grade

CANCER STAGING

• Measures how far cancer has spreadoutside the gland

• Two common staging systems:

– TNM Staging System

– Stage I-IV (A-D)

THE GOOD NEWS

If detected early, prostate cancer is highly treatable!

TREATMENT OPTIONS

• Watchful waiting

• Surgery

• External beam radiation therapy

• Hormone therapy

• Brachytherapy (seed implantation)

• Combination Therapy

WATCHFUL WAITING

• May be used for slow-growing tumors or elderly patients

• Requires frequent check-ups on progress of tumor

• Does not include any active treatment

SURGERY (RADICAL PROSTATECTOMY)

• Involves removal of entire prostate gland and surrounding tissue

• Can be very effective if cancer is confined to gland

• Requires hospitalization• Side effects include possible impotence and

incontinence

EXTERNAL BEAM RADIATION

• Uses radiation (x-ray) to destroy cancer cells

• A common treatment technique in early cancers

• Requires daily treatment for 8-9 weeks

• Side effects may include:– Incontinence – Urinary or rectal problems

– Skin irritation

– Impotence

– Fatigue and bowel irritation

HORMONE THERAPY

• Lowers level of male hormones (androgens) to shrink gland and slow tumor growth

• Sometimes used in combination withother therapies

• A treatment but not a “cure”

Now, an effective treatment option that also helps preserve

patient quality of life:

Brachytherapy

WHAT IS BRACHYTHERAPY?

• Implantation of radioactive “seeds” directly into the prostate gland

• Seeds deliver high-dose radiation directly to the site of the cancer

• Seeds release radiation over 3-9 months

BRACHYTHERAPY: PROVEN EFFECTIVE

• Modern technique developed in the 1980’s

• Involves a team of specialists - urologist, radiation oncologist, medical physicist

• Over 100,000 patients treated successfully• Published studies show results comparable

to surgery and external radiation 1,2

1. Ragde H, Korbe LJ, Elgamal AA, et al. Modern Prostate Brachytherapy: Prostate Specific Antigen results in 219 patients with

up to 12 years of observed follow-up. Cancer. 2000;89(1):135-141.

2. Sharkey J, Chovnick SD, Behar RJ, et al. Outpatient ultrasound-guided Palladium-103 brachytherapy for localized

adenocarcinoma of the prostate: A preliminary report of 434 patients. Urology. 1998;51(5):796-803.

How are We Different?

• Piedmont Prostate Center in conjunction with your urologist is the only medical clinic in North Carolina that can offer in office prostate brachytherapy.

• No hospitalization required!• The entire procedure is performed in the comfort

of the urologist’s office.

THE BRACHYTHERAPY PROCEDURE

• The entire procedure is usually done in 1-2 hours on an outpatient basis under local pain control.

• State of the art equipment and personnel specifically designed or trained for Brachytherapy is brought to you.

• No general or spinal anesthesia required!

• Usually no catheter required post procedure.

SMALL SEEDSBIG ADVANTAGES

• No major surgery required• No daily treatments• Normal activity is resumed quickly• Reduced risk of impotence, incontinence• Completely outpatient. No hospitalizations or

need for expensive anesthesia.

CHOOSING THE RIGHT OPTION FOR YOU

• Learn the facts• Talk to us or

your doctor• Get annual check-ups:

DRE and PSA • Live free of cancer

Triangle Urology AssociatesCathy Stutts, RN

919-313-3609cathys@triangleurologync.com