Prostate Cancer Options
The early stage of prostate cancer means that the cancer has not spread beyond the prostate. There are several different treatment options to consider: surgical removal of the prostate (prostatectomy), implantation of radioactive seeds called brachytherapy, external-beam radiation therapy, hormone therapy, freezing the tumor (cryotherapy) and watchful waiting.
Most people research the options, talk it over with family member and further discuss with their physician. Tread among the medical professionals sometimes influence the younger men diagnosed with prostate cancer; however, new studies have found that the age of the patient does not make a difference in the long-term therapeutic outcome. Each treatment has different risk factors to consider and different benefits.
According to researchers Christne Bouchardy, MD, MPH, Elisabetta Rapita, MD, MPH and colleagues from Geneva University, analyzed data on all 844 prostate cancer patients diagnosed with early prostate cancer from 1989 through 1998 in Geneva, Switzerland. Their research revealed that men who underwent surgery were 2.3 times less likely to die of prostate cancer than men who were treated with external radiation.
This research led to belief that the more of the prostate cancer removed and the less you leave, the less chance you have for metastases which is cancer cells that spread to other parts of the body. Even if surgery does not get every cancer cell, surgery patients with recurrent cancer have more options that radiation patients with the recurrent cancer.
It is believed that recurrence after surgery is easier to treat successfully with irradiation or irradiation plus hormonal therapy than after irradiation, when only hormonal therapy remains as the only option.
Although not a part of the Switzerland study, according to Ash Tewari, MD at the Brady Urology Institute of Comell University, a study shows that survival for 10 or even 15 years, there is a distinct advantage in patients who under went surgery for localized prostate cancer. This has implications for patients comparing different treatment options.
Radiation implanted in the body is prostate brachytherapy or seed implants. The idea dates back to 1913 when surgeons inserted a radium capsule into the prostatic urethra, the canal that runs from the bladder to the prostate. This procedure of implanting radioactive material locally to stop the growth of cancer cells was more art than science until the 1980’s. By that time, the development of transrectal ultrasound allowed surgeons to have a clearer view of the target tissue. It is imperative that the implant delivers an effective dose to the prostate while avoiding surrounding organs.
The objective use of radiation continues to be a common treatment option for men with clinically localized prostate cancer. The priority goal of any treatment is to stop the disease from progressing to other parts of the body.
Another study conducted by Louis Potters, MD, Chairman of Radiation Medicine at North Shore University Hospital and LIJ Medical Center, and his colleagues identified 2,119 consecutive prostate cancer patients treated between 1992 and 2005, and narrowed their selection to men under 60 years old. Their treatment regimens consisted of lasting prostate brachytherapy with or without hormone therapy, lasting prostate brachytherapy with external beam radiation, or a combination of those therapies. Their study included 237 patients who had been followed for an average of 56 months after treatment. The goal was to see whether there was a difference in the rate of progression among the treatments and if it had anything to do with the age of the patient or disease-related risk factors.
The study concluded that age did not factor into the treatment equation. The study also derived that brachytherapy is an appropriate option for men at any age.
Surgery is not necessarily the best choice for every patient. Another consideration is that radiation therapy is an option for patients with short life expectancy, because survival isn’t always the only factor to consider when weighing treatment options, quality of life after treatment must be consider also.
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