Prostate Cancer Treatment Options
With new technologies like Intensity Modulated Radiation Therapy (IMRT) coming to the forefront of cancer treatment options, GBMC's Oncology Center remains a leader in cancer care in the region. Among the treatments now available are some innovative options for patients with prostate cancer.
Robert K. Brookland, MD, Chairman of the Department of Radiation Oncology at GBMC, ensures that the prostate cancer patients receive the best treatments available. "It is necessary to first determine if the cancer is confined to the prostate or if it has extended beyond," he notes. "We examine the appearance of the cancer; is it in one spot of the prostate-Spread throughout-Biopsies are needed to determine the extent."
The biopsies are then examined and given a Gleason score-a number ranging from 2-10 that indicates the severity of the cancer and helps in determining treatment options. The Gleason score along with a blood test determining the Prostate Specific Antigen (PSA) level and the age of the patient allow the physician to recommend the most effective treatment option.
1. Watch and Wait - Physicians monitor the cancer growth and recommend further treatment in the future if needed.
2. Curative Therapy - If the cancer is local in nature, radiation or surgery are used to eliminate the cancer completely.
3. Systematic Therapy - If the cancer is spread throughout, a combination of hormonal and chemotherapy and at times radiotherapy are used to control the disease.
Most local cancers follow a curative therapeutic approach. For men who are over age 70, radiotherapy is generally favored. For men who are under 70 years in age, a prostatectomy is often selected. However, the side effects of the surgery can include urinary incontinence and impotence. Due to the potential side effects, many younger men select radiation therapy since there are fewer side effects and the results are comparable.
1. - Radioactive "seeds" are implanted into the prostate gland. The seeds are either Iodine-125 (I-125) or Palladium-103 (Pd-103). The seeds emit radiation to destroy the cancer in the prostate without damaging healthy tissue. I-125 emits radiation for about one year, while Pd-103 emits radiation for four to five months. Side effects of the treatment include irritation to the rectum and bladder, and burning or bleeding during urination. Most side effects peak at one month and then subside.
2. - Either standard radiation using three dimensional treatment planning and multi-leaf collimation (MLC) delivering radiation that is tightly conformed to the prostate; or IMRT, which delivers higher dosages of radiation to cancer cells and lower dosages to nearby normal cells, thereby increasing the chances for eliminating cancer cells and minimizing potential side effects to normal tissue. GBMC is the first community hospital in the greater Baltimore area offering IMRT. IMRT is a unique means of delivering radiation therapy. It allows physicians to boost the radiation dose by 10-15%, yet still protect the rectum. With IMRT, the intensity of the radiation beam can be modulated, allowing the majority of the radiation to be distributed to the affected area, while protecting healthy tissue. This is especially important for prostate cancer patients, since a common side effect of radiation treatment is damage to the rectum. IMRT protects the rectum, while concurrently destroying cancer cells.
Since there are many treatment options available to prostate cancer patients, a variety of treatment plans may be offered. Plans can include one treatment option (seeds, radiation or hormones); a combination of two treatments (hormones and seeds or hormones and external radiation); or all three (hormones, seeds and external radiation). The treatment selected is customized to each patient.
Regardless of the plan selected, the physicians at GBMC ensure the patients receive the highest quality of care with the most effective treatment for their disease.
Return
