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Loss Of Sexual Function

Which is Better – Surgery vs. Radiation for Prostate Cancer?

Both studies found that patients who chose a radical prostatectomy the complete removal of the prostate gland suffered the most significant drop in their quality of life, particularly related to sexual function.

Those who opted for active surveillance, the most conservative approach and one pioneered in Toronto, identified as having the best quality of life at three months and one year compared with all of their counterparts.

But at two years post-treatment, the results were about the same as those who underwent targeted radiation therapy, or brachytherapy, in which radioactive seeds are placed inside the tumour to target cancer cells and reduce damage to surrounding healthy tissue.

Why I Traveled Across The World For Prostate Cancer Treatment

When I was diagnosed with prostate cancer, I was determined to find the best care and treatment. As an orthopedic surgeon, I have traveled the world delivering lectures. After receiving my diagnosis, I knew that I would have to make a decision about undergoing surgery or radiation therapy.

I consulted some of the best surgeons and oncologists in the world but wanted to do my own research to see what was best for me. I wanted to avoid permanent side effects, so I decided to explore different types of radiation therapy. My biopsy showed that the cancer had not spread, but the tumor was beginning to grow outside of my prostate.

Researching prostate cancer treatment and deciding on MD Anderson

I live in India, but had my MRI and biopsy reviewed by multiple doctors worldwide. I eventually decided on a hospital in California. In January 2020, I started treatment with hormone therapy there. I had to wait eight weeks before I could start radiation therapy, so I used that time to continue educating myself. I wanted to learn more about my cancer and the treatment I was about to get.

I requested a consultation with Dr. Frank at MD Anderson. After meeting him in person, I knew he personified the spirit of MD Anderson. He brings new ideas and technologies to cancer treatment. He lives the dream of Making Cancer History®. My wife and I trusted Dr. Frank, so we decided to move my treatment to MD Anderson.

Undergoing MARS brachytherapy and proton therapy treatment for prostate cancer

The Initial Causes Best Doctor Prostate Cancer

One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

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Find The Best Surgeon You Can Get It Done Right

Radical prostatectomy is a very difficult operation. It takes not only skill, but the kind of expertise you get only after being involved in a lot of procedures, first from the sidelines as a doctor in training, and then learning how to do it meticulously with the guidance of an expert surgeon.

The very best prostate surgeons specialize in the prostate. Thats often all they do, and they do a lot of these procedures every year.

You dont want to be part of the learning curve.

Another point: Because there are so many bad surgeons out there, you cant trust everything you read on the internet or from hospitals propaganda.

Our goal is to weed out the bad surgeons, so they stop doing procedures they arent skilled enough to do.

As for you, well, this is your one shot at this. Do your due diligence. How can you find the right surgeon? We have developed this checklist with the help of three experts. Please. Take the following things into consideration before you go under the knife:

Questions To Ask When Searching For The Best Prostate Cancer Care

Best Prostate Cancer Doctors In Usa

Men diagnosed with prostate cancer face some difficult choices. Should they proceed with surgery or radiation, and if so, what kind? If they’re low risk and the cancer is not likely to spread, do they have the patience for active surveillance? And in the midst of all these questions, there’s this one: Which doctor or hospital delivers the best care?

The short answer is no one knows, at least not by any objective measure. But experts are beginning to agree about what matters for prostate cancer patients. We’ve collected some of those measures in the list below. They may help you assess the quality of a urologist or oncologist as you seek the best care.

Many doctors will tell you they don’t have answers to these questions. Even those who do won’t know if they are above or below a national average, because there is no such thing yet. But if you ask, you’ll get a sense of how your doctor thinks about quality and about your desire to make an informed decision. And maybe you’ll learn about what matters most to you.

Here’s the list:

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Request An Appointment For Prostate Cancer Care

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Choosing Your Healthcare Team

It is likely that throughout the prostate cancer journey you will work with several medical specialists for treatment. Keep in mind that you have a choice in who manages your care. This is about finding the right treatment team for you to work with to make the right decisions for you. Make sure to find a team you are comfortable with and trust.

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Consider A Second Opinion

Seeking a second opinion following a prostate cancer diagnosis is very common and doing so can make you feel more confident in the treatment decision that you make. Its OK to get a second opinion at any point during your care. Here are some reasons you might consider getting a second opinion:

  • To understand all available treatment options and have peace of mind with your treatment decision
  • To get the opinion of another prostate cancer expert
  • To confirm a diagnosis or treatment plan
  • To hear information about your cancer explained in a different way
  • To share the opinion of more than one healthcare expert with your insurance company

Some people find it hard to tell their doctors that theyd like a second opinion. Your doctor shouldnt discourage you from getting a second opinion. If you are unsure of how to begin, here are a few ways to start the conversation:

  • Im thinking of getting a second opinion. Can you recommend someone?
  • Before we start treatment, Id like to get a second opinion. Will you help me with that?
  • If you had my type of cancer, who would you see for a second opinion?
  • I think that Id like to talk with another doctor to be sure I have all my bases covered.

Learn

Best Urologists In Montreal Qc

Why Doctors Don’t Talk About Brachytherapy | Ask a Prostate Expert, Mark Scholz, MD

Expert recommended Top 3 Urologists in Montreal, QC. All of our urologists actually face a rigorous 50-Point Inspection, which includes everything from checking reviews, ratings, reputation, history, complaints, satisfaction, trust and cost to the general excellence. You deserve only the best!

DR. ANDREW STEINBERG – STEINBERG UROLOGY

6900 Boulevard Décarie, Suite M265, Montreal, QC H3X 2T8 DIRECTIONS

Since 2005

Heres The Deal:Dr. Andrew Steinberg is one of the leading urologists in Montreal. He graduated from McGill University. He is recognized as one of his peers’ most compassionate urology specialists. Dr. Andrew Steinberg is proud to serve Montreal with world-class urological care. He is an expert in the laparoscopic management of prostate cancer, kidney cancer and adrenal diseases. Dr. Andrew Steinberg has a special interest in the management of general urological issues such as enlarged prostate , kidney stones and female urinary incontinence. He is currently practicing at Steinberg Urology. At Steinberg Urology, they pride themselves on their compassionate and approachable nature. Steinberg Urology is located in the centre of Montreal, in Decarie Square. They are committed to providing first-class clinical outcomes with care and compassion. They are dedicated to providing top-quality urological services with patient care using state-of-the-art technology and comprehensive clinical facilities.

Since 2010

License #92876

DR. SERO ANDONIAN – ROYAL VICTORIA HOSPITAL

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Types Of Doctors That Treat Prostate Cancer

At Moffitt, each prostate cancer doctor specializes in a certain aspect of prostate cancer diagnosis or treatment. These specialists include:

  • Urologists, who perform surgical procedures such as robotic surgery, traditional open surgery and laparoscopic radical prostatectomy to physically remove cancerous tissue
  • Radiation oncologists, who develop the treatment plan for radiation therapy, which may include intensity modulated radiation therapy , image guided radiation therapy , stereotactic ablative radiotherapy or brachytherapy
  • Interventional radiologists, who specialize in minimally invasive procedures, such as radiofrequency ablation and image-guided therapies, as well as administration of radiopharmaceutical therapies
  • Medical oncologists, who determine the combination of drugs and dosage most appropriate for a patient receiving chemotherapy and/or hormonal therapy
  • Uropathologists, who perform biopsies and run lab tests to detect the presence of cancer and the nature of the cancerous tissue
  • Uroradiologists, who use ultrasound, bone scans, CT scans, MRIs and other medical imaging to determine the location of the cancer and whether or not it has spread

Access The Right Treatments At The Right Time

When it comes to treating prostate cancer, it is important to have access to the best expertise possible so you can receive the right treatments at the right time. The University of Maryland Cancer Network gives you the opportunity to connect with the best treatment options available.

Led by the University of Maryland Greenebaum Comprehensive Cancer Center , the UM Cancer Network provides you access to nationally renowned experts, the latest treatments, and promising clinical trials close to home. When you work with a UM Cancer Network cancer center, your community hospital will work in partnership with UMGCCC to help you beat cancer.

Find out more about prostate cancer treatments.

Find an UMMS cancer center near you.

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How Is Prostate Cancer Diagnosed

A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope.

A biopsy is a procedure that can be used to diagnose prostate cancer. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.

A Gleason score is determined when the biopsy tissue is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2 to 10. The lower the score, the less likely it is that the cancer will spread.

A biopsy is the main tool for diagnosing prostate cancer, but a doctor can use other tools to help make sure the biopsy is made in the right place. For example, doctors may use transrectal ultrasound or magnetic resonance imaging to help guide the biopsy. With transrectal ultrasound, a probe the size of a finger is inserted into the rectum and high-energy sound waves are bounced off the prostate to create a picture of the prostate called a sonogram. MRI uses magnets and radio waves to produce images on a computer. MRI does not use any radiation.

Consider A Multidisciplinary Team

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To receive the best care possible for prostate cancer, seek care from a multidisciplinary medical team. A multidisciplinary team is a group of healthcare professionals from different specialties that work together to suggest a treatment plan for you based on your diagnosis, personal health, and preferences to ensure you have the best health outcome and highest quality of life. Expert medical oncologist Dr. Alicia Morgans, from Vanderbilt Cancer Center, speaks on the importance of putting together a multidisciplinary team.

If you are unable to work with a multidisciplinary team, round out your team of professionals with a visit to an oncologist, even if you have been diagnosed with very early stage disease. This will give you a full understanding of all available treatments so you have the best chance to beat the disease. It will also help you understand your potential options if the cancer returns.

Most of the time the physician who makes the diagnosis of prostate cancer is the urologist. It is important to work with the urologist as you put together your team for treatment and support. Specialists involved in the treatment and management of prostate cancer are noted below.

Urologist

Radiation Oncologist

A radiation oncologist is a highly trained physician specializing in the treatment of prostate cancer using the various types of radiation approved to treat the disease.

Medical Oncologist

Primary Care Physician

Oncology Social Worker

Physical Therapist

Nutritionist

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Experience Still Matters With Robotic

A surgeon may have to perform well over a thousand robotic-assisted prostate cancer surgeries before becoming fully proficient at the procedure. Previous studies of robotic-assisted prostate surgery have suggested that it doesnt take long for surgeons to learn how to perform the procedure safely.

To assess the number of robotic-assisted prostate surgeries that a surgeon must perform before becoming fully proficient, researchers assessed 3,794 patients who were treated by one of three surgeons.

A key outcome that was considered in the study was the rate of positive surgical margins. A positive surgical margin means that cancer is found at the edge of the tissue that was removed during surgery it may be a sign that not all of the cancer was removed.

  • The rate of positive surgical margins declined as surgeons gained experience. The lowest rates of positive surgical margins came after a surgeon had performed more than 1,600 robotic-assisted prostate surgeries.6

Resources To Find And Evaluate Doctors

Administrators in Medicine DocFinderInformation on licensing and disciplinary actions taken against doctors in 18 states links to state medical boards of remaining states.

American Board of Medical Specialties Includes a database to find doctors who are ABMS Member Board Certified Specialists, a designation achieved through additional training and education.

American College of SurgeonsInformation about finding surgeons who are Board Certified as well as information about surgical specialties. Includes database of member surgeons.

American Medical Association DoctorFinderEducation, board certification, and hospital admitting privileges for doctors who belong to the AMA.

American Society for Radiation Oncology RT AnswersIncludes searchable database of radiation oncologists.

American Society of Clinical Oncology Cancer.NetOncologist-approved cancer information from the American Society of Clinical Oncology can be found on the site Cancer.Net. This site includes a Find a Cancer Doctor tool with tips on choosing a doctor and a database of oncologists.

Urology Care FoundationSearchable database of member urologists.

Medicare Physician and Other Healthcare Professional DirectoryProvider profiles including specialties, practicing locations, and phone numbers. Other information may also include education, gender, residency, foreign languages spoken, and hospital affiliation.

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Heres What You Should Know About This Treatment Option

Men who get diagnosed with prostate cancer have several options to choose from for their next step. Many men with slow-growing, low-risk cancer follow active surveillance, a wait-and-see approach that monitors the cancer for changes.

But if the cancer shows higher risk or has already begun to spread, other treatments are recommended. There are two options: surgery to remove the prostate or radiation to destroy the cancer cells.

Studies comparing these two approaches demonstrate no advantage of one over the other with respect to cancer control. Your path will depend on factors like your current health, the specifics of your cancer, and personal preference. Yet for many men, radiation can be the better option.

“Its much more precise than the traditional radiation used for other kinds of cancer, and research also has found that long-term quality of life is often better, with fewer adverse health effects compared to surgery,” says Dr. Anthony DAmico, a radiation oncologist with Harvard-affiliated Dana-Farber Cancer Institute and Brigham and Womens Hospital.

There are two main ways to deliver radiation to the prostate: external beam radiation and brachytherapy.

When Deciding On A Treatment Plan

Treating High-Risk Gleason 8: A Modern Approach | Mark Scholz, MD | PCRI
  • How likely is my cancer to cause problems if Im not treated right away?
  • Should I consider watchful waiting or active surveillance as an option? Why or why not?
  • Do you recommend a radical prostatectomy or radiation therapy? Why or why not?
  • Is laparoscopic or robot-assisted prostatectomy an option for me?
  • What types of radiation therapy might work best for me?
  • What other treatment might be right for me? Why?
  • Am I eligible for any clinical trials?
  • What risks or side effects should I expect from my treatment options?
  • What are the chances that I will have problems with incontinence or impotence?
  • What are the chances that I will have other urinary or rectal problems?
  • If these side effects happen, are they treatable?
  • How quickly do I need to decide on treatment?
  • What should I do to be ready for treatment?
  • How long will treatment last? What will it be like? Where will it be done?
  • How might treatment affect my daily activities?
  • What are the chances my cancer will come back with the treatment plans wehave discussed? What would be our next step if this happened?

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