Diagnosis And Imaging Services For Prostate Cancer
At UT Southwestern, our dedication to precision starts with prompt and accurate diagnosis. Our highly accurate diagnostic techniques include:
- Digital rectal examinations
- TRUS/MRI-guided biopsy
- Ultrasound-guided biopsy
If a patient is diagnosed with prostate cancer, our physicians will develop a unique plan of care. Because the disease usually grows slowly, we might recommend a watch-and-wait approach, also known as active surveillance, which involves close monitoring without treatment.
For patients who do require treatment, we offer advanced techniques that include medical therapies, radiation therapy, and surgery.
Our urologists and radiologists work together to provide additional options for men with suspected or confirmed prostate cancer, including MRI-guided transurethral ultrasound ablation of the prostate .
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Prostate Cancer Radiation Therapy Side Effects
While care is taken to minimize damage to other areas of the body, there can be some side effects of radiation therapy. While not every patient experiences these side effects some men experience bowel issues such as diarrhea, impotence and problems urinating after radiation for prostate cancer. These may not be permanent. Talk to your oncologist about any side effects youre experiencing during or after prostate cancer treatment.
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.
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Physicians With Special Experience
There are three categories of physician who are liable to have more experience in the management of prostate cancer than physicians in general:
Urologists Urologists are specially trained in the management of disorders of the male and female urogenital systems. Urologists are surgeons who have then subspecialized in urology. In America the majority of urologists are members of the American Urological Association . A relatively select group of urologists consider themselves to be subspecialists in urological cancers, including prostate cancer. Many of these subspecialists will belong to an organization called the Society of Urologic Oncology and/or the Society of Surgical Oncology . The majority of urologists are board certified by some appropriate organization which means that they have passed a rigorous evaluation of their knowledge and experience. In America a board certified urologist would be certified by the American Board of Urology. In Canada, the comparable organization is the Royal College of Physicians and Surgeons of Canada. Nearly every country in the world has a system like this to certify the abilities of specific types of physician.
We know of no formal North American organization that is specifically coordinated for physicians who specialize in cryosurgery . Cryotherapy specialists are likely to have trained in some other specialty first. There is also no board certification in cryosurgery. There is, however, an International Society of Cryosurgery.
Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
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Radiopharmaceuticals That Target Psma
Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.
Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.
This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.
This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.
Possible side effects
Some of the more common side effects of this drug include:
This drug can lower blood cell counts:
- A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
- A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
- A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.
This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.
Shreyas S Joshi Md Mph
- Dr. Joshi specializes in the surgical treatment of urologic cancers primarily involving the bladder, kidney and prostate.
- Assistant Professor, Department of Urology, Emory University School of Medicine
- Ms. Kamm collaborates with physicians to care for patients undergoing treatment at Emory Proton Therapy Center.
- Nurse Practitioner, Emory Proton Therapy Center
- Ms. Karem works at Emory Saint Joseph’s Hospital with patients of all cancer types providing resource referrals and counseling services.
- Social Worker, Emory Saint Joseph’s Hospital
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Valerie Buckley Ms Cso Rd Ld
- Nutrition Advisor
- A Registered Dietitian, Ms. Buckley provides cancer patients who are undergoing treatment at Winship Cancer Institute with personalized nutrition advice.
- Clinical Dietitian, Winship Cancer Institute of Emory University
- Ms. Burke works with oncology patients treated at Emory Decatur Hospital and Emory Hillandale Hospital
- Social Worker, Oncology, Emory Decatur Hospital
- Ms. Cahn provides comprehensive genetic counseling services for individuals who are at risk for hereditary cancer.
- Licensed Certified Genetic Counselor, Winship Cancer Institute of Emory University
Does Msk Offer Proton Therapy For Prostate Cancer
Some men with prostate cancer may choose to receive another form of external-beam radiation therapy called proton therapy. Proton therapy can deliver a high radiation dose to the prostate while lowering the radiation dose to normal surrounding tissue. It is unclear if there is any advantage to proton therapy compared with IMRT. We are now studying how these approaches compare in terms of side effects and outcomes at the New York Proton Center. These efforts are being led by radiation oncologist Daniel Gorovets.
What You Can Do
If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.
General nutritional guidelines apply during treatment.
Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.
What Is Prostate Cancer
Most cancers are named for the organ in which the tumor originates. Almost all prostate cancers are of a type called adenocarcinomacancers that originate in glandular tissue.
At the time of diagnosis, it is important to know the extent of the tumor. The tumor is considered to be local when it is contained within the prostate gland itself. If it has spread to other organs or tissues, it is metastatic prostate cancer. When cancer cells break away from the original tumor, they can travel through lymph fluid, or blood, and metastasize to other places in the body, where another tumor may form. If prostate cancer cells spread to bones, the cancer is called metastatic prostate cancer in the bone.
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What Should Patients Know About Msks Approach To Treating Prostate Cancer
At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.
Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.
The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.
We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.
How Does Radiotherapy Work
Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy is high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.
Radiotherapy treats the whole prostate. It aims to treat all the cancer cells, including any that have spread to the area just outside the prostate. The treatment itself is painless but it can cause side effects that may cause you problems.
You may have radiotherapy to a wider area, including the nearby lymph nodes, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. If you do have radiotherapy to a wider area, you will be more likely to get side effects.
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Speak With A Patient Care Expert Now
Many patients find their way to Envita Medical Centers because they have a resistant form of cancer and theconventional options for treatment have been exhausted with little to no results. We offer a different approach tocancer treatment by combining the latest in research-based naturopathic and conventional treatment options from aroundthe world and not just the United States. Every level of the treatment Envita provides is more personalized and moretargeted in our clinical opinion than standard regimens. When you are a patient at Envita you are not a number, youare a person, and we take care of our patients, offering a compassionate top-level customer service and care. There ismuch more we would love to discuss with you about your prostate cancer including our proprietary methods for attackingresistant cancers. If you or a loved one is suffering from prostate cancer or any other form of cancer, please contactour Patient Care Coordinators at 866-830-4576. Our Patient Care Coordinators are experts in their fields and can helpset you on the path to recovery. May God bless you on your journey to healing.
Consider A Multidisciplinary Team
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.
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.
Primary Care Physician
Oncology Social Worker
Palliative Care Specialist
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Diarrhea Flatulence Or Painful Defecation
These symptoms usually occur after the second or third week of treatment. Symptoms will resolve after the treatment ends. During radiation, dietary modification usually helps reduce the frequency and severity of diarrhea. Try to avoid or reduce fried foods, greasy foods and highly spiced foods. Reduce foods with insoluble fiber, such as lettuce and cauliflower, and increase low-fiber and soluable-fiber foods, such as bananas, mashed potatoes, applesauce, white rice, canned or cooked fruits and vegetables.
Maintain your intake of lean proteins, such as turkey, chicken and fish, and increase your fluid intake to avoid dehydration. Using moist toilet paper, baby wipes or sitz baths may help relieve rectal irritation. Your doctor may recommend anti-diarrheal medications. Contact your doctor if you see blood in your stool, if the diarrhea worsens or if you become light-headed or dizzy.
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Tiffany Barrett Ms Rd Cso Ld
- Nutrition Advisor
- Ms. Barrett leads the nutritional services team at all Winship locations providing personalized nutrition advice to patients who are undergoing cancer treatment.
- Manager of Winship Dietitians, Winship Cancer Institute of Emory University
- Dr. Bausum supports patients with cancer by incorporating a variety of integrative medicine tools alongside patients’ conventional oncology care regimens.
- Integrative Oncology Specialist, Winship Cancer Institute of Emory University
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Causes And Risk Factors
About 14 percent of men are at risk for prostate cancer. Approximately 5 to 10 percent of prostate cancers are hereditary. Other prostate cancers can have underlying environmental causes or can be caused by a combination of environment and genetics.
Family history is the most common risk factor for prostate cancer. Other risk factors such as obesity, smoking, prostatitis, and vasectomy have been suggested to increase the link for prostate cancer. However, a definite association has not been proven.
Patients should speak with a genetic counselor or their doctors for more details about these risk factors and protective factors that might reduce the risk for prostate cancers, as well as screening and preventive options.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.
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