Choosing A Prostate Cancer Treatment: Surgery Versus
AdvantagesRadical prostatectomy has many advantages over radiation which include shorter recovery times, Treatment choices are different for that stage of cancer.Patients treated with radiation are twice as likely to die from prostate cancer, Radiation wont give you that kind of answer, Brachytherapy Improves 10-year Overall Survival Compared to Prostatectomy Alone in Young Men with Low- andProstate surgery is better than radiation for younger men says Dr, and those with radiotherapy did better than those with active surveillance the differences were statistically but not clinically significant, You may be curious about which method is best for your case, Treatment choices are different for that stage of cancer.
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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.
Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.
A physician can recommend a number of treatments to address an enlarged prostate. An enlarged prostate will require surgery to relieve the symptoms. In most cases, surgical treatment for an enlargement of the penis is enough. Moreover, a doctor may recommend a course of treatment based on symptoms. A TURP procedure is not painful and requires less recovery time than open surgery. The recovery period will be shorter and less traumatic.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
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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.
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
A bacterial infection can also lead to prostate issues. Acute bacterial infections can be hard to treat. Some men with a bacterial infection may need to take antibiotics to prevent or treat symptoms. Symptoms of the disease include fever and chills, pain in the lower back and the tip of the penis. Some men may have blood in the urine, frequent urination, and blood in the urine. If you suffer from acute bacterial prostatitis, a medical professional should be able to prescribe you the appropriate treatments to prevent the disease.
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Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
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Prostate Cancer Treatment At Moffitt Cancer Center
At Moffitt Cancer Center, the physicians within our Urologic Oncology Program collaborate to create individualized, multispecialty treatment plans according to each patients unique health situation. Patients at Moffitt benefit from the latest advancements in prostate cancer surgery, radiation therapy and other treatment approaches like chemotherapy and clinical trials.
In cases where prostate cancer surgery is appropriate, Moffitt surgeons use minimally invasive techniques and robotic-assisted technology to achieve optimal results for our patients with minimal discomfort. Patients who require radiation therapy also have access to leading-edge treatments, including image-guided radiation therapy and stereotactic ablative radiotherapy that delivers high-energy X-rays with pinpoint accuracy. Whats more, Moffitt is an American College of Radiology-accredited center a distinction that speaks directly to the high level of our medical technology and expertise of our specialists.
Contact Moffitt at or submit a new patient registration form online if youd like to speak with a physician about what prostate cancer treatment options are best for you. We welcome patients with or without referrals.
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Is There A Role For Focal Ablation Of Prostate Cancer
One of the unique characteristics of prostate cancer is the spectrum of the disease as it relates to disease aggressiveness, age range of those affected, and treatment priorities. The age range in a large personal series of approximately 5000 RP performed by one of the authors of this review is 36 to 81 years. The risk and extent of disease ranges from men with a single biopsy core with 1-mm GGG 1 cancer to all biopsies showing GGG 4 and 5 disease. The priority of some men is to cure the disease whereas others are motivated to preserve quality of life. It is reasonable to propose that the optimal management of prostate cancer should include AS, whole-gland treatment, and an alternative offering potential for oncological control with preservation of quality of life. We believe this option is FA of prostate cancer.
British Columbia Specific Information
Prostate cancer is a cancer of the prostate gland, which is a gland that produces the milky liquid found in semen. Patients with low-risk prostate cancer have a 10-year cancer survival rate of over 99%.
You are considered a low-risk patient if you have a PSA value that is equal or less than 10 nanograms per millilitre , a Gleason score that is equal or less than 6, and your cancer stage is T1c/T2a. PSA is your prostate specific antigen measured by a blood test, the Gleason score indicates how aggressive the cancer is by looking at tissue biopsy results, and the cancer stage describes how much the cancer has spread.
Active surveillance has been developed to allow for careful management of men with low-risk prostate cancer. For more information, visit BC Cancer Agency – Prostate.
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
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Surgery Vs Radiation May Lower Risk Of Death From High
Radical prostatectomy is associated with improved cancer-specific survival compared with external beam radiation therapy among men with high-risk prostate cancer, a new study finds.
Investigators led by Francesco Chierigo, MD, of Policlinico San Martino Hospital, University of Genova in Genova, Italy, first studied cancer-specific mortality rates among 24,407 patients at high risk according to National Comprehensive Cancer Network criteria using the 2010-2016 Surveillance, Epidemiology, and End Results database. Second, they studied the same patients stratified by Johns Hopkins University criteria for high-risk and very high risk prostate cancer. To minimize confounding, patients were propensity score matched by age, PSA, biopsy Gleason score, and clinical T and N stages. The investigators also adjusted for mortality from other causes as a proxy for comorbidity burden.
In the entire NCCN high-risk cohort, 40% underwent RP and 60% underwent EBRT. At 5 years, CSM rates were lower among patients treated with surgery instead of radiation: 2.3% RP vs 4.1% EBRT. RP was significantly associated with a 32% reduced risk for CSM, Dr Chierigo and colleagues reported in The Journal of Urology.
The data suggest that RP holds a CSM advantage over EBRT in the combined NCCN high-risk cohort, and in its subgroup of Johns Hopkins very high-risk patients, according to Dr Chierigos team.
Prices And Where To Get It
The cost of a radical prostatectomy varies depending on insurance status and location of surgery.
Costs may include hospital fees, anesthesia fees, and surgeon fees. The average cost of hospital fees for prostatectomy in the United States is about $34,000. Anesthesiologist and surgeon fees average about $8,000. What out-of-pocket expenses the person being treated incurs will depend on their insurance.
The location of the procedure can be with a local surgeon, or the person being treated may travel to see a regional or national expert.
Table 1 Why A Low Psa Does Not Mean You Are Cancer
The Prostate Cancer Prevention Trial included a provision that men randomized to receive placebo undergo a prostate biopsy at the end of the study, even if they had normal PSA levels and digital rectal exams. To their surprise, investigators found that many of these men had prostate cancer in some cases, high-grade prostate cancer.
PSA level 13 *Note: A PSA level over 4.0 ng/ml traditionally triggers a biopsy. Adapted with permission from I.M. Thompson, et al. Prevalence of Prostate Cancer Among Men with a Prostate-Specific Antigen Level 4.0 ng per Milliliter. New England Journal of Medicine, May 27, 2004, Table 2.
This study inadvertently provided evidence not only that prostate cancer occurs more often than once believed, but also that PSA levels may not be a reliable indicator of which cancers are most aggressive. Both findings add weight to the growing consensus that many prostate tumors currently being detected may not need to have been diagnosed or treated in the first place.
Original Medicare Covers Chemotherapy And Cancer Treatments
Medicare Part A and Part B make up Original Medicare, which covers some hospital and medical care needs.
Medicare Part B covers doctor visits, surgeries and outpatient hospital services, including chemotherapy. Medicare Part A provides coverage for inpatient hospital care.
How Medicare pays for chemotherapy depends on where you receive your treatment:
- Hospital outpatientYou will typically pay a Medicare Part B copayment for chemotherapy received in a hospital outpatient setting. Your copay will typically be a set dollar amount, rather than a percentage of costs.
- Doctors office or freestanding clinicAfter meeting your Part B deductible , youre typically responsible for paying 20% of the Medicare-approved amount for the treatment.
Original Medicare can also provide coverage for the following cancer treatment and screening services:
- Prostate cancer screenings
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Dr Samadi Shares Why Prostate Surgery Is Better Than Radiation For Younger Patients
Choosing between the many variants of surgery or radiation, in case of prostate cancer, is a difficult decision. Often, doctors are biased towards the treatment they feel theyre more experienced in. Our discussion with Dr. David Samadi aims at making light of his stance as to why prostatectomy is his preferred course of action. His website prostatecancer911.com takes issue with all the treatment options and the advantages and disadvantages that each of them entail.
Proton Beam Radiation Therapy
Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.
Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.
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What You Need To Know About The Prostate Is Surgery Better Than Radiation For Prostate Cancer
The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Is Prostate Surgery Possible After Radiation
Dr. Samadi, if a patient with prostate cancer chooses to get radiation treatment, what are the chances of him undergoing surgery, in case of remission?
Dr. Samadi: When we talk about prostate cancer, there are low risk prostate cancers and there are high risk prostate cancers. Youve probably heard of the classification called Gleason score. We, urologists, use that to figure out exactly what type of prostate cancer were dealing with here. In my practice, I like to cure the patients by removing the prostate. There are many advantages for prostate removal. When you undergo a prostatectomy, youre going to know exactly what type of prostate cancer you have. You will find out how much cancer you have in the prostate, because the needle biopsy is a random biopsy and doesnt always give you the best picture. Whats important is, six weeks after prostate surgery, your PSA should go down to zero and should stay zero for the rest of your life. The advantages of the surgery is that the follow-up is very easy. If the cancer reoccurs after surgery, then I would use a low dose radiation as a back-up plan.
Some of the side effects of radiation is secondary chance of rectal cancer. Patients can get rectal bleeding and bladder bleeding. Side effects of radiation comes as time goes on. So, if I can avoid giving patients radiation and cure them with good quality of life, thats what I would prefer. If youre doing well, then I will just continue watching the PSA.