Prostate Cancer Treatments Have Serious Long
New research strongly reinforces the notion that prostate cancer is vastly overtreated with often dire results.
A study out Wednesday in the New England Journal of Medicine focused on treatment side effects, following a group of 3,533 men for 15 years after they got either surgery or radiation for cancer that had not spread beyond the prostate. Radiation produced fewer side effects — especially in the first years after treatments– but both groups experienced huge impacts.
This paper tells you that if you get treatment there are a lot of side effects regardless of the therapy you chose, the senior author Dr. David Penson, professor of urologic surgery at Vanderbilt University Medical Center, said in an interview.
Most men were in their sixties when they were first treated. Two years after treatment 60.8 percent of the men who had undergone radiation had erectile dysfunction, compared to 78.8 percent of those who chose surgery. By 15 years, the numbers became 87 percent and 93.9 percent. Many men also suffered urinary and bowel problems and those, too, grew worse with time.
A rational argument is that such side effects are acceptable if the treatment is saving lives. But the paper raises serious doubts.
So many of these men have low-risk disease that probably doesn’t need to be treated, Penson said.
Learning that lesson could spare an enormous amount of misery and money.
How Does Radiotherapy Treatment Work
Radiation therapy works by use of high doses of radiation to kill or slow down its growth rate. In prostate cancer treatment it is used to kill the cancerous cells or slow the growth rate. It also kills the nearby healthy cells as it kills the cancerous cells.
Where curing the cancer is impossible, radiotherapy is used to reduce the symptoms such as pain caused by cancer tumor. It can also be used to prevent the problems that result from cancer tumor such as loss of bowel and bladder control, blindness etc.
*All individuals are unique. Your results can and will vary.
Here are different types of radiations and how they work:
What You Need To Know About The Prostate Long
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.
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What Is A Late Effect
A late effect is a side effect that is caused by treatment but happens months to years after the cancer treatment has finished. Some side effects that you develop during treatment can last for months to years after treatment is completed . These are often called long-term side effects.
Late effects can be health issues or psychological, emotional, and practical challenges.
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.
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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.
Problems With Your Bones
Radiotherapy can damage the bone cells in the pelvic area, and also lower the blood supply to the bones. The bones can become weaker. This is called avascular necrosis. Damage to the bones can cause pain and sometimes makes it hard to walk or climb stairs.
Your doctor will monitor you carefully, including checking your bone strength with a DEXA scan. They might suggest treatment with painkillers and walking aids to help you get around. You might also need to take medicines to strengthen the bones called bisphosphonates. These drugs can help to control pain and reduce the risk of fractures.
Sometimes, tiny cracks can appear in the pelvic bones some years after treatment. They are called pelvic insufficiency fractures. This is more likely to happen in people who have general weakening of their bones as they get older . It is also more likely in people who are taking hormone therapies or steroids.
Speak to your doctor if you have any pain in your bones. The pain usually gets worse if you move around or do exercise and gets better when you sit still or rest. Your doctor might ask you to have x-rays, a CT scan or an MRI scan to see if there are any fractures in the bones.
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Having External Beam Radiotherapy
You have external beam radiotherapy as an outpatient in the radiotherapy department. Radiotherapy is given using a machine that is like a big x-ray machine. This is called a linear accelerator .
You usually have it as a series of short, daily treatments. The treatments are given from Monday to Friday, with a rest at the weekend. Your course of treatment may last for 4 to 8 weeks. Radiotherapy is not painful, but you will need to lie still while you have it.
You may have radiotherapy over 4 weeks instead of over 7 weeks. The total dose of radiation is the same for both. But when it is given over 4 weeks, the dose for each treatment session is higher. Doctors call this hypofractionation. Both are effective treatments. Your cancer doctor will recommend the best timing and way for you to have your radiotherapy.
The radiotherapy does not make you radioactive. It is safe for you to be with other people during external radiotherapy, including children.
When Is Brachytherapy Alone The Right Choice
For some patients with disease that is confined to the prostate and not too aggressive , brachytherapy alone is a good option. It is also convenient for the patient as it is done in an outpatient setting and most people can get back to work within a few days.
But brachytherapy is not right for everyone. For some patients with less-aggressive disease, a watch-and-wait approach would be preferred. At MSK, our philosophy is that when the disease is caught very early, it is very appropriate to do active surveillance and hold off on treatment.
This philosophy applies to patients with a low PSA level, or nonaggressive disease as reflected by a Gleason score of 6 with evidence of cancer in only a few of the biopsy samples and no evidence from the MRI of a significant amount of disease. There are also very select patients with Gleason 7 disease who may be candidates for active surveillance.
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Five Visits Few Side Effects
Prostate cancer is the second most common cancer in men worldwide.1
Today, MRIdian is changing the paradigm for prostate cancer treatment and may offer patients the ability to treat their cancer with just five fractions and fewer side effects.
Prostate patients treated with MRIdian SBRT have no early grade 3 GI/GU toxicity and a 60 to 90 percent lower grade 2 GI/GU toxicity, as compared to standard LINAC treatments, without the need for fiducials or spacers.2
Better for patients. Better for clinicians. Learn more about MRIdian today.
Learn how MRIdian works for prostate
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The Purpose Of Prostate Surgery
Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.
It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.
Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:
Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.
The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.
Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.
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Date Of Treatment Comorbidity And Socioeconomic Factors
The National Patient Registry includes diagnoses and procedures from inpatient and outpatient care that have been found to be 8595% accurate . Data from the National Patient Registry were used to determine date of treatment and retrieved diagnoses and procedures as measures of adverse effects after treatment. The Charlson Comorbidity Index was calculated as previously described . Data on socioeconomic factors including marital status and educational level were retrieved for each subject from the Longitudinal Integration Database for Health Insurance and Labor Market Studies . The levels of education were low , intermediate and high . Data on type of RT were combined from NPCR and RETRORAD, an audit that collected information on type of RT, treatment time, total dose and fractionation directly from the RT verification/oncology information systems and local databases in oncology departments in Sweden .
What Is A Radiation Oncologist
If a patient is undergoing radiation, the cancer treatment plan may be managed by a radiation oncologist who carefully monitors the persons overall health and well-being through the process.
With advanced cancer, a patient may also be referred to a medical oncologist. This specialized doctor uses medicines such as chemotherapy and hormone therapy to treat cancers. Its common for several medical specialists to work together on a treatment plantheyre known as a cancer care team.
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What Are The Side Effects Of Cyberknife Treatment
At Orange County CyberKnife, were proud to be one of the premier providers of radiation therapy treatments in the Orange County area. Our flagship treatment is CyberKnife: a revolutionary cancer treatment system that uses high-dose radiation to eliminate cancer cells and tumors. In many patients, CyberKnife produces almost no side effects but as with any radiation therapy treatment, side effects are possible. If youre curious to learn the side effects of CyberKnife, we can help.
Treatment Areas And Possible Side Effects
|Part of the Body Being Treated||Possible Side Effects|
Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is over. But sometimes people may have side effects that do not improve. Other side effects may show up months or years after radiation therapy is over. These are called late effects. Whether you might have late effects, and what they might be, depends on the part of your body that was treated, other cancer treatments youve had, genetics, and other factors, such as smoking.Ask your doctor or nurse which late effects you should watch for. See the section on Late Effects to learn more.
- Posted:May 1, 2018
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Side Effects Of Prostate Cancer Treatment
The side effects of treatment vary depending on several factors, and they can be distressing. You should talk through options and concerns with your doctor before deciding which treatment to use for your prostate cancer.
Some common side effects of types of treatment include:
- Surgery many men will have temporary urinary incontinence . Almost all men will have a change to their sexual function and most men will have erectile dysfunction .
- Radiotherapy a small number of men will have bowel problems. Between 40 and 80 per cent of men who have radiotherapy will experience immediate or delayed erectile dysfunction.
- Brachytherapy erectile dysfunction and bowel problems can occur. Some men may experience painful urination and irritation of the bladder for several months after therapy. Urinary incontinence is not usually a problem.
- Hormone therapy side effects may include erectile dysfunction, tiredness, mood changes, hot flushes and loss of sex drive.
Coping with some of these side effects can be very difficult. It is important that you discuss possible side effects with your specialist before treatment.
Side Effects Of Prostate Radiation
Side effects of prostate radiation is an important topic, which many doctors and their patients have to discuss before proceeding to the procedure further on. In most cases, radiation treatment for prostate cancer has the same side effects as brachytherapy . But its important to keep in mind that every person will have different side effects from the same procedure and health in general.
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Side Effects Of Radiation For Prostate Cancer
The primary potential side effects of radiation treatment for prostate cancer include bowel problems, urinary problems and sexual function issues.
According to patient-reported outcomes measuring quality of life from men who participated in the 10-year, randomized Prostate Testing for Cancer and Treatment trial, men who were treated with radiation reported little increase in urinary leakage after radiation therapy. They also reported less sexual dysfunction when compared to men who were treated with surgery. However, men treated with radiation reported a higher incidence of bowel problems, such as loose and bloody stools. These side effects are often short-term for most patients, but some experience long-term side effects.
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Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
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