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Diablo Valley Oncology

12 January 2016 Written by  By Stephen Taylor, MD
Published in January 2016 Articles

Prostate cancer is the most common cancer in men, and the second leading cause of cancer deaths in men, second only to lung cancer.

 There are no symptoms of prostate cancer in its earliest, most curable stages. The combina­tion of the digital rectal exam and the prostate specific antigen (PSA) screening tests have allowed for the earlier detection of prostate cancer. Approximately 90% of prostate cancer patients can now be discovered at potentially curable stages.

Not every patient with prostate cancer needs to be treated. There are several types of prostate cancer, and many men with the slowest growing type do not require immediate treatment. However, there are some types that are more aggressive, can be life threatening, and do require treatment to prevent spread, before it becomes incurable. Men with this type are faced with a decision on which treatment to choose. They have a choice between one of the various forms of radiation therapy or surgery to remove the prostate gland in its entirety. There have been significant advances in both radiation treatments and surgery. Calypso beacons can be placed inside the prostate to help localize the exact boundaries of the prostate during radiation treatments which helps to prevent radiation damage to surrounding organs such as the bladder and rectum. This significantly reduces the risk of side effects.

Robotic surgery has revolutionized the surgical treatment of prostate cancer. It is a minimally invasive procedure which removes the cancerous prostate gland in its entirety and local lymph nodes when indicated. It usually involves one night in the hospital, minimal pain, minimal scaring, and rapid return to normal function. There is still a small risk of incontinence (2%) and risk of impotence.

I found a nodule in the prostate of a 56 year old patient on rectal examination. His PSA was normal at 2.1. He had a prostate biopsy which showed he had prostate cancer, the slow growing type (Gleason 6). He was normally sexually active and a long distance runner. Because of his young age, he decided to have surgery rather than active surveillance. He had a robotic radical prostatectomy where the nerves for erection were preserved. The final pathology revealed a more aggressive type (Gleason 7), but no spread outside the prostate and all lymph nodes free of disease. He is now 1 year after surgery, fully continent (no leakage), potent and able to engage in sexual activity. His PSA level is undetectable. He just finished a 100 mile run, where he raised $5,000 for prostate cancer research!

Advances in treatment of prostate cancer, with robotic surgery and new forms of targeted radiation therapy allow men quick recovery, minimal risk of permanent side effects, and return to a normal life with high chances of being cured of their disease.  

Read 1778 times Last modified on Tuesday, 12 January 2016 16:02
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