Dr. Grier discusses B.P.H. treatment options, including the new Urolift Treatment System
Please contact Sound Urological Associates for more information. Phone (425) 775-7166.
In this video, Marco Salazar, MD, PHD of Sound Urological Associates answers the most common questions about Prostate Cancer.
If you are located in the greater Seattle area, Sound Urological Associates would be happy to discuss these issues with you in further detail. Please call to schedule an appointment at (425) 775-7166.
If you are diagnosed with prostate cancer, there are multiple factors which determine your treatment options. These include your PSA level, whether or not abnormalities are felt on your prostate, the amount of prostate cancer present in your biopsy, and the Gleason score, which is a measure of the aggressiveness of the prostate cancer. Multiple scoring systems have been created, using these variables, to determine your prostate cancer risk category. Your risk category determines which treatments are best for you.
For men that have low risk prostate cancer, many advocate for the strategy of active surveillance. This involves undergoing a PSA test and prostate examination every 3 months. Also, to confirm the original biopsy findings, the prostate biopsy is repeated, typically at one year. The idea is that as long as the prostate cancer is stable, there is no need for treatment. Remember that the majority of men with prostate cancer will die with it, not from it. Only if the prostate cancer becomes more aggressive does one proceed to curative therapy. For this strategy to succeed, a man needs to be comfortable not undergoing immediate treatment, and be diligent about making all of his appointments.
Men harboring intermediate risk prostate cancer are recommended to undergo treatment with intent to cure. Options include surgical prostate removal, known as prostatectomy, or destruction of the cancer by radiation therapy. In general, it is believed that the chance of cure using either radiation or surgery is equivalent.
Prostatectomy requires a hospital stay, and has all of the risks of undergoing major surgery. The advantage of prostatectomy is that the prostate is thoroughly evaluated after removal to determine if the cancer has migrated into the surrounding areas. In addition, way stations for cancers, called lymph nodes, are also removed at the time of surgery, providing additional information regarding whether or not the cancer may have spread. The side effects specific to prostate cancer surgery include urinary incontinence and trouble with erections. A majority of prostates removed in this country are now done using minimally invasive techniques, with the aid of a robot.
Radiation therapy for prostate cancer can occur with the entire radiation dose given at once, called brachy- or seed therapy, or the radiation dose given in small amounts during the course of many weeks, called IMRT. For more advanced prostate cancer, both IMRT and brachytherapy are sometimes combined. While avoiding major surgery, problems with urination and erections can still occur, in addition to irritation of the rectum and bladder, leading to urinary and fecal urgency, bleeding, and discomfort.
Men with high risk cancer are a special case. This will be discussed in detail in next week’s blog.
As with everything having to do with prostate cancer, there is no straight-forward answer. We at Sound Urological Associates would be happy to discuss these issues with you in further detail. Please call to schedule an appointment at (425) 775-7166.
As discussed in last week’s blog, prostate cancer screening is controversial. How do you know if it’s right for you? The American Urological Association recommends that all men between the ages of 55 and 69 have a discussion with their doctor regarding the risks and benefits of prostate cancer screening, taking into account each man’s individual situation. Men who are African American, have a family member afflicted with prostate cancer, or have worsening problems with urination are at higher risk of developing or harboring prostate cancer. These men should consider beginning screening at an earlier age, and as needed if urinary symptoms are present.
Harms associated with prostate cancer screening include the risk of undergoing a prostate biopsy, particularly infection, and the risk of undergoing treatment for prostate cancer when treatment was not necessary.
In general, it takes 10 to 15 years to achieve maximum benefit after undergoing treatment for prostate cancer. This is because a typical prostate cancer is relatively slow growing and problems, including death, often develop after 10 years. In other words, it does not make sense to undergo screening and treatment of prostate cancer if other medical conditions are likely to shorten your life. For example, if you are a former or active smoker, and are admitted to the hospital multiple times yearly with exacerbation of your COPD/emphysema, it is likely that your lung condition, and not prostate cancer, will be your life limiting disease. Prostate cancer screening in this scenario is unlikely to be beneficial. The life expectancy of an American man is 76 years. Many authorities believe that older men should not undergo screening as they are unlikely to derive benefit.
That said, regardless of age, if you are predicted to live at least 10 years, screening may be right for you. If you are found to have prostate cancer, your treatment options will be based on the risk category of the tumor. This will be discussed in greater detail in next week’s blog. Even if you are found to have prostate cancer that is advanced and/or has spread, treatment can prolong the length and quality of your life.
Again, this is not an easy topic. We at Sound Urological Associates would be happy to discuss this in further detail, addressing the particulars of your situation. Please call (425) 775-7166 to schedule an appointment.