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Prostate Cancer - How is it treated?

It is important to highlight that prostate cancer is usually a slow-growing cancer and if detected early may well be curable. There are many different treatment options for prostate cancer at present and you now need to choose one of the options available. This is a very important decision and you should take as much time as you think you need to do make it. Your doctor will help you make the right choice for you but cannot make this decision for you.

Not all prostate cancers are the same. Your doctor will talk to you regarding the Gleason Grade of your cancer, your clinical staging during DRE and radiological staging. Using these three factors, prostate cancer can be divided into low risk, medium risk and high risk prostate cancer. In addition, your doctor will also take into account your age, existing illness and family history. Therefore, it is important to realize that prostate cancer treatment is often tailored towards an individual patient and will differ from person to person. When you attend for a consultation, will discuss the implications of these factors in great detail with you.

Below is a short guide to some of these factors:

 The Gleason grade

Prostate cancer is graded using the Gleason ‘system’, which assigns a number from 2-10, depending on the microscopic appearance of the cancer cells. This appearance predicts the aggressiveness of the cancer. The higher the score, the more aggressive the tumour.

Generally, Gleason 2-4 is considered low risk, Gleason 5 -6 considered moderate risk and Gleason 7-10 considered moderate to high risk. These risk categories are directly related to how dangerous the prostate cancer may be to you and therefore has a major influence on the treatment options that we will recommend.

Clinical staging

Clinical staging refers to what is felt during a DRE and is referred to as clinical T staging. It gives an idea of how big the cancer is and how far it might have progressed. It can be divided into the following:

  • T1 – normal feeling prostate
  • T2 – discreet lump felt INSIDE the prostate
  • T3 – discreet lump felt EXTENDING OUT of the prostate
  • T4 – disease felt to have spread into organs surrounding the prostate

The T stage will also influence the type of treatment choice that we will recommend to you.

Tests and investigations for prostate cancer.

To find out how far the cancer might have progressed, further tests are required. These improve the accuracy of the staging process and involves various types on Xray tests. Essentially, these tests help to ensure that the cancer has not spread elsewhere in your body and remains localized to within your prostate. Often, the tests that we use are a combination of whole body bone scan and MRI of the prostate. Your specialist will advise you if tests are necessary.

 

What are the treatment options for prostate cancer?

Choosing a treatment option for prostate cancer can be difficult and confusing. You may find yourself in a dilemma. It is important therefore, to find a specialist in the field of prostate cancer to discuss these different options, whichever route you decide to follow. Your urologist and his colleagues will help you explore all possibilities, weigh up the pros and cons, and then decide on the treatment that you feel most comfortable with.

Every individual’s prostate cancer is different for the reasons mentioned above. Not every treatment is suitable for anyone. For example, surgery to remove the prostate would not be appropriate if the cancer is shown on MRI or bone scan to have spread to other parts of the body.

If you are treated by Nottingham Urology Group, you will be benefit from the expertise of two prostate cancer specialists. Regardless of the person you see, we discuss all our patients as a routine to ensure that they end up with the best advice possible. We do not offer every treatment that is available but we focus on what we do best and often perform these highly demanding operations together to ensure that you receive the best possible outcome for you.

Our surgeons specialise in radical prostatectomy (prostate removal) using laparoscopic (keyhole) surgery and have the largest series in the East Midlands. In addition we also offer HIFU treatment. We work closely with our radiation oncology colleagues who offer external beam radiotherapy. We can all give you a comprehensive overview of other treatment options such as brachytherapy (seed implants). If you decide to explore various treatment options, we know who best to refer you to if you wish to explore these options, either locally or nationally.

The most important thing is for you to feel you have made the right choice.

Below, you will find a brief explanation of the treatments options for prostate cancer and who they are suitable for. Please come and see us if you think we can help. Treatment options: