Treatment For Prostate Cancer | Radiation Therapy For Prostate Cancer
About the Prostate
The prostate is a gland found in men that is part of the genitourinary system, a system which also includes the bladder, kidneys and testis. It is located in the pelvis, just below and behind the bladder, and just in front of the rectum. The prostate is located at the “neck” of the bladder, where it funnels down and becomes the urethra, which runs through the prostate. The prostate is a single gland, but it does have a right and left side, or lobes. The prostate tissue is surrounded by a thin rhine, or capsule.
The purpose of the prostate is to aid in making the seminal fluids, which during ejaculation, are used to move the sperm out of the body. Two glands, called seminal vesicles, also contribute to the ejaculate. The seminal vesicles are also attached to the prostate from above, and lie behind the bladder.
As men get older, the prostate can enlarge. This is a benign occurrence, often called BPH, or benign prostatic hypertrophy. Since the urethra runs through the prostate, BPH can sometimes cause the prostate tissue to bulge into the urethra, causing some urinary symptoms such as a weak urine stream or nighttime frequency.
About Prostate Cancer
For a cancer to form, for reasons not entirely known, something in the normal cells of the prostate goes awry, and the normal activity of a prostate cell changes. It loses its ability to know when to stop growing, and becomes malignant – it becomes a prostate cancer cell, which may call for radiation therapy for prostate cancer or another treatment.
Prostate cancer cells grow at first within the confines of the prostate itself. Sometimes the cells are in only one particular area of the prostate, and sometimes they may be in several locations or “zones,” or “lobes.” Prostate cancer can grow locally and pierce the capsule of the prostate toward the neighboring per-prostatic area or into the seminal vesicles, eventually spreading further away from the prostate gland itself. That’s when metastasis occurs. That typically happens to the lymph nodes in the pelvis, or to the bones.
Signs & Symptoms
In the past, most men with prostate cancer were diagnosed after presenting with new urinary symptoms, including blood in the urine, or a significant change in how they were able to urinate (frequency, weak stream, etc.). This is not a common presentation however, since most men will have some of these symptoms as a normal part of aging.
A more common sign of cancer is the finding of a nodule or abnormality during a routine digital rectal examination, or DRE. Most men will have a DRE during their annual physical exam. If asymmetry, firmness or nodularity is detected, a referral to a Urologist for investigation will likely be made.
However, in the last decade, most men with prostate cancer have a perfectly normal DRE and no urinary symptoms at all, but instead present with an abnormal blood test called the prostate specific antigen (PSA). PSA is a protein that is made only by normal or cancerous prostate cells. All men have a detectable amount of PSA in their bloodstream, which is there because it can “leak” into the blood from the prostate at low levels. Prostate cancer cells also may make this PSA, and cause more of it to leak into the bloodstream where it can be detected during a routine blood test. If the PSA level is high (many labs use a normal range of 0 and 4.0 ng/ml), or if the PSA level has risen significantly over a short time period, a man might be referred to a Urologist for further investigation. It should be noted that an elevated PSA does not mean that prostate cancer is present, as other benign conditions can cause an elevation in PSA, such as a prostate infection (prostatitis), or the normal enlargement of the prostate with age (due to BPH or benign prostatic hypertrophy), etc.
I've Been Diagnosed with Prostate Cancer, What Happens Next?
Radical Prostatectomy for Prostate Cancer
External Beam Radiation for Prostate Cancer including IGRT & RapidArc
Seed Implants for Prostate Cancer
Seed implants became a very popular treatment for prostate cancer, in large part because of the convenience of this treatment. It is typically performed in about an hour or so. The pendulum has swung toward Image Guided Radiation Therapy (IGRT) and away from seed implantation, since the cure rates are the same, but the side effects of a seed implant tend to be greater.
What About Hormone Therapy?
What Happens if my Initial Treatment Doesn't Work?
Options after failed radiation: If the PSA does not respond as expected, it may point to residual or recurrent cancer in the prostate. Options for salvage therapy include radical prostatectomy, cryotherapy or, in certain cases, brachytherapy or hormone therapy.
Preventing Prostate Cancer
Another study called the SELECT trial randomized men to take Vitamin E and/or Selenium, to see if these supplements might decrease the incidence of cancer. The results of this trial ended early and were reported in December 2008 – showing that neither Zinc or Selenium were able to reduce the incidence of getting prostate cancer.
Although much speculation about diet has been made, including the benefits of Lycopene found in tomatoes and Saw Palmetto, a natural herb, there is conflicting data on even these two substances. Apart from outright preventing prostate cancer, what can be done then? Clearly, the most important thing that you can do to increase the chance of cure is to ensure early detection of the disease.