Ca p treatment

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Ca p treatment

  1. 1.
  2. 2. You have a diagnosis of prostate cancer. <br />Elevated PSA, DRE or both<br />Had a recent biopsy <br /> <br />Video will review grading staging <br />Further testing<br />Treatment options for localized prostate cancer<br />
  3. 3. Grading – Gleason score 1-10, higher score more aggressive is the tumor, <5 or 6 not very aggressive, more than 7 is more aggressive <br /> <br />Is it localized-confined to the P.G.<br />Locally advanced tumor cells spread to surrounding tissues. In metastatic cancer is at a distance from the P.G, possibly to more distant organs, bones, lymph nodes. <br />
  4. 4. Additional tests:<br />Bone scan. X-ray film of the entire body that highlights <br />areas where the cancer spread the bones. such as the pelvis or lower spine. <br />Ultrasound-look for effects of a urinary blockage on the kidneys. <br />Computed tomography (CT) scan. This is the best way to detect the extent of the primary cancer as well as distant metastases. and can identify enlarged lymph nodes <br />
  5. 5. Cystoscopy<br />A thin, flexible tube equipped with a <br />light and tiny camera on the end is inserted through the urethra in the penis to the bladder. This shows <br />whether the cancer has spread to the urethra or bladder.<br /> <br />Tests used to determine if the cancer is localized or spread beyond the prostate gland<br />
  6. 6. Staging<br />system of classifying tumors by size, location and extent of the spread, <br />good indicator for prognosis. <br />The cancer is assigned one of four stages, based on how far it has spread. <br />The stages of prostate cancer are as follows: <br />• Stage I (or A): Confined to the prostate. <br />• Stage II (or B): tumor is larger and can be felt on digital <br />rectal exam. cancer confined to prostate. <br />• Stage III (or C): The cancer has invaded other tissues neighboring the prostate (seminal vesicles or other nearby tissues). <br />• Stage IV (or D): The cancer has spread to lymph nodes, bones, or to other organs. <br />Knowing the stage and grade of disease can help to determine how aggressively the disease needs to be treated and can also help predict the prognosis<br />
  7. 7. Treatment<br />No “one size fits all” treatment for prostate cancer. <br />The choice of treatment depends on age, general medical condition, life expectancy, how fast the cancer is growing an<br />benefits and the potential S.E. of the treatment. <br />
  8. 8. Watchful Waiting<br />-localized disease, low stage and grade, age of patient, life expectancy, and agree for regular monitoring of the PSA level<br />
  9. 9. ERT<br />high-powered X-rays to kill cancer <br />cells. while minimizing harm to surrounding tissue. <br /> <br />Usually 30-40 treatments <br />mild side effects (rectal urgency, frequent urination <br />and urinary urgency), but in most cases they disappear shortly after the treatment course is finished. <br />Erectile dysfunction- <br />
  10. 10. Radioactive Seed Implants-Brachy<br />iodine or palladium implanted <br />men with small prostate gland, tumor confined to the prostate and low PSA levels (<10)<br />50-100 rice-sized radioactive seeds are placed in the prostate through ultrasound-guided needles. <br />Single treatment requires an anesthesia<br />Side effects- Urinary problems, ED, or rectal symptoms (loose stools, discomfort).<br />
  11. 11. Surgery - RP<br />This consists of the surgical removal of the entire prostate. This operation is for localized disease <br />Requires hospitalization from 1-3 days<br />Usually go home with a catheter for a few days<br />There is an excellent survival rate if cancer has not spread. <br />Complications of this procedure include urinary incontinence and impotence in at least 50% of the patients<br />
  12. 12. Robotic RP <br />5 pencil sized openings are made in the abdomen<br />Hospitalized one day<br />Home with a catheter<br />Side effects are incontinece and ED<br />
  13. 13. Cryotherapy<br />inserting a probe freezing areas of cancer in the prostate. reserved for localized cancer for men who are unable to withstand surgery or radiation. <br />Cryotherapy has several advantages over surgery and radiation therapy. <br />There is less bleeding, earlier hospital discharge, shorter recovery times, <br />
  14. 14. HIFU<br />Uses HIFU through a rectal probe<br />Requires a catheter after the procedure<br />Less incontinence and ED than surgery<br />Not approved by the FDA at the present time<br />Available in Europe, Bahamas, Mexico<br />
  15. 15. Summary<br />Most common cancer in men<br />If localized to the prostate, most men can be cured<br />No one treatment is right for everyone.<br />Need to have a thorough discussion with your doctor<br />Refer you to my website<br />Or Gov. website- http://www.cancer.gov/cancertopics/types/prostate<br />

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