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

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