STAGES OF PROSTATE CANCER99 Route 37 West Toms River, NJ 08755 (732) 557-3120www.newjerseyck.com
Prostate Cancer OverviewPossible Signs of Prostate Cancer:Weak or interrupted flow of urineFrequent urinationTrouble urinatingPain or burning during urinationBlood in the urine or semenPersistent pain in the back, hips, or pelvisPainful ejaculation¨ The prostate is awalnut-sized glandlocated in a man’slower abdomen thatcontrols the flow ofurine and semen.¨ Prostate cancer is aleading cause ofcancer death amongAmerican men, secondonly to lung cancer.99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
Diagnosing Prostate CancerProstate Cancer can be diagnosed by:¨ Digital Rectal Exam (DRE) – examination ofthe rectum.¨ Prostate-specific antigen (PSA) test –measures the level of PSA in the blood. PSAmay be found in an increased amount in theblood of men with prostate cancer.¨ Transrectal Ultrasound Biopsy – provides apicture of the prostate for the doctor toanalyze.¨ Gleason Score – determines how likelyprostate cancer is to spread.99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
The TNM Staging SystemA staging system describes how far a cancer has spread.The most widely used staging system for prostate cancer isthe American Joint Committee on Cancer (AJCC) TNMsystem.The TNM system for prostate cancer is based on 5 keypieces of information:¤ The extent of the primary tumor (T category)¤ Whether the cancer has spread to nearby lymph nodes (Ncategory)¤ The absence or presence of distant metastasis (M category)¤ The PSA level at the time of diagnosis¤ The Gleason Score, based on the prostate biopsy (or surgery)99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
Prostate Cancer - Stage I¨ Cancer is found in the prostate only.¨ Cancer is microscopic and cannot be felt during theDRE or seen on imaging tests.¨ Cancer is found in one-half or less of one lobe ofthe prostate.¨ PSA level lower than 10 ng/mL.¨ Gleason Score is 6 or lower.99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
Prostate Cancer - Stage IIA99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com ¨ Cancer is more advanced thanStage I but has not spread outsidethe prostate.¨ The cells are usually moreabnormal and may tend to growmore quickly.¨ Cancer is found in more than halfof one lobe of the prostate.¨ PSA level is lower than 20 ng/mL.¨ Gleason Score is 7 or lower.
Prostate Cancer - Stage IIB99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com ¨ Cancer is found in opposite sides of the prostate.¨ Cancer cannot be felt during a DRE and is notvisible by imaging.¨ The tumor has not spread outside the prostate.¨ PSA level is 20 ng/mL or higher.¨ Gleason Score ranges from 2 to 10.
Prostate Cancer - Stage III99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com ¨ Cancer has spread beyond theouter layer of the prostate.¨ Cancer may have spread tonearby tissues like the seminalvesicles.¨ PSA can be any level.¨ Gleason Score can range from2 to 10.
Prostate Cancer - Stage IV¨ Cancer has spread(metastasized) beyond theseminal vesicles to nearbytissues or organs such asthe rectum, bladder orpelvic wall.¨ Cancer has spread todistant parts of the body,which may include otherlymph nodes or bones.Prostate cancer oftenspreads to the bones.¨ Cancer has spread tonearby lymph nodes¨ PSA can be any level.¨ Gleason score can rangefrom 2 to 10.99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
Prostate Cancer TreatmentTreatment OptionsActive SurveillanceSurgeryExternal-Beam Radiation TherapyBrachytherapyProton TherapyStereotactic Body Radiation Therapy¨ Treatment options depend on:¤ The stage of the cancer¤ The patient’s age and health¤ The patient’s Gleason Score¤ Whether the cancer is recentlydiagnosed or recurring¤ The patient’s prostate-specificantigen (PSA) levels99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
CyberKnife® SBRT Treatment Process99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com ¨ Prior to stereotactic body radiation therapy with CyberKnife, smalltissue markers known as fiducials are implanted in the prostate tohelp pinpoint the tumor location throughout each treatment.¨ About a week later, patients are fitted with a custom body mold ofsoft material that they lie on during treatments. The fitting process ispainless.¨ This treatment processincludes¤ Consultation appointment¤ Pretreatment procedures¤ CyberKnife treatment¤ Follow-up
Additional Resources99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com
Our CenterOpened in 2011, New Jersey CyberKnife at the J. Philli Citta Regional CancerCenter is active in clinical research. New Jersey CyberKnife opened a clinical trialin collaboration with the University of Pittsburgh to evaluate stereotactic bodyradiation therapy for low, intermediate and high-risk prostate cancer patients.Results from the trial will add to the body of clinical research examiningstereotactic body radiation therapy for prostate cancer and will help doctorsanalyze effects and outcomes to improve prostate treatment protocols. MedicalDirector Dr. David D’Ambrosio has also published several peer-reviewed researchpapers on prostate cancer.99 Route 37 West Toms River, NJ 08755 (732) 557-‐3120 www.newjerseyck.com Medical Director: Dr. David AmbrosioChairman of Radiation Oncology at Community Medical Center: Dr. Rajesh IyerCyberKnife Nurse: Debbie Moriarty, RN, MSN, OCNConnect With Us