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Southern California Urology Institute
Gary Bellman, M.D., F.R.C.S.
Board Certified Urologist
Fellowship Trained, Certified in Robotic Surgery

Expertise, Understanding, and
Extraordinary Results


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Prostate Cancer Awareness- Understanding Treatment Options

By: Dr. Gary Bellman on September 20, 2013, 1:07 pm

When it comes to treating prostate cancer, there’s more good news than you might think. The most effective treatments carry a cure rate of about 90% when the cancer is caught early and confined to the prostate, as 75% of them are when diagnosed. What’s more, treatments are improving…

Much of the current news about prostate cancer has placed its focus on screening.  In reality, screening is only one piece of the prostate cancer picture.  More than 200,000 men in the U.S. will be diagnosed with prostate cancer this year.  Most of these men will have to weigh a variety of treatment options and make a series of decisions about managing their disease.

So, if you have just been diagnosed with early-stage prostate cancer, what are the most effective treatments out there today?  Here are some important questions men can keep in mind when facing a diagnosis of prostate cancer, and information they can use to help make these important decisions–

Does my cancer need to be treated?

This question in itself comes as a big surprise to many men.  The idea that they have cancer, but not treating the cancer, runs counter to the widely held belief that doing something is always better than doing nothing.
In fact, most prostate cancers grow slowly; This has led to the investigation of ‘observational approaches’ to managing localized prostate cancer (cancer that has not spread outside of the prostate gland at the time of diagnosis).  Observation is also referred to as ‘watchful waiting‘ or ‘active surveillance.’
 

“What’s the best treatment for prostate cancer?”

For men with localized prostate cancer who are not candidates for observation alone, or who aren’t comfortable with this approach, there are a number of options to treat their disease.  The most common treatments chosen by men in the US are surgery (nearly half of all men), followed closely by radiation treatment (about 40%).
 

What are the most common side effects of prostate cancer treatment?

The two most common complications of both surgery (prostatectomy) and radiation are sexual and urinary difficulties.  During prostatectomy, the bladder, urethra (the tube that carries urine), and the nerves that control erections can all be affected post-surgery.  This is because the bladder is next to the prostate gland, and the urethra and erection nerves run through the gland.
Radiation for prostate cancer can be delivered in different ways.  All of these treatment approaches are designed to kill cancer cells in the prostate and to minimize damage to the nearby bladder, urethra, and nerves that control erections, but damage to these structures remain a possibility. Regardless of which form of radiation treatment is chosen, the chances of these complications are similar to the rates seen after surgery.

Is robotic surgery better than other types of surgery?

Prostate surgery can be done in a number of different ways, but over the past 10 years, ‘robotic’ prostatectomy has become the most common approach and is now used for more than 80% of prostate removals in the U.S.  This procedure uses a mechanical arm and magnification system that is operated by the surgeon from a control panel set up in the operating room. This system allows the surgeon to have a better view of the prostate gland and surrounding structures and to remove the diseased gland; this is designed to decrease chances of causing harm to the adjacent normal tissues and organs.
 

Is proton therapy better than other types of radiation?

Just as the use of robotic surgery has increased rapidly in recent years, there is a new method of radiation treatment called proton beam therapy that is growing dramatically. Instead of the photons used in traditional radiation treatments, proton beam therapy uses different sub-atomic particles (protons) that are designed to deliver a very high dose of radiation to the cancer cells but release very little radiation on the way to the tumor; the idea is that this limits the damage to normal surrounding tissues.  There is also no convincing evidence that complication rates are lower with proton therapy.
 

“What other prostate cancer treatments are available?”

Hormone treatment, called androgen deprivation therapy or ‘ADT’, is sometimes used for localized cancer, usually in addition to radiation treatment. Other approaches approved to treat early stage prostate cancer in the US include cryotherapy, which kills cancer cells by freezing the prostate gland, and stereotactic body radiation therapy (SBRT, sometimes referred to as ‘cyberknife’ treatment), which is designed to deliver high doses of radiation to tumors. Only about 1 in 10 men currently choose these methods as the first choice to treat prostate cancer.
 

Experience is the best teacher when it comes to treating prostate cancer.

Here at Southern California Urology Institute, Dr. Gary C. Bellman has over 20 years of experience and has earned the trust of many patients through being a compassionate and integral physician.  Dr. Bellman can be reached through his office at 818.703.9500.


For an appointment or consultation with Dr. Gary Bellman,
please contact the office or call 818-912-1899




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