Cancer of the prostate, diagnosis and treatment:
Today’s goal of diagnostics is discovering a cancer at its earliest stage where it can be eradicated and the patient can expect to live cancer free.
Symptomatic cancers signify more advanced stage and poorer outcomes. That is why the advent of performing a PSA in patients who are at risk permitted early diagnosing at early stages of Prostate Cancer. Patients with a family history of prostate cancer amongst blood relatives (sons of fathers with CaP, paternal Uncles with CaP brothers of patients with CaP) are at higher risk to develop CaP as well as Afro-Americans.
Prostate cancer is diagnosed on biopsy specimens sent to the Pathology Lab. It is done under ultrasonic guidance; it is pain free and usually uncomplicated. The biopsy is recommended for patients who have an elevated PSA level (above 4.0 /), hard nodule of rectal examination and/or abnormal Transrectal Ultrasound suspicious for Cancer. There may be symptoms associated with prostate enlargement: slow stream, frequency, rarely bleeding.
Once diagnosed the patient may undergo staging of the cancer, testing that will show if the cancer spread to the bones or lymph nodes.
If the cancer is confined to the prostate the patient is presented with several options of treatment:
Surgery: if the general health conditions permit and the patient has at least 10 years of life expectancy.
It is done nowadays Robotically that gives the best chances for remaining Cancer Free, continent of urine and resuming sexual activities because of possible preservation of the neurovascular bundle that controls that function.
Patients who had multiple abdominal surgeries who developed dense intraperitoneal adhesions placement of Robotic Ports is dangerous. It may lead to damage of intestines, internal organs or major vessels (aorta, vena cava). These patients may undergo another minimally invasive surgery via perineal approach. The results , short recovery time and minimal blood loss are similar to Robotic Surgery.
For patients who would not benefit from surgery because of short life expectancy or whose poor health puts them to unnecessary risk for not surviving surgery Dr. Plawner offers radioactive seed implant or external beam radiation.
For patients who were unfortunate to develop metastatic disease Dr. Plawner is offering medical treatment consisting of giving injections every 3-4 months of Lupron in combination with Casodex to contain the cancer. At the same time Dr. Plawner manages the patient’s bone health because of osteoporosis that follows this type of treatment. For those unfortunate patient’s whose cancer keep progressing Dr. Plawner works with Oncologists who treat the cancer with chemotherapy.