prostate cancer treatment options

ì PROSTATE CANCER TREATMENT OPTIONS

2010 West Chester Pike Suite 115, Havertown, PA 19083 (610) 446-‐6850 www.phillycyberknife.com

PROSTATE CANCER OVERVIEW

ì  The prostate is located in a man’s lower abdomen and controls the flow of urine and semen.

ì  Second only to lung cancer, prostate cancer is the leading cause of cancer death among American men.

ì  According to the American Cancer Society, an esEmated 238,590 cases of prostate cancer will occur in the US during 2013.


http://www.slideshare.net/phillycyberknife/pck-acs-2013-data-overview

TREATING PROSTATE CANCER

ì  The stage of the cancer

ì  The patient’s age and health ì  The patient’s Gleason Score —

This determines how likely it is that a tumor will spread

ì  Whether the cancer is recently diagnosed or recurring

ì  The patient’s prostate-‐specific

antigen (PSA) levels — PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer

Prostate cancer treatments differ primarily in technical nature and potenEal side effects. Treatment options can depend on the following:


TREATMENT OPTIONS

ì  Prostate cancer treatment options include: ì  Watchful Waiting

ì  Surgery ì  External-‐Beam Radiation Therapy ì  Brachytherapy

ì  Proton Therapy ì  Stereotactic Body Radiation Therapy


WATCHFUL WAITING

ì  The concept of watchful waiting has emerged as a viable option for men who decide not to undergo immediate surgery or radiation therapy.


SURGERY

ì  Procedure & Recovery Time ì  Procedure lasts 3 – 4 hours ì  Requires general anesthesia and a three-‐day

hospital stay ì  Recovery usually requires a few weeks at

home and often a post-‐treatment catheter for approximately 6 weeks

ì  Patients may experience pain associated with surgery

ì  Potential side effects

ì  Erectile dysfunction ì  Urinary incontinence

Radical Retropubic Prostatectomy: Surgery in which the prostate gland is removed and that may include biopsies of nearby lymph nodes.


EXTERNAL-‐BEAM RADIATION THERAPY

ì  Procedure & Recovery Time ì  Approximately 40 daily radiation treatments over a period of seven to eight

weeks ì  Treatment takes approximately 15 minutes ì  Outpatient procedure that allows most patients to return to their normal

routine

ì  Potential side effects ì  Temporary rectal and urinary irritation ì  Erectile dysfunction ì  Lacks the ability to correct for movement of the prostate during treatment,

resulting in possible damage to healthy tissue surrounding the prostate

Intensity Modulated Radiation Therapy or IMRT: IMRT targets radiation beams to the location of the patient’s tumor.


BRACHYTHERAPY

ì  Procedure & Recovery Time ì  One-‐time procedure that requires patients to

remain in the hospital for several hours

ì  Patients are usually allowed to return home on the same day

ì  Potential side effects ì  Erectile dysfunction ì  Urinary irritation, frequency and obstruction ì  Rectal injury

Brachytherapy: Small radioactive seeds are implanted within the prostate gland and give off radiation to the immediate surrounding area over the course of several months. After a year, the radioactive material degrades, and the seeds that remain are harmless.


PROTON THERAPY

ì  Procedure & Recovery Time ì  Treatment is usually delivered five days a week for

approximately eight weeks

ì  Patients are usually able to return to their normal routine after treatment

ì  Potential side effects ì  Few to no side effects when compared to traditional

radiation therapy

Proton Therapy: Noninvasive treatment that uses a particle accelerator to deliver a focused ray of proton particles that destroy cancer cells.


STEREOTACTIC BODY RADIATION THERAPY

ì  Procedure & Recovery Time

ì  Patients are treated in five or fewer outpatient sessions over the course of one to two weeks

ì  Treatment procedures take about 30-‐90 minutes

ì  Patients experience no pain with CyberKnife and are usually able to return to their normal routine after treatment

ì  Recovery is often immediate

ì  Potential side effects

ì  Few to no side effects when compared to traditional radiation therapy or surgery

Stereotactic Body Radiation Therapy: Noninvasive procedure that delivers targeted radiation beams to the prostate without incision or sedation using CyberKnife® technology.


CYBERKNIFE TREATMENT PROCESS

The treatment process includes:

ì  Consultation appointment

ì  Pretreatment procedures

ì  CyberKnife treatment

ì  Follow-‐up

Prior to stereotactic body radiosurgery treatment with CyberKnife, small tissue markers known as fiducials are implanted in the prostate to help the CyberKnife pinpoint the tumor location throughout each treatment, so the radiation beams can be locked on the tumor. About a week later, patients are fitted with a custom body mold of soft material that they lie on during treatments. The fitting process is painless.


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PHILADELPHIA CYBERKNIFE

Newly published research from Philadelphia CyberKnife shows that SBRT’s success rate is comparable to other treatments, including conventional surgery, which is often held as the gold standard treatment for prostate cancer. In addition, SBRT offered more convenient treatment and less risk of side effects like erectile dysfunction. The study, “Stereotactic body radiation therapy for the primary treatment of localized prostate cancer,” appeared in the March 2013 issue of the Journal of Radiation Oncology. Researchers tracked the five-‐year progress of 70 men treated with SBRT. The results “support the growing body of literature indicating SBRT for prostate cancer is effective and well tolerated,” the study concluded. The results offer hope for men who don’t want surgery or can’t undergo it because of other health problems. It also offers an alternative radiation option to IMRT or brachytherapy. In addition, SBRT carries a lower risk of erectile dysfunction.

OUR CENTER

Philadelphia CyberKnife established the first CyberKnife program in the greater Philadelphia area, giving our physicians the most experience treating patients with this technology in our region. Our patients have come from throughout the eastern United States, as well as numerous countries around the world, including England, India and Malaysia. Philadelphia CyberKnife is a service of Delaware County Memorial Hospital, a member of the Crozer-‐Keystone Health System.

Connect With Us Medical Director: Dr. Luther Brady Associate Medical Director: Dr. John Lamond DCMH Chief of Radiation Oncology: Dr. Rachelle Lanciano Chief Medical Physicist: Jun Yang, PhD, DABR CyberKnife Nurse Manager: Michael Good, RN


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