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Surgery for Prostate Cancer > Radiotherapy for Prostate Cancer > Prostate Brachytherapy > Electroporation for Prostate Cancer – Early Clinical Trials
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Medical specialists in urology, radiation oncology and medical oncology can advise you during this early consultation period what are your best prostate cancer options. The choice you need to discuss with them is whether it’s a case of no treatment with your doctor monitoring your medical condition or having to choose one of the treatment methods:
- chemotherapy or other forms of pharmaceutical treatment;
- surgery;
- radiotherapy;
- brachytherapy; or
- a prostate ablation technique.
Dr Lyn Oliver AM MSc PhD
Retired Medical Physicist
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Background
Just as breast cancer is the most prevalent cancer for women, prostate cancer is the number one cancer incidence for men. But, having been told you have prostate cancer, it’s not simple to decide what might be the best mode of treatment.
There are many complex issues that prostate cancer patients need to hear about and consider before choosing the optimum treatment.
For instance, you must first obtain advice from the medical practitioner (who is a specialist in prostate cancer) as to whether there should be any treatment at all.
There are non-malignant prostate situations that you should know about. In some cases, prostate cancer is a very slow growing malignancy. It can be so slow growing, you could die of another ageing cause first.
But then, prostate cancer can be aggressive and it is certainly NOT advisable to have no treatment under those circumstances . The problem is that medicine does not have a satisfactory means of recognising the fairly low risk type to the very aggressive prostate cancer type.
Men have become much more aware of getting a regular medical check and that’s good. Physical rectal examination, bladder frequency, MRI scans, PET body scans and PSA blood test can provide indicators for your physician to use and assess . A high PSA count indicates that the prostate is upset and, things like cancer, can cause a high PSA. But there are other non-malignant reasons for the PSA high count. Your medical specialist may elect to confirm this by a more direct method – this involves surgically inserting needles in a regular pattern into the prostate and taking biopsy samples for a pathology report.
Biopsy Diagnosis
The technique used in past years involved taking biopsy samples as a one-dimensional pattern. But when pathology samples are taken by the one-dimensional technique, there’s a possibility that detection of some or all the cancer is missed.
To limit missing detecting prostate cancer tissue, urologists have now developed a 3-D technique as described in this video (Youtube, Paul Arangua, Precision Prostate Cancer Treatment: 3D Staging Biopsy, University of Colorado, Auschutz Medical Campus, June 2014):
The most recent techniques enable the 3-D biopsy to be ‘fused’ onto MRI and ultrasound images during surgery (more information on this technique in later publications).
But there’s still considerable debate in the medical profession as to what might be the best pathway for medical screening and diagnosing of prostate cancer.
Treatment on Hold
During the initial decision making processes, the medical specialist will have considered the patient’s age, physical condition, the prostate physical examination, diagnostic images, biochemical tests and pathological diagnoses. Based on all the results, the medical specialist may recommend no treatment and will ask that you be regularly monitored and reassessed after reviewing future results.
Time to Decide Treatment
If the medical specialist decides treatment is necessary, the rationale to proceed will be explained to you. Your doctor(s) will generally provide learned advice before asking you to make the final decision for treatment.
But having decided that some form of prostate treatment is necessary, then you have to consider the pros and cons of each option before selecting which mode of treatment you will have.
The Government and medical services provide excellent support for patients during this early treatment stage and there’s plenty of reading and video material to help you. If you are a prostate cancer candidate, then make sure you make good use of all these information sources.
You should seek all forms of advice and seek support from a patients’ prostate group.
Treatment Complications
Despite improvements in techniques and technology, surgery and radiotherapy still cause (in varying degrees) undesirable complications such as erectile dysfunction, urinary incontinence and bowel toxicity.
In making your final choice for treatment, issues to consider include:
- avoiding erectile dysfunction;
- not having urinary incontinence or bowel problems;
- the choice of a suitably skilled surgeon;
- receiving the most up-to-date radiotherapy external beam or brachytherapy technique; and
- selecting a treatment option that suits your personal ability to cope and/or afford financially;
You can discuss these issues together with your medical details (e.g. extent of cancer, pathological grading, cancer distribution, etc.) with your medical specialist(s). The medical details can vary significantly from one patient to another and subtle differences play an important bearing on what you should choose as the optimum treatment.
It’s important that you ensure you obtain adequate information from all sources and your medical specialist(s) before deciding which form of treatment is best for you to have. Patients must feel comfortable with their final choice of treatment method.
Treatment Options
Because of the length of detail, this topic is split into treatment options:
- Surgery
- External Beam Radiotherapy
- Brachytherapy & Ablation Devices
Each of these prostate treatment techniques are described separately in articles to follow. Chemotherapy and other forms of pharmaceutical treatment are not included in this review.
Lyn Oliver, 7 May 2018
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> Welcome to community Information > Cancer Care Technologies > Technology in Surgery and Therapy > Index: All Articles
Surgery for Prostate Cancer > Radiotherapy for Prostate Cancer > Prostate Brachytherapy > Electroporation for Prostate Cancer – Early Clinical Trials
