This page provides links to details on certain treatment options. Links to this information are usually on websites of specific facilities. Please note that we are not recommending specific hospitals, facilities or medical doctors nor are we providing opinions on treatments.
Treatment options are preceded by a biopsy. A decision on performing a biopsy depends on PSA test results, a digital rectal exam, family history and age, as all of these are contributing factors. A tool of computing the risk of a positive biopsy may be used in the shared decision making process together with a specialized urologist or oncologist.
Once a pathology report after biopsy is obtained, the cancer will be classified as low, medium or high risk. The classification will usually be based on either the D'Amico classification or on the CAPRA score. In combination with nomograms predicting the probability of recurrence after treatment, these tools will be used in the personalized physician-patient decision on possible treatments.
There are a number of options for treating prostate cancer. For more descriptive details on these options see information provided by the National Prostate Cancer Coalition ("Zero").
With the exception of proton beam radiation and HIFU, all of these treatments are available in medical facilities within North Texas; currently, HIFU is available in the US through clinical trials only; two proton beam centers in the Metroplex are in the planning stage.
See also articles on treatments, including Active Surveillance, in the PCa News Archives.
1. Active Surveillance (Expectant Management, Watchful Waiting)
NCCN Guidelines for Active Surveillance
2. Radical Prostatectomy (Surgery)
- Open radical retropubic prostatectomy (view Johns Hopkins video
- Laparoscopic radical prostatectomy
- Robotic assisted laparoscopic radical prostatectomy
(Da Vinci Procedure); see also related videos
Da Vinci Robot
IMRT System in Action
Look for a quick description of some of the external beam therapies
- Brachytherapy (internal radiation, implants)
- Intensity Modulated Radiation Therapy (IMRT); external radiation
- Image Guided Radiation Therapy (IGRT); external radiation
- Cyberknife - external radiation ( http://www.youtube.com/watch?v=ZDFggNJH388 )
- Proton Beam Radiation Treatment - external radiation
(Proton videos); available at only a few locations within the US
4. Cryotherapy (based on freezing of the cancer; link; click on video)
5. High Intensity Focused Ultrasound (HIFU - click on video); available in the US through clinical trials only.
6. Hormone Treatment
7. Diets, Supplements
Note: In some cases, combined treatments ("adjuvant treatments": surgery/IMRT; surgery/hormone therapy; brachy therapy/IMRT; radiation/hormone therapy) may be used.
Focal treatments, treatments of portions of the prostate, are theoretically possible with any treatment. They are mainly used with HIFU, Brachy and Cryo surgery as well as with the newly advertised Nanoknife technology. No data on Nanoknife are available at this time.
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