Prostate Cancer

Prostate Cancer doesn’t have to slow you down.
You can be the man you’ve always been.

Prostate Cancer Treatment at Philadelphia CyberKnifePhiladelphia CyberKnife uses revolutionary technology in the fight against prostate cancer. It treats tumors by focusing pinpoint beams of radiation that destroy cancerous cells with minimal effect to the surrounding healthy tissue. For you, it means five or fewer treatments, compared to 40 treatments with traditional radiation, and a low occurrence of erectile dysfunction. With CyberKnife®, there’s no pain, no incision, and no hospital stay.

Cancer doesn’t fight fair, neither should you.

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Prostate TumorThe prostate is a walnut-shaped organ in a man’s lower abdomen that controls the flow of urine and semen through the penis. Prostate cancer is among the leading causes of cancer death among American men, second only to lung cancer. There is no single cause of prostate cancer, though there are several known risk factors:

  • Age – Risks generally increase for older men.
  • Race – African-American men have a higher risk for unknown reasons.
  • Nationality – Asian men, for example, have a lower risk.
  • Diet – Red meat and dairy products tend to increase risk. Several studies suggest that some dietary supplements like vitamin E and lycopene may reduce risks.
  • Lack of exercise
  • Family history of prostate cancer

What are the symptoms of prostate cancer?

Early-stage prostate cancer usually has no symptoms. Older men may experience frequent urination, though it’s likely due to an enlarged prostate in a condition known as benign prostatic hypertrophy, or BPH. Pain or bleeding is not commonly associated with early stages.

Prostate cancer is suspected if men have an elevated level of a substance in the bloodstream known as prostate specific antigen, or they have an abnormality like a nodule found during a digital rectal examination. A prostate-cancer diagnosis is confirmed, however, only through biopsy. If cancer is found, doctors determine the amount of risk to the patient based on specific biopsy findings.

Urologists usually perform biopsies as an outpatient procedure. An ultrasound probe is used to guide a needle that removes 10 to 12 small tissue samples from different parts of the prostate gland. Sometimes, additional diagnostic tests like a bone scan, CT or MRI are performed, depending on the specific diagnosis.

What are the treatment options for prostate cancer?

Prostate cancer can be treated with surgery, radiation therapy or a procedure known as brachytherapy used sometimes in combination with radiation therapy.

There is no conclusive data favoring any specific prostate-cancer treatment. Studies show that all treatment options appear to be equally effective. Treatments differ primarily in their technical nature and potential side effects. Patients eligible for all three should rely on their physician’s help in deciding.

Surgery

Patients may be advised to undergo surgery known as radical retropubic prostatectomy in which the prostate gland is removed and may include biopsies of nearby lymph nodes. The procedure usually takes three to four hours, requiring general anesthesia and a three-day hospital stay. Recovery at home usually lasts a few weeks, the first two of which require a Foley catheter inserted through the urethra into the bladder. Potential long-term side effects include a low risk of urinary incontinence and erectile dysfunction.

External-beam radiation therapy

Patients treated with external-beam radiation therapy receive a certain number of daily radiation treatments over a period of seven to eight weeks. Treatments are outpatient procedures that usually take about 15 minutes each.

External-beam radiation therapy is referred to as three-dimensional conformal or intensity-modulated radiation therapy. IMRT, as it’s known, allows doctors to customize the radiation beams to individual patients, resulting in much better targeting than with conventional radiation. The Calypso® system is a common piece of technology used in IMRT treatments to track and monitor the location of the prostate, ensuring greater accuracy during each procedure. However, IMRT lacks the ability to correct for movement of the prostate during treatment, resulting in possible damage to healthy tissue surrounding the prostate. Potential side effects include temporary rectal and urinary irritation as well as long-term erectile dysfunction.

Brachytherapy

With brachytherapy, doctors implant small radioactive seeds within the prostate gland that destroy tumors. Guided by an ultrasound device, doctors place the seeds with a needle inserted between the legs into the prostate. In rare cases, a temporary Foley catheter is used. Patients are usually allowed to return home on the same day. Potential side effects include urinary irritation that can last for several months and long-term erectile dysfunction.

Stereotactic radiosurgery

Similar to IMRT, the CyberKnife has the ability to conform radiation beams to the shape of the prostate. CyberKnife differs from IMRT, however, in being much more precise in aiming radiation and sparing surrounding healthy tissue. For example, CyberKnife has the ability to compensate for normal patient movements such as breathing, precisely targeting the prostate during the entire procedure and minimizing damage to surrounding healthy tissue. This level of accuracy enables the CyberKnife to use a technique known as hypofractionation, in which patients get a higher dose of daily radiation over a smaller number of treatments. Conventional forms of radiation therapy for prostate cancer require up to 41 consecutive daily treatments over a two-month period. CyberKnife can treat prostate patients in as little as five daily treatments. This can be attributed to CyberKnife’s ability to administer high-dose radiation rather than low dose radiation.

What is the CyberKnife treatment process for prostate cancer?

Prior to 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, ensuring the radiation beams are always locked on the tumor. The markers, which remain in the prostate permanently, are implanted by a physician in an outpatient procedure. 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. A CT scan is used in developing a custom treatment plan. Patients are then scheduled for no more than five CyberKnife treatments. Each treatment takes about 30-40 minutes, and patients can return home immediately.

Potential side effects are similar to those with standard radiation therapy and classified as late or early. Late side effects, which include erectile dysfunction, can continue for months and may be permanent. Early side effects show up in the first few months after treatment. They’re usually temporary and go away over time after treatment is completed. They include:

  • Urinary urgency and frequency
  • Nighttime urination
  • Mild burning during urination
  • Urgent bowel movements
  • Increased frequency of bowel movements or irritation of hemorrhoids

Side effects from CyberKnife treatment are usually similar to what is seen with conventional radiation therapy but fewer than what is seen with radioactive seed implantation. This results from CyberKnife’s accuracy, which spares more of the healthy tissue around the tumor site.