Prostate Cancer. Options for Localised Cancer

Transcription

1 Prosae Cancer Opions for Localised Cancer You or someone you know is considering reamen opions for localised prosae cancer. his leafle is designed o give you a shor overview of he opions available. For more informaion please see he bookle Localised Prosae Cancer - A guide for men and heir families. he bookle explains localised prosae cancer, he reamen opions and heir pros and cons. s purpose is o help men make decisions abou reamen opions. can be hard o obain a prined copy, bu is available in elecronic PDF forma on he inerne from he Cancer Council of Vicoria websie Wha facors influence reamen choices? G12609 Nov 2013 Paien relaed hese are ofen he mos imporan in deermining he choice of reamen. hese facors include: Age. Life-expecancy. Aiude owards poenially aggressive reamen. Cos.

2 F Prosae cancer relaed Exen of disease. Hisopahologic appearance (grade he appearance of he umour under microscopic examinaion). PSA-level. C C e f C Prosae relaed Size of he gland. Degree of benign enlargemen. Amoun of obsrucion o urine flow. A i H Paien relaed medical condiions Such as: Hear disease. H d H Lung disease. Vascular disease. Bleeding disorders. Previous bowel or pelvic surgery. nflammaory bowel disease. Previous reamen for serious malignancies. Bearing in mind he facors jus menioned, you and your docor can discuss he various opions given below. A q H P b

3 No reamen his is ofen a valid reamen. You and your docor migh selec his opion if i appears likely ha he disease is so slowly progressive ha you are unlikely o be roubled by i. has he advanage ha i avoids he rouble, cos, and poenial sideeffecs of acive reamen. However, he risk is ha he disease may progress more rapidly han anicipaed and hen cause rouble which migh have been avoided. Radical prosaecomy Radical prosaecomy is surgical removal of he prosae. his is a major operaion, wih he poenial problems of any major operaion, whichever way i is performed. has very good cure raes in paiens wih disease enirely confined o he prosae gland. involves a hospial say for around a week, and an indwelling urinary caheer for a while longer. Mos, bu by no means all, men become impoen and a small proporion of men are lef wih permanen inconinence. Exernal beam radioherapy his is he use of an x-ray beam produced by a reamen machine, called a linear acceleraor. Exernal beam radioherapy adminisers a high dose of radiaion o he prosae and he immediae surrounding issue. has high cure raes for early sage disease, bu i is ofen chosen for locally-advanced disease in which he cure raes are no quie so high. Exernal beam radioherapy involves 7-8 weeks of daily aendance a a radioherapy cenre, from Monday o Friday. Common side-effecs are iredness, bowel irriaion and bladder irriaion. Radioherapy can also have long-erm complicaions, including impoence and minor disurbance in usual bowel habi. Occasional recal or urinary bleeding is someimes seen, serious bleeding is very rare.

4 High dose rae brachyherapy High dose rae brachyherapy is anoher way o deliver radiaion o he prosae. is a reamen opion for men wih inermediae sage prosae cancer. Brachyherapy is a form of radioherapy where a radiaion source is placed inside or near he area ha requires reamen. High dose rae brachyherapy for prosae cancer involves a small surgical procedure in which hollow plasic caheers are insered ino he prosae. Once insered an individual reamen plan is calculaed and a number of radiaion reamens are delivered, usually over 2 days. o deliver he high dose rae brachyherapy reamen he plasic caheers, which are in he prosae, are conneced o a machine which houses a small radioacive source. he radioacive source ravels hrough he plasic caheers, delivering he radiaion o he prosae. he reamen akes approximaely minues, depending on your individual reamen plan. Once all he reamens are compleed he caheers are removed and you can leave hospial. L L m d r L o r m A High dose rae brachyherapy is usually given in combinaion wih exernal beam radioherapy. is used o increase or boos he dose o he prosae achieved wih exernal beam radioherapy reamen. Usually he exernal beam radioherapy componen will go for five weeks, raher han six or seven which would be he lengh if he exernal beam radioherapy is given alone. is hough ha his combinaion of high dose rae brachyherapy and exernal beam radioherapy will have beer cure raes, and less sideeffecs han exernal beam radioherapy reamen alone. does, however, involve a minor operaion, and a shor inpaien say in hospial. D

5 Low dose rae or permanen seed brachyherapy Low dose rae or permanen seed brachyherapy is a reamen opion for men wih early sage prosae cancer. Early sage prosae cancer means here is lile risk of spread ouside of he prosae gland. n hese men, low dose rae brachyherapy is hough o have a cure raes comparable o radical prosaecomy. Low dose rae or permanen seed brachyherapy involves a small operaion where long hin needles are precisely guided ino he prosae. hese needles hen implan iny radioacive seeds ino he prosae. hese seeds remain permanenly in he prosae giving a high dose of radiaion over a prolonged period. he radiaion from hese seeds has very low peneraing power, which means a high dose can be given o he prosae, bu here is lile radiaion o surrounding healhy issues. his minimises side-effecs. Advanages Quick. nvolves only a minor surgical procedure. Causes lile disrupion o your home or work life. Lile chance of inconinence or recal bleeding. Much smaller risk of impoence compared wih oher acive reamens. Disadvanages Significan bladder irriaion for monhs aferwards is common. Occasionally men migh require a urinary caheer.

6 Oher reamens Apar from he no reamen opion, hese are he only reamen opions available in Ausralia which are recognised o have curaive poenial. Oher reamens can be used for men wih prosae cancer, bu are unlikely o lead o long-erm conrol. hey will ypically knock-back he cancer for variable periods of ime, someimes a very long ime. hese are briefly menioned for compleeness. Hormone reamen Hormone reamen or androgen deprivaion involves suppression of he male hormone, esoserone. his can be done in many ways, eiher wih drugs or surgically. will cause a regression of he prosae cancer, and remission from he disease ha may las many years. neviably he cancer has he poenial o come back, given sufficien ime. his form of reamen is commonly used in men wih early sage prosae cancer in a combinaion wih radiaion, bu also wih surgery. rans-urehral resecion of prosae (or URP) his involves a urological surgeon removing par of he prosae. is usually done for men wih obsrucion o heir urine flow. Mos commonly, such obsrucion is no caused by cancer. f i is, hen he URP will rea he sympom of he cancer, bu will no cure he underlying cancer. Chemoherapy Chemoherapy is he use of drugs o kill cancerous cells. is very effecive for some cancers bu i has very limied use for prosae cancer. Chemoherapy is someimes used in advanced disease o help alleviae sympoms, bu i has no proven place for he aemped cure of localised prosae cancer. N i u e p m R R o w p i m p E a o E r C R a b

7 Cryoherapy Cryoherapy involves he desrucion of issue hrough he use of exremely low emperaures. For prosae cancer, cryoherapy is used o freeze he prosae issue, causing irreversible damage. Cryoherapy is ypically used for men who: Have local recurrence afer any form of radioherapy reamen. Are older men and no fi for surgery and do no wish o have radioherapy. A he momen cryoherapy is no suppored by Medicare, so he reamen is quie expensive. High-inensiy focused ulrasound (or HFU) High-inensiy focused ulrasound or HFU is a highly precise procedure ha applies high-inensiy focused ulrasound energy o locally hea and desroy diseased or damaged issue. HFU is ypically used for men who: Have local recurrence afer any form of radioherapy reamen. Men wih sympomaic prosae cancer who do no wan o have surgery or radioherapy. A he momen HFU is no suppored by Medicare, so he reamen is quie expensive. How can find ou more? Please ask your radiaion oncologis if you require furher informaion on reamen opions for prosae cancer. We have more deailed informaion bookles on many of he reamen opions described here. Furher informaion can also be found on o he Melbourne Prosae nsiue websie

8 Y c a F b g c a d Prosae Cancer - Opions for localised cancer WBRO Paien nformaion Commiee Prosae Cancer - Opions for localised cancer. Vicoria: William Buckland Radiaion Oncology. Firs Published November 2013 his ediion November Commercial Rd Melbourne, Vicoria 3004 elephone Facsimile radiaion oncology P.O. Box 424 raralgon, Vicoria 3844 elephone Facsimile is V W P WBRO Paien nformaion by William Buckland Radiaion Oncology is licensed under a Creaive Commons Aribuion-NonCommercial-ShareAlike 3.0 Unpored License G12609 Nov 2013