All but ignored in their early years, the prostate begins to loom large for men of a certain age. Frequently to blame is benign prostatic hyperplasia (BPH), an enlargement of the gland – similar to a walnut in size, shape and weight – with an array of troublesome urinary-tract symptoms. It’s estimated that BPH plagues 50% of men between 51 and 60 and as many as 90% of those 80 and older.
The prostate is also the site of a more worrying problem. Over his lifetime, one man in eight will develop prostate cancer. According to National Cancer Institute estimates, this year some 248,000 American men will be diagnosed with the disease.
But the good news is, most will survive it.
As with cancer in general, early diagnosis increases the likelihood of successful outcome. September’s Prostate Cancer Awareness Month serves to remind men at average risk for prostate cancer to consider an annual prostate-specific antigen (PSA) screening after 50.
Though opinions differ on who will benefit from the simple blood test, a discussion with his primary care provider can help a man determine if the PSA screening is right for him.
For a patient newly diagnosed with prostate cancer, the most important thing is to learn about the treatment options from physician specialists.
Patients are generally assigned to risk groups that aid in determining optimal treatment strategies. For some, active surveillance or androgen deprivation therapy alone might be recommended, though these are not curative.
The potentially curative treatments include surgery and radiation therapy, which a patient should discuss with a board-certified urologist and a board-certified radiation oncologist, respectively, to decide on the most appropriate treatment strategy in his individual case.
The decision will likely depend on a combination of factors, among them the extent and appearance of the tumor (its stage and grade); overall health and life expectancy; and comfort level with possible side effects.
For instance, in the initial radiation therapy consultation at Beaufort Memorial New River Cancer Center, we would review a patient’s medical records; explain national guidelines for assessing radiation therapy as a treatment option; discuss what treatment entails; and encourage questions to ensure good understanding and allay fears.
Either alone or combined with other therapies, intensity-modulated radiation therapy (IMRT) is used successfully for patients in all prostate cancer risk groups. During the non-invasive treatment, today’s advanced linear accelerators deliver powerful high-energy X-rays to prostate tumors with great precision, maximizing dosage while limiting exposure to surrounding tissue. As a result, urinary and gastrointestinal side effects are minimized.
Radiation therapy typically consists of treatment sessions five days a week for four to nine weeks. Each session lasts about 15 minutes, though actual treatment time is considerably less.
The patient meets regularly with the radiation oncologist and, over the course of treatment, gets to know the entire treatment team well, because we believe that inspiring trust and building relationships are as crucial to healing as the treatments themselves.
Dr. Paul Saconn is a board-certified, fellowship-trained radiation oncologist at Beaufort Memorial New River Cancer Center in Okatie.