The new test offers valuable information because it extends our detection abilities
so we can locate cancer beyond the point of the histological specimen - by millimeters
or centimeters from each core (biopsy zone in the prostate) - giving us the ability
to project our detection capabilities across almost the entire organ. It does this
by detecting a field effect of epigenetic signatures that are unique to prostate
cancer (hypermethylation in CaP - specific genes RASSF1, APC, and/or GSTP1). If
these signatures are not detected, it gives us the added assurance that your prostate
is free of cancer (at least a 90% negative predictive value with this assay). Conversely,
if a field effect is detected, these signals will give us valuable information to
use in a focused re-biopsy: potentially giving us a timely advantage and greatly
improving our chances to find, characterize, and develop a specific plan to deal
with prostate cancer if, again, it exists.
Two types of radiation therapy are used to treat prostate cancer: brachytherapy
and external radiation therapy (XRT).
Oncotype DX is a genetic test of prostate biopsy tissue, indicated for men with low grade prostate cancer to determine the aggressiveness of the cancer and the likelihood of the cancer spreading.
This treatment involves implanting tiny radioactive capsules (called "seeds")
into the cancerous prostate. The seeds emit radiation that kills cancerous tumor
cells. Men with small tumors confined to the prostate (stage T1 or T2) and those
with only moderate prostate enlargement are candidates for brachytherapy. The procedure
is performed on an out-patient basis and takes 45-60 minutes. Brachytherapy patients
usually resume routine activity within a day or so. For those who additionally have
obstructive voiding symptoms, transurethral resection of the prostate (TURP) surrounding
the urethra may be performed before brachytherapy is initiated.
External Radiation Treatment (XRT)
XRT is recommended as an alternative to surgery for cure of disease confined to
the prostate. XRT is usually given on an outpatient basis for 6-8 weeks. High energy
x-rays are projected into the prostate tissue from a machine outside the body. The
radiation destroys cancer cells and shrinks the tumor.
Hormonal therapy for prostate cancer involves the use of medication to block production
of testosterone, which prostate cancer cells use to grow. Drugs used for hormonal
therapy include Lupron®, Zoladex®, Vantas®, Eulexin®, and Viadur®.
Radical retropubic prostatectomy is the "gold standard" treatment for localized
prostate cancer. Radical prostatectomy is the surgical removal of the prostate and
surrounding tissues, including the seminal vesicles and pelvic lymph nodes.
Good candidates for prostate cancer surgery have one or more of the following characteristics:
- Generally good health
- Tumor confined to the prostate gland (Stage T1 or T2)
- Age under 70 years
- Life expectancy greater than 10 years
Radical retropubic prostatectomy involves an incision in the lower abdomen. This
gives the surgeon access to the prostate, seminal vesicles, and the pelvic lymph
nodes. Based on findings intraoperatively and the tumor volume anticipated from
the number of positive biopsy cores done before surgery, every attempt is made to
save the cavernosal nerves to the penis (nerves providing erection/potency). This
maneuver adds little time or complexity to the case and can be offered by most recently
trained urologists today, including myself.
DaVinci Robot-Assisted Laparoscopic Prostatectomy
Robot-assisted prostatectomy is a minimally invasive, robotic-assisted surgical
procedure that removes the cancerous prostate gland.
Typically, patients remain in the hospital for 2 days after surgery and are catheterized
for 7 days postoperatively.
The 10 year survival rate after radical prostatectomy ranges from 75% to 97% for
patients with well and moderately differentiated cancer and 60% to 86% for patients
with poorly differentiated cancer.
When cancer is confined to the prostate, the disease is usually curable with erectile
function and urinary control being salvaged in the vast majority of patients.
Prostate Cancer FAQs
Prostate cancer is the most common non-skin cancer in
America, affecting 1 in 7 men.
In 2015, approximately 220,800 men will be diagnosed with prostate cancer, and more than
27,540 men will die from the disease. One new case occurs every 2.4 minutes and a man dies
from prostate cancer every 19.1 minutes.
It is estimated that there are nearly 3 million U.S. men currently living with prostate
A non-smoking man is more likely to develop prostate
cancer than he is to develop colon, bladder, melanoma, lymphoma and kidney cancers combined.
As with all cancers, “cure” rates for prostate cancer
describe the percentage of patients likely remaining disease-free for a specific time. In
general, the earlier the cancer is caught, the more likely it is for the patient to remain
Because approximately 90% of all prostate cancers are detected in the local and regional
stages, the cure rate for prostate cancer is very high—nearly 100% of men diagnosed at this
stage will be disease-free after five years. By contrast, in the 1970s, only 67% of men
diagnosed with local or regional prostate cancer were disease-free after five years.
Prostate Cancer News
Visit RenalAndUrologyNews.com for the latest Prostate Cancer news and information.