• Prostate Cancer

    Prostate cancer is the most common cancer that affects men in today’s society.
    Approximately one in six men will have prostate cancer. Our biggest challenge is to find prostate cancers that are significant, that is they’re going to lead to morbidity, or even mortality.

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    Dr. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, discusses prostate cancer.
    Dr. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, discusses prostate cancer.
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    Dr. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, discusses active surveillance.
    Dr. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, discusses active surveillance.
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    Dr. Peter Black, BSc, MD, FRCSC, FACS, Urologist, discusses prostate cancer testing.
    Dr. Peter Black, BSc, MD, FRCSC, FACS, Urologist, discusses prostate cancer testing.
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    Peter Black, BSc, MD, FRCSC, FACS, Urologist, discusses reducing prostate cancer risk.
    Peter Black, BSc, MD, FRCSC, FACS, Urologist, discusses reducing prostate cancer risk.
  • What is Prostate Cancer?

    What are treatment options for prostate cancer? Fortunately, there are many different treatment options for prostate cancer. Identifying treatment options for you will depend on:

    1. The Grade of the cancer, also known as Gleason Score.
    2. Whether or not the cancer has spread to other parts of the body (the absence or presence of metastasis).
    3. Your age and general health status.
    4. Prior prostate treatments you may have already undergone.

                                   

    The three standard therapies for men with organ-confined or localized prostate cancer are:

    1. Active surveillance.
    2. Surgery.
    3. Radiation therapy.

    Active surveillance refers to close observation of prostate cancer without direct treatment of the cancer itself.  Your healthcare team will watch the cancer closely rather than provide treatment right away. The cancer is closely monitored with periodic tests and exams to check if prostate cancer is growing or spreading to see if your condition is getting worse. Treatment is given when the cancer appears to be changing.

    Surgery for prostate cancer is called a radical prostatectomy and involves the removal of the prostate gland with or without some lymph nodes in the pelvis. This can be performed with key-hole surgery called laparoscopy (usually done with a robot to help the surgeon) or through a small incision in the lower part of the abdomen called open surgery. Radiation therapy is performed either from the outside (called external beam radiation) or with radiation “seeds” that are placed in the prostate (called brachytherapy).  Your doctor may prescribe a treatment to reduce testosterone, called androgen deprivation, for a short period of time in conjunction with radiation.

    Treatments for metastatic prostate cancer:

    If the prostate cancer has spread outside the prostate gland, treatments are centered around drugs that reduce testosterone. These treatments, called androgen deprivation or ADT, are given to reduce testosterone – a hormone that is required for prostate cancer to grow.  Other treatments that your doctor may consider may include:

    1. Chemotherapy treatment.
    2. Pills that work with ADT to reduce the ability of prostate cancer cells to use testosterone.

    In summary, there are many different treatments for prostate cancer.  Identifying the best treatment will depend on your specific situation and your preference after discussion with your doctor.  Now Health Network 

  • Prostate Cancer Risk

    What is prostate cancer stage and grade?

    Once prostate cancer is diagnosed, one of the first things doctors do is determine how aggressive cancers are (also known as tumor grade) and how much of the prostate is involved and if the cancer has spread outside of the gland to nearby tissues or other parts of the body (otherwise known as tumor stage).  This information is important to help determine the treatment options for men newly diagnosed with prostate cancer. 

    What is tumor Grade?:

    When a tumor is discovered on prostate biopsy, the aggressiveness of the cancer can be classified into a category called tumor grade.  In general, the higher the grade, the more aggressive cancers are. In prostate cancer, the grade is most commonly described as a Gleason Score. The Gleason Score of a prostate cancer is between 2-10. Scores 6 or less are considered mildly aggressive, 7 is considered intermediate aggressive, and scores 8-10 are considered very aggressive.   In summary, the higher the Gleason Score, the more aggressive the cancer is, and the greater the risk of cancer spreading outside of the prostate gland.

    What is tumor Stage?:

    Stage refers to the amount of cancer in the prostate and whether the cancer has spread outside the gland. A digital rectal exam (DRE) can help to determine how much of the cancer is involved and if the cancer is protruding outside the prostate gland; however, often the prostate gland feels completely normal.  Patients with cancer that has spread outside the prostate gland have metastatic disease.  Those without cancer that has spread is called localized or organ-confied prostate cancer.

    There are several tests that may be useful in determining tumor stage and many men do not require such tests. Sometimes, more tests are required to determine if the cancer has spread. Indications that may suggest further testing is required include:

    1. High PSA
    2. High tumor grade
    3. Symptoms that may indicate cancer that has spread such as pain in the bone.

    Tests that may help cancers that have spread include: CT Scan, Bone Scan, MRI, and PSMA-PET Scan.  If you are newly diagnosed with prostate cancer, discuss with your treating doctor to see if you need one or more of these tests ordered.

    In summary, doctors determine prostate cancer grade and stage after the diagnosis. This is used to determine the aggressiveness of the cancer and also whether the cancer has spread outside of the prostate gland. All of this information is important for the doctor to determine the next step in the treatment of prostate cancer. 

     

     

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