PRAIRIE DOC®
  • Home
  • About
  • People
  • Television
  • Podcasts
  • Perspective
  • Donate
  • Contact
  • Foundation
  • Book

November 07th, 2022

11/7/2022

 
Prairie Doc Perspective Week of November 6th, 2022                        
Prostate Cancer:  Know Your Options
By Daniel G Petereit, MD, FABS, FASTRO

Over my 30 year career as a cancer physician I have witnessed firsthand the tremendous progress in treating cancer patients.  There continues to be controversy in the screening and treatment of prostate cancer (PC) for which I am grateful to have the opportunity to share more information with you.

PC screening consists of obtaining a PSA and rectal exam, followed by a biopsy if indicated. In 2012, the United States Preventive Task Force (USPSTF) recommended against PC screening.  Studies following their recommendations demonstrated a substantial decline in both PC screening and diagnosis of early stage PC, and a subsequent increase in the rates of more aggressive PC.  In 2017 the USPSTF reversed their prior recommendation, listing PSA as a reasonable screening test in men ages 55- 69.

For men with early stage PC, active surveillance is recommended that includes obtaining a PSA every 6 months and a repeat prostate biopsy 1-2 years later.   For patients who require treatment surgery and radiation are equivalent options.  Many patients in the US and in SD only hear about these options from the urologist who performed the biopsy.  There are advantages and disadvantages for both approaches.  

Patients deserve to hear about both treatments before making a decision that impacts their life. One of the most effective radiation options for earlier stages of PC is prostate brachytherapy (BT) or “seed implants” for appropriate patients. This is a one hour outpatient procedure that yields some of the highest cure rates.  Multiple studies have demonstrated quality of life and patient satisfaction favors BT and is the most cost-effective treatment.

A significant area of controversy is the management of aggressive PC as we are now seeing more of these patients due to the previous lack of screening.  A misconception in the medical community is that these patients should all be surgically treated. While surgery is an appropriate option,  many patients still require 6 weeks of radiation to eliminate cancer left behind with higher rates of incontinence and impotency.  Another proven treatment option is daily external beam radiation followed by BT that produces some of the highest cure rates.  The recurrence rates are lowest with this approach compared to surgery. 

Unfortunately, many patients in the US do not have access to prostate BT, especially in rural areas.  The only radiation option for them is 8 weeks of daily radiation which can be a dilemma with the travel required.  Prostate BT was previously performed at cancer centers in SD, but is now only available in Rapid City. 

Selective prostate screening and treatment reduces PC death rates.  Proper patient selection is critical when deciding on treatment. Thoroughly informed patients who consent to treatment are less likely to regret their medical decisions.

Patients deserve to know their options.

Comments are closed.

    Archives

    March 2023
    February 2023
    January 2023
    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016

    Categories

    All

    RSS Feed

PRAIRIE DOC® MEDIA IS A PART OF HEALING WORDS FOUNDATION.

FIND SCIENCE-BASED PEDIATRIC MEDICAL INFORMATION ON OUR SISTER SITE. 
Healing Words Foundation logo
Play Eat Sleep logo
  • Home
  • About
  • People
  • Television
  • Podcasts
  • Perspective
  • Donate
  • Contact
  • Foundation
  • Book