THE TEAL STAGE OF BLUE | INTERMEDIATE RISK
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Many treatments have irreversible consequences, so the goal is to do it right the first time. It is well known that long-term survival is improved by receiving optimal treatment upfront. The first treatment is your best opportunity to eradicate cancer…
PSA plays a variety of roles, the most familiar being screening to detect prostate cancer. PSA also helps to define the Stages of Blue. Another role of PSA is to detect cancer relapse after surgery or radiation. Lastly, rises or declines in PSA after hormone therapy or chemotherapy…
The two major components of the pathology report from a random 12-core biopsy are the Gleason score, which measures how aggressive the tumor appears, and the quantity of cancer, i.e., the extent of disease detected by the 12-core specimen…
Multiparametric MRI (MRI) provides a three-dimensional image of the prostate, giving important information about the cancer’s location, size, and how “aggressive” it appears. MRI also greatly increases the confidence that higher-grade cancers are not being overlooked in men on active surveillance. MRI is usually performed without an endorectal coil…
Once the proper Stage of Blue is assigned, the different treatments appropriate for that Stage can be considered and compared. In the prostate cancer treatment realm, decisions are usually based on comparisons among several alternatives. In the most general sense, there are four main types of treatment…
While multiparametric MRI and color Doppler ultrasound are excellent tools for monitoring disease inside the prostate, scanning the rest of the body for cancer that may have spread to the lymph nodes or bones is also critical. Body scans are necessary for every Stage of Blue except Sky…
Permanent seed implantation, also known as brachytherapy, involves the insertion of small, carefully spaced, radioactive pellets into the prostate. After implantation, the seeds emit a low but continuous energy over a period of…
High dose rate brachytherapy (HDR) is done in 4 steps. The first step is placement of catheters into and around the prostate. Once the catheters are in position, the two next steps are called “simulation” and “dosimetry.” Simulation involves taking…
Intensity modulated radiation therapy (IMRT) is a specialized form of external beam radiotherapy. A device called a linear accelerator is used to administer high-energy photon beams to the prostate. IMRT is delivered in small, daily doses over…
The treatment recommended depends upon which subtype of Intermediate Risk a patient’s cancer falls into. For example, in patients with Favorable Intermediate-Risk prostate cancer, permanent seed implants alone are preferred. On the other hand, the Unfavorable IntermediateRisk subtype tends to behave more like High-Risk. In these men…
Prostate cancer cells are dependent on testosterone for their survival, so when testosterone is removed, they shrivel and die. Radiation and surgery can’t cure cancer that has already spread outside the prostate. Only hormone therapy, otherwise known…
Permanent loss of sexual and urinary function usually has substantial emotional consequences, affecting a man’s capacity for intimacy and his self-esteem. Doctors in the industry often gloss over the likelihood of impotence, implying that the risks are just about the same with every type of treatment. Studies do not support this conclusion…
Men contemplating prostate cancer treatment need to consider another defining characteristic of prostate cancer—the precarious anatomic location of the prostate deep in the lower portion of the pelvis, positioned…
Erectile dysfunction (ED) is a risk with every type of treatment for prostate cancer, but the exact risk is very specific to each patient. The better a man’s erections are before prostate cancer treatment, the better chance he has of preserving function. However…
Loss of bladder control (urinary incontinence) after surgery can be a devastating complication with a very negative impact on quality of life. Bladder control problems for the first few months following radical prostatectomy are to be expected. A biofeedback program may be…
Radiation for prostate cancer may cause short- or long-term side effects. Even though radiation targets the cancer cells, normal body tissues near the tumor can be affected. Specifically, we are talking about…
Blocking testosterone, a hormone that induces libido, strength, endurance, emotional stability, and potency, creates all kinds of side effects…
The post-treatment surveillance policy for men who have undergone an attempt at curative surgery or radiation is to check PSA quarterly for the first two years, biannually for the next three, and annually thereafter. For radiation patients, a yearly digital rectal examination is also recommended. After treatment with…
Ideally, food intake should be from whole food sources (unprocessed, unadulterated, natural), with only a small percentage of food products (processed, refined, boxed, bottled, canned, packaged, and powdered). Whole foods provide…
The risk of a sedentary lifestyle is about the same as a pack-a-day smoking habit. “Sitting is the new smoking.” After age 60, just through the normal aging process, men lose 1% of their muscle every year. Hormonal treatments accelerate...
When it comes to dietary supplements, less is more. Mega-doses suggest a worse outcome or prognosis in patients with cancer.
This article will discuss an alternative type of imaging, called color Doppler ultrasound (CDU). Unfortunately, CDU followed by targeted biopsy is available in only a few centers around the United States. Even so, this article will expound the many advantages of CDU for the diagnosis and staging of prostate cancer...
Proton therapy is simply using a beam of protons to deliver precision radiation therapy. In a fashion identical to intensity modulated radiation therapy (IMRT), patients are treated daily on an outpatient basis. A typical treatment session lasts...
Stereotactic Body Radiation Therapy (SBRT) delivers a much larger dose of radiation per patient visit than IMRT. SBRT technology is relatively new. Thus, there are fewer clinical trials comparing it with other therapies. Despite this, SBRT has...
Teal splits into three subtypes: Low, Basic, and High-Teal. Low-Teal has only one intermediate risk factor, with all the remaining predictive factors being the same as Sky. Treatment options for Teal encompass a wide spectrum, ranging from surveillance alone for some men in Low-Teal to multimodality therapy with seeds…