Should I consider Proton Beam radiation?

No. Proton Beam radiation is a leftover technology that first originated in the 1950’s. Current studies show that it is not only extremely costly and time consuming, but also much less effective than seed implants. One study from the largest proton center in the country, at Loma Linda, in fact reported that the 5-year success rate with proton therapy was only 73% * ! This is in comparison to 10 year success rates with seed implants of greater than 90%. For this reason, most centers have decided not to pursue this older technology and have focused their attentions on more innovative seed implants and IMRT.

What about Cryotherapy?

Cryotherapy is when part of the prostate is frozen. While some believe this technology is improving, there are no major studies available with results at more than 5 years. In addition, side effects such as impotence and incontinence are much greater with cryotherapy than with seed implants, and in fact, are similar to more radical surgery. Most centers reserve cryotherapy for the treatment of prior external radiation failures, and not for the up-front treatment of newly diagnosed men. This procedure should only be performed by experienced urologists.

Are all men with prostate cancer eligible for seed implants?

We believe that all men without evidence of metastasis (cancer spread to other organs) have a chance to be cured of their cancer by a prostate seed implant and/or IMRT. We recommend that men diagnosed with prostate cancer consult with both a urologist and a radiation oncologist. Based on extensive data, we can tell you what your risk of having disease outside the prostate is. We will review your past medical history and current physical condition and discuss the pros and cons of surgery, external radiation, and seed implants. We have seed implant protocols to treat men with both early and advanced stage disease.

What is most important is that men take their time and feel comfortable with their decision. If a man chooses prostatectomy, we suggest he have this performed by an experienced urologist. If he chooses a seed implant, we recommend that our uniquely experienced radiation oncologists treat him.

I’ve heard some people say that they do not think the PSA blood test is important for cancer screening. What do you think?

Both the American Cancer Society and the American Urological Association strongly recommend regular PSA blood tests and physical exams because research supports that they lead to prostate cancer being diagnosed in earlier, more treatable stages and, thus, can potentially save lives.

How does radiation kill cancer cells?

Radiation, in this case, X-ray or Gamma-ray radiation can damage a cancer cell’s ability to multiply, ultimately leading to its death. Cancer cells are much more sensitive to radiation damage than normal cells and are less likely to repair any damage done.

Is it all right to give hormone blockers and radiation together?

Yes. Not only is it all right, research has shown that the combination can improve results in men with more advanced or aggressive prostate cancers.

How long will I be out of work with a prostate seed implant?

Most men can return to work and their normal activities in 24-48 hours.

Since I have radioactive seeds in my prostate, am I at risk to other people?

No. The amount of radiation given off outside the body is almost none. For peace of mind, we do recommend that you do not hold pregnant woman or young children in your lap for one to two months following your implant.

Will I have to wear a urinary catheter after a seed implant?

Most men go home without a catheter, although some may wear it for up to 24 hours.

Can I have surgery if the cancer re-grows in the prostate after radiation?

Yes, however, it is very unusual for cancer to re-grow in the irradiated area.

How do I know if I was cured by a radical prostatectomy?

The answer is quite simple. A PSA blood test done two months after surgery should reflect a PSA < 0.2 If this is not the case, you may have some cancer cells left behind that should be irradiated. In this circumstance, we may recommend IMRT external radiation, as there is no longer a prostate in which to accurately implant the seeds.

Is there any hope if I am diagnosed with late/advanced stage prostate cancer that has already spread?

Yes. There are many promising hormonal and chemotherapeutic treatments on the horizon. Any member of our team will be happy to discuss these with you and refer you to a medical oncologist for additional evaluation.

What should I do now?

If you have not been diagnosed with prostate cancer and are concerned that you may be at risk or would like to be screened, you should consult your physician for a physical exam and PSA blood test. If you have been diagnosed with prostate cancer and would like to consider a prostate seed implant, you should discuss this with your urologist.