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Wednesday, July 30, 2014
Chances of Recovery and Effects of Treatment Options
I have a 60% cancer spread in the the prostate and the urologist has recommended 2 options to treat the aforementioned as well as a lymphadenectomy and sem. vesicolectomy that needs to be done as soon as possible. Are we on the right track selecting surgery or could chemotherapy give a better percentage chance at recovery? The urologist summed it up as 80% - 90% via surgery and 70% - 80% via chemotherapy. The complications also seems to be problematic in various ways. Could I also suffer from hot flashes if I choose surgery?
The treatment for prostate cancer depends on the grade of the cancer (determined by the Gleason score on prostate biopsy) and stage of the disease (whether localized to the prostate or spread beyond the prostate), besides the volume of the cancer. Age of the patient would also be a factor to consider when making this decision. It is difficult to comment on the treatment option without this information.
I assume that you must be having a clinically localized cancer since surgery is being considered as an option. Usually the other comparable option in this situation is radiation therapy. Cryotherapy (using cold energy to freeze the tumor) is another option which can sometimes be used in highly selected cases, but the long term results are limited. Chemotherapy or hormone therapy is usually not a first line treatment in clinically localized disease.
Each of these options have their individual side effect/complication profile which is important to know before making a decision. Hot flashes can occur after hormone therapy but usually not after surgical removal of the prostate gland (radical prostatectomy). Robotic surgery is a newer minimally invasive technique of treating the prostate cancer surgically.
I have provided some general information regarding your disease but you would need to provide some more information about your age, ser PSA, prostate biopsy report (gleason score, volume of disease) and clinical stage in order to get a more specific response to your question.
Krishnanath Gaitonde, MD
Assistant Professor of Clinical Urology
College of Medicine
University of Cincinnati