Prostate Cancer Treatment

High-Tech Cancer Treatment: Stereotactic Radiosurgery
Stereotactic radiosurgery (SRS) is a non-invasive form of radiation therapy that concentrates high doses of radiation on very precise areas with minimal exposure to surrounding healthy tissue. Committed in its fight against cancer, RWJBarnabas Health has invested in the region’s most robust SRS program, offering Cyberknife and TomoTherapy treatment options.
Cyberknife is a non-invasive robotic radiosurgery system used to treat cancerous and non-cancerous tumors.
TomoTherapy uses 3-D imaging from computerized tomography (CT scanning) to locate and confirm the shape and position of tumors before therapy begins.
Radiation Therapy
Radiation therapy utilizes high-energy rays or particles to kill cancer cells. The two main types of radiation treatment used for prostate cancer are external beam radiation and brachytyerapy (internal radiation).
External beam radiation involves targeting a beam of radiation at the tumor by a machine outside the body.
Internal radiation therapy – also called brachytherapy or seed implant therapy - involves surgically placing radioactive sources into the affected area during a one- to two-day procedure.
High-dose rate (HDR) brachytherapy, which treats intermediate and high-risk prostate cancer, involves implanting radioactive sources into the targeted area and immediately removing them after each treatment session. HDR brachytherapy protocol has been proven to be particularly effective against aggressive cancers and spares men the urinary, bowel or sexual problems often associated with other forms of prostate cancer treatment. Using 3-D conformal radiation therapy that ensures radiation delivered is confined to the prostate, the high-dose rate radiation implant is inserted through a minimally invasive procedure performed under epidural anesthesia by a team consisting of a radiation oncologist and a urologist.
Permanent (low dose rate or LDR) seed brachytherapy for men with early-stage prostate cancer involves the placement of low-energy radiation seeds that remain in the prostate for several months to deliver treatment. This technique is beneficial because it enables a high-dose of radiation to be delivered to the prostate with limited damage to surrounding tissues.
Robotic Surgery
A robotic-assisted prostatectomy is one of the most innovative treatments for prostate cancer. Robotic surgery enables surgeons to operate with greater precision and accuracy, better visualization and enhanced dexterity and comfort. During a robotic prostatectomy, the surgeon uses a sophisticated, computer-enhanced system to guide the surgical tools through tiny incisions to remove the prostate. By using robotic technology, surgeons have a better tool to spare surrounding nerves, which enhances patient recovery and clinical outcome.
Patient benefits include:
  • Reduced pain and trauma to the body
  • Less blood loss and need for transfusions
  • Less post-operative pain and discomfort
  • Lower risk of infection
  • Shorter hospital stay
  • Faster recovery time and return to normal daily activities
  • Minimal scarring This minimally invasive alternative to traditional surgery

Chemotherapy (chemo) uses anti-cancer drugs injected into a vein or given by mouth. As chemo enters the bloodstream and goes throughout the body, this treatment is potentially useful for cancers that have spread (metastasized) to distant organs.
Active Surveillance - also known as the “watch and wait” approach - requires no treatment until your doctor detects signs that the cancer is growing more aggressively. This option is for patients who have cancer that is confined to the prostate gland and defined as low to medium in aggressiveness.
Prevention and Early Detection
Men can prioritize their health by arming themselves with the latest information about prostate cancer prevention and early detection. It’s also important to know family history to understand risk levels.
Know the Signs
Early prostate cancer usually causes no symptoms, while advanced prostate cancer sometimes causes symptoms including:

  • Problems urinating, including a slow or weak urinary stream or the need to urinate more frequently, especially at night
  • Blood in the urine
  • Trouble getting an erection (erectile dysfunction)
  • Pain in the hips, back (spine), chest (ribs), or other areas
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control

(Source: American Cancer Society)

Prevention

While there’s no sure way to prevent prostate cancer and certain risk factors can’t be controlled, it’s generally recommended that men with average risk of prostate cancer make choices that benefit their overall health.
Some studies show that a healthy diet and lifestyle can reduce the risk of prostate cancer, and even slow progression. It’s suggested that diets high in certain vegetables (including tomatoes, beans and other legumes) or fish may be linked with a lower risk of prostate cancer. Currently, the best advice about diet and activity to possibly reduce the risk of prostate cancer is to: eat at least 2 ½ cups of a wide variety of vegetables and fruits each day; be physically active; and maintain a healthy weight.
Eat Well

  • Eat more fat from plants than animals
  • Load up on fruits and vegetables
  • Limit fat intake from red meat and dairy products
  • Monitor calcium intake and avoid taking more than 1,500 mg of calcium a day
  • Eat more fish with omega-3 fatty acids like salmon, tuna and herring
  • Try to incorporate cooked tomatoes, broccoli, and cauliflower into weekly meals
  • Cut back on dairy products
Maintain a Healthy Weight & Exercise
The American Institute for Cancer Research cites strong and consistent evidence that staying at a healthy weight lowers risk for advanced and aggressive prostate cancer. Studies show that men who are obese may have an increased risk of prostate cancer.
Early Detection/Screenings
Prostate cancer screening can help find cancer before an individual has symptoms, and in its earliest stage, when treatment is most effective. Two screenings used to detect prostate cancer are the prostate specific antigen (PSA) blood test and a digital rectal examination (DRE).
PSA is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. While it’s normal for a small amount of PSA to be in the bloodstream, high levels of PSA may indicate prostate cancer is present. However, other conditions, including an enlarged or inflamed prostate, can also increase PSA levels.
It’s best to meet with a physician to determine when to have a PSA test.
Digital rectal exam (DRE)
During this exam, a physician inserts a gloved, lubricated finger into the rectum to examine the prostate for any irregularities in size, shape and texture.
Since there are varying recommendations on when men should get screened, it’s important that men consult their doctors to discuss both the benefits and risks of screening.
Click here to locate to an RWJBarnabas Health urologist or primary care physician.

Diagnosed With Prostate Cancer? Questions to Ask Your Doctor
It’s completely normal to feel stressed and scared when you’re told you have prostate cancer. While you can access general information from organizations like the American Cancer Society (ACS), the best source of information is your doctor.
It’s a good idea to ask your doctor questions to help you better understand your situation and treatment options. The ACS offers a sampling of questions - although all may not apply to you.
When you’re told you have prostate cancer:

  • What type of prostate cancer do I have?
  • How do I get a copy of my pathology report?
  • What’s my PSA (prostate-specific antigen) level? What does this mean?
  • What’s the cancer’s clinical state and grade (Gleason score)? What does this mean?
  • What are my chances of survival, based on my cancer?
  • What are my treatment options, what are the pros and cons, and what do you recommend?

When deciding on a treatment plan:

  • What are the chances the cancer will return after this treatment?
  • What would we do if the treatment doesn’t work or if the cancer comes back?
  • Will I be able to have children after treatment?
  • How long will my treatment last?
  • What are the risks and side effects?
  • What are the chances that I will become incontinent or impotent?