What Everyone Should Know About Prostate Cancer
What everyone should know about prostate cancer – Prostate cancer’s not a cancer with a lot of straight forward, clear-cut answers and solutions. And coming to the final decision as to what to do, can be a very complex and, difficult road. Because this is an academic center, and a center with a lot of expertise, we can offer the patient a variety of options that give the patient the best opportunity to treat their cancer effectively.
We screen for prostate cancer, and have for the last twenty-five years, with a blood test, called prostate specific antigen, or PSA. PSA has good and not so good aspects to it. One of the problems with PSA, is that anything going on in the prostate can make the PSA elevated. On the flip side, there are cancers that maybe don’t make a lot of PSA, and that leads us to sometimes missing cancers. I don’t think we should discard PSA testing.
I think there is real value to PSA testing, because we have witnessed a drop in death rates in this country, over the last fifteen years, from PSA testing. A better approach, I think, would be to use the PSA to identify people at particularly high risk of prostate cancer, and then, rather than proceeding directly to a blind ultrasound guided biopsy, would be to go on to an imaging test. With the conventional method of using ultrasound guidance to guide prostate needle biopsy we sample less than one percent of the total tissue of the prostate.
So, there’s a significant chance of missing a significant cancer, as well as over detecting very, very tiny and low-grade cancers that we’re increasingly learning pose little to no risk to a man’s life. Using an MRI ultrasound fusion device, we can do a better job of finding the cancers we want to find and avoiding finding the cancers that, are not risky to a man’s life.
When any of us sees a patient with early prostate cancer, we’re really looking at the whole picture and trying to put the whole thing together as a package before making a recommendation. The surgical approach as to treating prostate cancer have evolved dramatically. Starting in about 2001 was the introduction of the daVinci robot that many of us use now to do prostate surgeries. That helped, potentially, reduce blood loss.
It helped us, potentially, have patients recover more quickly, We have a large cadre of patients who are undergoing active surveillance. Those patients who have, low risk cancer, and sometimes, surgery is not the right choice for those patients. But there’s a subset of patients with really dangerous prostate cancer. And what we know from experience is that one treatment is probably not gonna cure them.
So, we feel like a multidisciplinary approach is the way to go, and so we have a tumor board, “He presented with an abdominal mass…” it’s a chance for everybody together to discuss the patient, and come to a consensus about what’s likely to help them the best. In the last five years, there’s been a huge increase in the number of therapies available for patients with advanced prostate cancer. The team we have here now, I think is phenomenal, and we do want to build on that, and really take advantage of the knowledge that’s here.
The research resources that are here are unparalled, so that we can continue to improve the lives of patients with prostate cancer.
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