Did You Know…?

Prostate cancer is now the most common type of cancer in males.

If not treated early and effectively, however, prostate tumors  can start to grow and spread into other tissues such as lymph nodes and bone.  Although only a small proportion of prostate cancers progress to this severe stage, the ones that do can spread relatively quickly and are not easily treated or cured. 

It is most commonly found in the outer portion of the prostate gland. 

The cancer can grow without symptoms for years, even decades. 

Prostate cancer is rare before the age of 40, and the  risk increases with age. Its cause is unknown.


Read how "Breakthrough Robotic Surgery Tackles Prostate Cancer" at Danbury Hospital.

Click here for A Patient Guide to the Management of Prostate Cancer from the American Urological Association Foundation.

 

Prostate Cancer

Brachytherapy or Radioactive Seed Implantation

Introduction - The Prostate Gland

The prostate gland is located at the base of the penis just below the bladder and in front of the rectum. It produces the fluid that transports semen during ejaculation. The size and shape of the prostate gland vary considerably among men, but it is usually about two inches in diameter (roughly the size and shape of a large walnut).

Cancer of the Prostate

Prostate cancer, like other cancers, is a disease of the body’s cells.  Normal cells reproduce themselves by dividing—facilitating growth and replacing worn-out and injured tissue. Cancer is characterized by the uncontrolled growth of abnormal body cells.  Occasionally, cells grow abnormally into a tumor mass. Some tumors are benign (non-cancerous); others are malignant, or cancerous. Cancers invade and destroy nearby tissues and organs or spread to other parts of the body.

Prostate cancer is now the most common type of cancer in males.  If not treated early and effectively, however, prostate tumors  can start to grow and spread into other tissues such as lymph nodes and bone.  Although only a small proportion of prostate cancers progress to this severe stage, the ones that do can spread relatively quickly and are not easily treated or cured.  It is most commonly found in the outer portion of the prostate gland.  The cancer can grow without symptoms for years, even decades.  Prostate cancer is rare before the age of 40, and the  risk increases with age. Its cause is unknown.

Goals of Prostate Cancer Treatment

Ideally, treatment for any cancer should cure the disease, be easily tolerated, and cause minimal or no problems. This concept is particularly important in prostate cancer for several reasons. Some men have an aggressive form of cancer that can lead to death from this disease. In other men, prostate cancers can grow so slowly that it causes few if any problems during a patient’s natural lifetime. However, there is no absolute way to determine if prostate cancer will be aggressive or slow growing.  Therefore, for most men whose disease is confined to the prostate, treatment is preferable to waiting and watching, especially since, as our life expectancies continue to increase, even slow-growing cancers could in time become life-threatening.

In other words, the ideal treatment for prostate cancer should effectively arrest or cure the disease particularly in men with aggressive cancer--but cause little, if any, problems--especially for men with slow--growing disease. Furthermore, since many men with prostate cancer are older or have other medical problems that make it impossible for them to undergo radical treatment, a treatment that minimizes trauma and complications is essential.

What is Brachytherapy?

Brachytherapy involves the implantation of radioactive seeds into the prostate. Iodine-125 and palladium are well suited for prostate implantation. They give off very low energy radiation that does not significantly travel outside the area of the prostate gland. This limits risk of radiation damage to surrounding body organs and poses little or no threat to those in close contact with them.

How is Implantation Done?

Tiny pellets containing radioactive medication, such as Iodine-125 or palladium are used. Seeds are permanently implanted directly in the middle of the prostate where they give off low-level radiation continuously for up to one year. Using TRUS (transrectal ultrasound) guidance, these seeds can be positioned so that  radiation is distributed throughout the entire prostate gland. Since only a small area is irradiated by each seed, relatively little radiation reaches the adjacent normal organs-the colon, which is directly under the prostate gland or the bladder, lying on top of the gland.

Who are Poor Candidates for Implantation?

Patients with very large prostate tumors which have extended beyond the prostate capsule or to other organs (Stages C and D or T3 and T4). Patients with very large benign portions of their prostate (BPH or benign prostatic hyperplasia) or patients who have had prior prostate surgery (TURP or transurethral resection of prostate) may be poor candidates for implantation.

Who are Best Candidates for Implantation?

Patients with small prostate tumors localized to the prostate are the best candidates (Stages A and B or any T1 or T2, depending on the staging system used). That means that about 50-60% of the patients with prostate cancer will fit this criteria. The development of more sensitive tumor detection techniques means that prostate cancer patients are being diagnosed at earlier stages, permitting more patients to become potential candidates for seed implantation.

Click here for A Patient Guide to the Management of Prostate Cancer from the American Urological Association Foundation..
 
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