STEP 1

Read Treatment Information At  www.cancer.gov

I started off by reading both the treatment reviews and the other articles in the treatment section at the NCI site in an effort to get a basic understanding of the disease, staging, and treatment options.

I discovered that the patient has Stage 2 disease.

Here are some excerpts:

Three treatment options are generally accepted for men with localized prostate cancer: radical prostatectomy, radiation therapy, and surveillance:

·                 Radical prostatectomy is a surgical procedure to remove the entire prostate gland and nearby tissues. Radical prostatectomy may be performed using a technique called nerve-sparing surgery that may prevent damage to the nerves needed for an erection.

                Laparoscopic surgery is the newest type of surgery to     

                remove the prostate. It is done with smaller incisions using

                a slender tube with a camera on the end (laparoscope),

                which may be robotically controlled.

                Compared with other types of prostatectomy, this technique

                may lead to shorter hospital stays, faster recovery, and less 

                blood loss and pain. However, it is fairly new and not widely

                used. Some surgeons have limited experience with this

                type of surgery.

                Since it is newer, researchers have not had the chance to

                follow its effectiveness for as long as they have for

                standard surgery.

·                 Radiation therapy involves the delivery of radiation energy to the prostate. The energy is usually delivered in an outpatient setting using an external beam of radiation. The energy can also be delivered by implanting radioactive seeds in the prostate using a needle.

·                 Surveillance , taking a wait-and-see approach, may be recommended for patients with early-stage prostate cancer, particularly those who are older or have other serious medical conditions. These patients have regular examinations. If there is evidence of cancer growth, active treatment may be recommended.

                In some cases, it may be a way to avoid the harms of

               treatment without shortening life expectancy. Or, it can be a

               decision based on age and other serious health problems –

               older men in their 70s and 80s may not have the same  

               views  about undergoing surgery or radiation therapy as

               younger men.

Choosing a treatment option involves the patient, his family, and one or more doctors. They will need to consider the grade and stage of the cancer, the man’s age and health, and his values and feelings about the potential benefits and harms of each treatment option.

Often it is useful to seek a second opinion, and patients may hear different opinions and recommendations. Because there are several reasonable options for most patients, the decision can be difficult.

Patients should try to get as much information as possible and allow themselves enough time to make a decision. There is rarely a need to make a decision without taking time to discuss and understand the pros and cons of the various approaches.

After reviewing this material, I felt comfortable with the basic treatment options. I began to understand that there is no clear-cut optimal treatment for men with early prostate cancer.

Because of the patient’s age (57) it seemed to me that surveillance may not be the best choice. I clearly needed more information about both surgery and radiotherapy. I needed to know more about the cure rates of each technique and the side effects associated with each.

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