Prostate Cancer Staging & Treatments
Best medical treatments for prostate cancer
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Accurate Cancer Staging and Personalized Treatment Options
Beth Israel Deaconess Medical Center (BIDMC) prostate specialists have decades of experience in carefully planning for and treating prostate cancer. The prostate cancer treatment plan is personalized for each man.
We offer specialized tools in decision-making that let us better understand what’s important to you. Then, we base our advice on your preferences.
Our multidisciplinary team — including urologists, medical oncologists and radiation oncologists — helps you make the best decision for your treatment. We individualize our recommendations based on your preferences, quality-of-life and details about your cancer.
Staging Prostate Cancer: Gleason Scale
Your prostate specialist will order a prostate biopsy (removal of tissue sample) to make an accurate diagnosis. Your doctor sends the tissue sample to the laboratory.
At the lab, a pathologist carefully checks the tissue for cancer cells. The pathologist also grades each sample on what is known as the Gleason scale to measure the cancer’s aggressiveness. The pathologist grades samples from 6 to 10:
- Level 6 is a low-grade cancer
- Level 7 is intermediate
- Levels 8-10 are aggressive cancers
Thanks to prostate-specific antigen (PSA) tests, most cancers that specialists find today are in an early stage.
Hormonal Therapy
Specialists may recommend hormonal therapy for men with any stage of prostate cancer. The goal of hormonal therapy is to block the production of or action of the male hormones that fuel prostate cancer.
Medical oncologists typically use multiple hormone blockers in combination. Some of the common types:
- Casodex (bicalutamide)
- Eulexin (flutamide)
- Lupron (leuprolide acetate)
- Orgovyx (relugolix)
- Nilandron (nilutamide)
- Zoladex (goserelin acetate implant)
Because the testicles produce male hormones, some men also have testicle removal surgery to cut off the hormone supply. If you have advanced prostate cancer, you’ll likely get chemotherapy drugs such as Novantrone (mitoxantrone). These chemotherapy drugs do not cure the disease but often ease pain and other symptoms.
More About Prostate Cancer Staging & Treatments
Men with early-stage prostate cancer have many treatment options. The treatment that’s best for one man may not be the best for another. The treatment that’s right for you depends on these main factors:
- Your age
- Grade of the tumor (Gleason score)
- Number of biopsy tissue samples that contain cancer cells
- Stage of the cancer
- Your symptoms
- Your overall health
You may receive a combination of treatments:
- Hormonal therapy
- High Intensity Focused Ultrasound
- Robot-assisted prostatectomy (removal of prostate gland)
Your doctor will describe your treatment choices, the expected results of each and the possible side effects. You and your doctor will work together to develop a treatment plan that meets your medical and personal needs. You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods.
Quality of Life
Treatment for early-stage prostate cancer is highly effective. In some cases, it can be associated with temporary or long-term side effects related to urinary, sexual or bowel and rectal concerns. These side effects vary with age and type of treatment. Post-treatment care, when needed, may include urinary and sexual rehabilitation services.
If your doctor considers your cancer to be high risk, you may have a bone scan, CT scan or MRI scan. Your doctor uses the results of these imaging tests to check if the cancer has spread beyond the prostate.
If the cancer has spread to other organs, it cannot be cured and therapy directed only toward the prostate usually isn’t an option. Hormonal therapy can delay the progression of the disease but cannot cure aggressive prostate cancer.
In most cases, the prostate cancer team will suggest some combination of these treatments:
The goal of these treatments is to extend life and relieve pain, rather than to cure the disease.
Quality of Life
We track our treatment outcomes for every patient. We are happy to share these details with you. We believe you deserve straightforward information about success rates at BIDMC and the impact treatment could have on your quality of life.
With our supportive care services, your prostate care team remains engaged in your care after treatment. We can help address ongoing side effects of treatment with services such as urinary and sexual rehabilitation.
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