You’ve been diagnosed with prostate cancer. Now what?

There are more treatment options than ever for prostate cancer. Radiation Oncologist Dr. John Pablo explains how radiation therapy is used to treat this common male cancer.

There are some unique characteristics when it comes to prostate cancer.

If you get diagnosed with this disease, there are more options than ever to treat prostate cancer. And, it’s not one size fits all. Each treatment can be different and is personalized for each individual patient.

“I always tell my prostate patients that it’s very unique when a patient goes to see a cancer doctor who tells them their options and then to go home, think about it, research it, maybe get another opinion, and then decide what you want to do,” says Dr. John Pablo, radiation oncologist and medical director of the Lewis Cancer & Research Pavilion Radiation Oncology Center.

“My consultations with prostate cancer patients tend to be pretty long. I try to go over all the options, all the pros and cons,” Dr. Pablo says. “It’s more important to custom tailor the treatment options to each of our patients and allow them to make an informed choice based on what’s right for them.”

About prostate cancer

Prostate cancer is a slow-growing disease that begins when cells in the prostate gland start to grow out of control. Other than skin cancer, prostate cancer is the most common cancer in men in the United States, according to the American Cancer Society.

About one in eight men will be diagnosed with prostate cancer during their life, but each man’s risk can vary based on age, race and ethnicity and other factors. However, prostate cancer is most common in older men. The average age of men who are first diagnosed with prostate cancer is 67, reports the ACS.

While prostate cancer is the second-leading cause of cancer death in American men (only behind lung cancer), most men diagnosed with the disease do not die from it. That’s most likely due to earlier detection and advancements in treatment.

Related Article: Prostate Cancer Awareness: Men, now is the time to get screened

Treating prostate cancer

There are many treatment options for prostate cancer including active surveillance, surgery, radiation therapy, chemotherapy or hormone therapy. Which treatment options are recommended depend upon the “risk category” to which a patient falls in, says Dr. Pablo.

That’s another unique thing about prostate cancer. Unlike other cancers, your disease isn’t characterized by stage but a risk category, such as low-risk or favorable intermediate or high-risk. Then based on risk category and also the patient’s health, age, life expectancy, prostate size and bladder health, he will be given a list of options for treatment. Genetic testing also is playing a larger role in determining the best course of treatment.

“And that treatment is different for each patient,” Dr. Pablo emphasizes. “Then with our guidance, they have to choose. I have a rule of thirds. A third of the guys want to have the surgery yesterday and get this thing out. Another third of the guys want anything but surgery, and the final third are really in between and trying to figure things out.”

Treating prostate cancer with radiation therapy

One treatment option for prostate cancer – and Dr. Pablo’s specialty – is radiation therapy. Radiation therapy is commonly used to treat prostate cancer, sometimes after surgery or sometimes as the sole modality.

Radiation uses high energy rays to kill cancer cells. Radiation therapy could be given via CyberKnife®, TrueBeam® or brachytherapy.

Related Article: What can I expect from radiation therapy?

Especially for men who are low-risk or favorable intermediate, CyberKnife® treatment is a good option. CyberKnife® is a dedicated radiation treatment machine that gives ultra hypo-fractionated radiation treatments to various cancers. The radiation delivered by the CyberKnife® machine is extremely accurate, while adjusting for any motion of the prostate during the treatment. Because of the high – but safe – dose, prostate cancer patients are treated in just five sessions, either daily or every other day, for about 30 minutes per session, Dr. Pablo says.

Our radiation oncologists also can do a five-session CyberKnife®-like treatment on the TrueBeam® machine, which is great news for our South Carolina prostate cancer patients. CyberKnife® is only in Savannah, but we have TrueBeam® machines each at our Bluffton and Hilton Head offices.

TrueBeam® also is a highly-precise device that delivers a radiation beam that targets cancer and keeps exposure to healthy cells to a minimum.

“We have all these tools available,” Dr. Pablo says. “It’s not saying one is better than the other. It just gives us more options and the ability to custom tailor treatments.”

Not all patients will be candidates for the five-session treatment. Some may opt for and be better suited for 20 to 28 sessions of radiation therapy. This can include men with large prostates or pre-existing urinary problems.

Sometimes CyberKnife® or brachytherapy can cause urinary symptoms or make existing problems worse, Dr. Pablo says. However, the overall side effects of radiation therapy for prostate cancer have decreased over the years. For example, men are experiencing less GI symptoms, such as diarrhea, Dr. Pablo says.

“For our patients that require treatment or decide to have treatment, radiation is so accurate now and the imaging is great,” Dr. Pablo says. “We are seeing less and less of the side effects of treatment, especially from the rectal side. As well as surgically, as they do more robotic surgery, we are seeing improved side effects.”

Getting support

If you do get diagnosed with prostate cancer, it can come with a lot of emotions for both you and your loved one. A Prostate Cancer Support Group is held at the LCRP every other month. You can join other patients, survivors and caregivers for discussion and answers to any questions you have. Light refreshments also are served.

The meetings are in the second-floor conference room at the LCRP from 6 p.m. to 7:30 p.m. The next scheduled meeting is for Wednesday, July 10.

For more information, contact Jerry Thomas at savprc@gmail.com.