This document provides information on treatment options for prostate cancer. It discusses several treatment approaches including watchful waiting, surgery, external beam radiation therapy, brachytherapy, proton therapy, and stereotactic body radiation therapy. For each treatment option, it provides details on the procedure and recovery time, as well as potential side effects. The goal of the document is to educate patients diagnosed with prostate cancer on the various treatment approaches available.

1. ì
PROSTATE
CANCER
TREATMENT
OPTIONS
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2. PROSTATE
CANCER
OVERVIEW
ì The
prostate
is
located
in
a
man’s
lower
abdomen
and
controls
the
flow
of
urine
and
semen.
ì Second
only
to
lung
cancer,
prostate
cancer
is
the
leading
cause
of
cancer
death
among
American
men.
ì According
to
the
American
Cancer
Society,
an
esEmated
238,590
cases
of
prostate
cancer
will
occur
in
the
US
during
2013.
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3. TREATING
PROSTATE
CANCER
ì The
stage
of
the
cancer
ì The
patient’s
age
and
health
ì The
patient’s
Gleason
Score
—
This
determines
how
likely
it
is
that
a
tumor
will
spread
ì Whether
the
cancer
is
recently
diagnosed
or
recurring
ì The
patient’s
prostate-­‐specific
antigen
(PSA)
levels
—
PSA
is
a
substance
made
by
the
prostate
that
may
be
found
in
an
increased
amount
in
the
blood
of
men
who
have
prostate
cancer
Prostate
cancer
treatments
differ
primarily
in
technical
nature
and
potenEal
side
effects.
Treatment
options
can
depend
on
the
following:
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4. TREATMENT
OPTIONS
ì Prostate
cancer
treatment
options
include:
ì Watchful
Waiting
ì Surgery
ì External-­‐Beam
Radiation
Therapy
ì Brachytherapy
ì Proton
Therapy
ì Stereotactic
Body
Radiation
Therapy
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5. WATCHFUL
WAITING
ì The
concept
of
watchful
waiEng
has
emerged
as
a
viable
opEon
for
men
who
decide
not
to
undergo
immediate
surgery
or
radiaEon
therapy.
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6. SURGERY
ì Procedure
&
Recovery
Time
ì Procedure
lasts
3
–
4
hours
ì Requires
general
anesthesia
and
a
three-­‐
day
hospital
stay
ì Recovery
usually
requires
a
few
weeks
at
home
ì Potential
side
effects
ì Urinary
incontinence
ì Erectile
dysfunction
Radical
Retropubic
Prostatectomy:
Surgery
in
which
the
prostate
gland
is
removed
and
that
may
include
biopsies
of
nearby
lymph
nodes.
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7. EXTERNAL-­‐BEAM
RADIATION
THERAPY
ì Procedure
&
Recovery
Time
ì Approximately
40
daily
radiaEon
treatments
over
a
period
of
seven
to
eight
weeks
ì Treatment
takes
approximately
15
minutes
ì Outpatient
procedure
that
allows
most
patients
to
return
to
their
normal
routine
ì Potential
side
effects
ì Temporary
rectal
and
urinary
irritation
ì Erectile
dysfunction
ì Lacks
the
ability
to
correct
for
movement
of
the
prostate
during
treatment,
resulting
in
possible
damage
to
healthy
tissue
surrounding
the
prostate
Intensity
Modulated
Radiation
Therapy
or
IMRT:
IMRT
targets
radiation
beams
to
the
location
of
the
patient’s
tumor.
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8. BRACHYTHERAPY
ì Procedure
&
Recovery
Time
ì One-­‐Eme
procedure
that
requires
paEents
to
remain
in
the
hospital
for
several
hours
ì PaEents
are
usually
allowed
to
return
home
on
the
same
day
ì Potential
side
effects
ì Erectile
dysfunction
ì Urinary
irritation,
frequency
and
obstruction
ì Rectal
injury
Brachytherapy:
Small
radioactive
seeds
are
implanted
within
the
prostate
gland
and
give
off
radiation
to
the
immediate
surrounding
area
over
the
course
of
several
months.
After
a
year,
the
radioactive
material
degrades,
and
the
seeds
that
remain
are
harmless.
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9. PROTON
THERAPY
ì Procedure
&
Recovery
Time
ì Treatment
is
usually
delivered
five
days
a
week
for
approximately
eight
weeks
ì PaEents
are
usually
able
to
return
to
their
normal
rouEne
aVer
treatment
ì Potential
side
effects
ì Few
to
no
side
effects
when
compared
to
traditional
radiation
therapy
Proton
Therapy:
Noninvasive
treatment
that
uses
a
particle
accelerator
to
deliver
a
focused
ray
of
proton
particles
that
destroy
cancer
cells.
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10. STEREOTACTIC
BODY
RADIATION
THERAPY
Stereotactic
Body
Radiation
Therapy:
Noninvasive
procedure
that
delivers
targeted
radiation
beams
to
the
prostate
without
incision
or
sedation
using
Novalis
Tx®
technology.
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92025
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ì Procedure
&
Recovery
Time
ì PaEents
are
treated
in
five
or
fewer
outpaEent
sessions
ì Treatment
procedures
take
about
30-­‐40
minutes
ì PaEents
are
usually
able
to
return
to
their
normal
rouEne
aVer
treatment
ì Recovery
is
often
immediate
ì Potential
side
effects
ì Few
to
no
side
effects
when
compared
to
traditional
radiation
therapy

11. How
Does
Novalis
Tx
Treat
Prostate
Cancer
The
treatment
process
includes:
ì Consultation
appointment
ì Pretreatment
procedures
ì Novalis
Tx
treatment
ì Follow-­‐up
Prior
to
stereotacEc
body
radiosurgery
treatment,
small
metal
Essue
markers
known
as
fiducials
may
be
implanted
in
the
prostate
to
help
the
Novalis
Tx
pinpoint
the
tumor
locaEon
throughout
each
treatment,
so
the
radiaEon
beams
delivered
during
treatment
can
be
locked
on
the
tumor.
PaEents
are
then
scheduled
for
no
more
than
five
Novalis
Tx
treatments.
Each
treatment
takes
about
30
-­‐
40
minutes,
and
paEents
can
return
to
their
normal
rouEnes
following
each
procedure.
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CA
92025
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739-­‐3835
www.sdradiosurgery.com

12. Our
Center
Under
the
leadership
of
Medical
Director
Dr.
Brian
Volpp,
San
Diego
Radiosurgery
has
offered
advanced
cancer
treatment
from
some
of
the
region’s
most
experienced
radiation
oncologists
and
technicians
since
opening
in
2008.
Call
us
or
visit
our
website
to
learn
more
about
prostate
cancer
treatment
with
Novalis
Tx.
San
Diego
Radiosurgery
is
a
service
of
Palomar
Health
Downtown
Campus,
a
member
of
Palomar
Health.
Connect
With
Us
Medical
Director:
Dr.
Bryan
Volpp
Nurse:
Cathy
Blazek,
RN,
BSN
Medical
Physicist:
Mark
Young
555
East
Valley
Parkway,
Escondido,
CA
92025
(760)
739-­‐3835
www.sdradiosurgery.com