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Prostate Cancer:   Causes, Diagnosis, and Treatment Options Bruce B. Garber, MD, FACS Clinical Associate Professor Drexel University College of Medicine Graduate Hospital Philadelphia, PA
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
-Urine flows from the bladder through the urethra,    which is surrounded by the prostate -An enlarged prostate can cause difficulty passing urine  -The prostate is not in the rectum, but can be palpated during a   digital rectal exam
Incidence ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prostate Cancer: US Mortality and Incidence, 1973–1997  SEER Cancer Statistics Review 1973-1997. National Cancer Institute. Bethesda, MD.
Prostate Cancer: Causes ,[object Object],[object Object],[object Object],[object Object]
Prostate Cancer: Diagnosis  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gleason Pathologic Scoring System  for Prostate Cancer Gleason DF. In: Tannenbaum M, ed.  Urologic Pathology: The Prostate.  Philadelphia, Pa:  Lea & Febiger; 1977:171-197.
Prostate Cancer Staging Systems  ,[object Object],[object Object]
Whitmore-Jewett  Classification Stage A Microscopic cancer confined to the prostate and too small to be felt by digital rectal exam A1  Cancer well differentiated  and confined to one site A2  Cancer moderately or  poorly differentiated or  present in more than  one site
Whitmore-Jewett  Classification Stage B Cancer large enough to be felt on DRE B1  Small nodule on one lobe  of prostate B2  Large nodule, several small  nodules, or a nodule  containing poorly  differentiated cells
Whitmore-Jewett  Classification Stage C A large cancer involving nearly the entire gland C1  Cancer may have spread  a small distance beyond  the gland C2  Cancer has invaded the  neighboring tissue
Whitmore-Jewett  Classification Stage D Widespread (metastatic) cancer D1  Cancer in pelvic lymph  nodes D2  Cancer in bone or other  organs
Prostate Cancer: Treatment Options  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Non-curative Hormonal Therapy:  Currently Available Agents  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lupron Depot ®  is a registered trademark of TAP Pharmaceuticals, Inc. Copyright ©  2001 Bayer Corporation. Viadur™ is a trademark of ALZA Corporation under license to Bayer Corporation. Eulexin ®  is a registered trademark of Schering-Plough Pharmaceuticals. Nilandron   is a registered trademark of Aventis.
Therapies of Curative Intent: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radical Prostatectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
External Beam Radiation (EBRT) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Brachytherapy (radioactive seed implant) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cryoablation of the Prostate   (Cryosurgery, Cryotherapy)   CRYO = GREEK WORD FOR COLD   ABLATION = DESTRUCTION
What is Cryoablation? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],TARGETED CRYOABLATION OF THE PROSTATE (TCAP)
Technology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current Technology: 6-8 Probe Argon Cryosurgery System, Total Gland Ablation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Prostate Cryoablation  Probes inserted in between scrotum & rectum Transrectal ultrasound guides the procedure
Targeted Cryoablation of the Prostate (TCAP) Before  Probes Placed  Prostate frozen
Prostate Cryoablation Techniques ,[object Object],[object Object],[object Object]
Total Prostate Cryoablation
Nerve-Sparing Prostate Cryoablation
Focal Prostate Cryoablation
Results of Total Prostate Cryoablation ,[object Object],[object Object],[object Object],[object Object]
Cryoablation   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary: Prostate Cryoablation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Prostate Cancer: Causes, Diagnosis, and Treatment Options Bruce B ... Prostate Cancer: Causes, Diagnosis, and Treatment Options Bruce B ...

  • 1. Prostate Cancer: Causes, Diagnosis, and Treatment Options Bruce B. Garber, MD, FACS Clinical Associate Professor Drexel University College of Medicine Graduate Hospital Philadelphia, PA
  • 2.
  • 3. -Urine flows from the bladder through the urethra, which is surrounded by the prostate -An enlarged prostate can cause difficulty passing urine -The prostate is not in the rectum, but can be palpated during a digital rectal exam
  • 4.
  • 5. Prostate Cancer: US Mortality and Incidence, 1973–1997 SEER Cancer Statistics Review 1973-1997. National Cancer Institute. Bethesda, MD.
  • 6.
  • 7.
  • 8. Gleason Pathologic Scoring System for Prostate Cancer Gleason DF. In: Tannenbaum M, ed. Urologic Pathology: The Prostate. Philadelphia, Pa: Lea & Febiger; 1977:171-197.
  • 9.
  • 10. Whitmore-Jewett Classification Stage A Microscopic cancer confined to the prostate and too small to be felt by digital rectal exam A1 Cancer well differentiated and confined to one site A2 Cancer moderately or poorly differentiated or present in more than one site
  • 11. Whitmore-Jewett Classification Stage B Cancer large enough to be felt on DRE B1 Small nodule on one lobe of prostate B2 Large nodule, several small nodules, or a nodule containing poorly differentiated cells
  • 12. Whitmore-Jewett Classification Stage C A large cancer involving nearly the entire gland C1 Cancer may have spread a small distance beyond the gland C2 Cancer has invaded the neighboring tissue
  • 13. Whitmore-Jewett Classification Stage D Widespread (metastatic) cancer D1 Cancer in pelvic lymph nodes D2 Cancer in bone or other organs
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20. Cryoablation of the Prostate (Cryosurgery, Cryotherapy) CRYO = GREEK WORD FOR COLD ABLATION = DESTRUCTION
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. Prostate Cryoablation Probes inserted in between scrotum & rectum Transrectal ultrasound guides the procedure
  • 26. Targeted Cryoablation of the Prostate (TCAP) Before Probes Placed Prostate frozen
  • 27.
  • 31.
  • 32.
  • 33.