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Treatment: Prostate Cancer

Prostate Cancer Prevention, Screening and Treatment. Fast-Acting. Forward-Thinking. Patient-Focused.

One man in six will be diagnosed with prostate cancer during his lifetime. Yet only one man in every 30 will die of prostate cancer. The statistic, while encouraging, also leads to this question: How can I maximize my odds against being that one in 30? Early detection, prompt action when cancer is detected, and the most advanced treatments available are each patient’s best defense against prostate cancer. Whether you have been diagnosed with prostate cancer or you are simply concerned with preventing it, the Van Elslander Cancer Center is on your side. That means you will have access to regular screenings and, if cancer is detected, you will review your options quickly with your entire cancer care team. It means your team is a nationally recognized group of experts who can then help you begin treatment within a short time of your diagnosis. It means you have access to all national clinical trials, for the most advanced treatment options. It means, simply, that you will have every conceivable advantage.

Highlights at the Van Elslander Cancer Center

Who can benefit from the Van Elslander Cancer Center’s prostate cancer expertise? Any man, whether you are concerned with preventing the disease, interested in regular screenings to maintain your health, or are focused on surviving prostate cancer. The Van Elslander Cancer Center is dedicated to providing the fastest and most comprehensive treatment available. Here’s how:

  • A nutritionist is available to consult with you on dietary and lifestyle choices to help prevent prostate cancer.
  • Genetic counseling is available to assess your risk if you are concerned about a family history of prostate cancer.
  • A full range of screening options provide the potential for early detection, maximizing your potential for recovery.
  • Patients have access to several treatment options and all national clinical trials.
  • Our multidisciplinary physician team provides the optimal treatment regimen for the man with prostate cancer, providing important advantages for men who:
    • Have recently been diagnosed with prostate cancer.
    • Have experienced a relapse of their disease.
    • Have undergone surgery for prostate cancer within six weeks of their referral to the Center.
    • Have had abnormal screenings or symptoms of prostate cancer.
    • Have been referred by their family physician or another surgeon for a second opinion about their prostate health and/or prostate cancer.
    • Have not received any form of treatment for their prostate cancer, either proven or suspected.

How To Reach Us

To schedule a consultation, call (313) 647-3000 or toll free, 1-866-246-HOPE.

Second Opinion

Patients who have been diagnosed with prostate cancer may come to the Van Elslander Cancer Center for a second opinion consultation. Second opinions are strongly recommended for all cancer diagnoses, so that you and your oncologist can choose the best treatment. Patients should ask their physicians to submit pathology materials for our review; each case receives a written evaluation.

If you are a Van Elslander Cancer Center patient and would like to obtain a second opinion, we can assist you as part of the University of Michigan Cancer Center Network. Because we are affiliated with their network, Van Elslander Cancer Center patients receive priority treatment.

Who’s On Your Team?

Our multidisciplinary approach to cancer care ensures that in a single visit, each patient receives a complete team of nationally recognized experts, including:

  • Primary Care Physician (usually conducts screening; if screening is abnormal, the following team members will become involved:)
  • Urologist or urologic surgeon
  • Radiation Oncologist
  • Oncology Nurse
  • Medical Onologist

Specialized Services

  • Nutritional and Lifestyle Counseling: Our staff nutritionist can work with you to create diet and exercise guidelines to minimize your risk for colorectal cancer.
  • Prostate-Specific Antigen Blood Test (PSA) – in this screening exam, a vial of blood is analyzed for PSA levels, which tends to elevate if prostate cancer is present. A level of under 4 nanograms per milliliter of blood is considered normal. If the level is above 4, but less than 10, you have about a 25% chance of having prostate cancer. From there, chances of having prostate cancer increases with the PSA level.
  • Digital Rectal Exam – a screening exam in which the doctor examines your rectum with a finger to check for any irregular prostate size, location or firmness that might indicate cancer. The exam is painless and takes only a short time. While the DRE is considered less accurate than the PSA blood test, it can sometimes find cancers in men with normal PSA levels.
  • Transrectal Ultrasound (TRUS) – this diagnostic exam is used when the PSA or DRE exams detect an abnormality. Sound waves from a small probe create a video image of the prostate in order to locate tumors. The procedure takes approximately 15 minutes. This technique can also be used to guide a needle used in a biopsy if there is a prostate tumor.

Staging

To determine how far the cancer has spread, your cancer care team uses a process of analysis known as staging. The stage of your cancer impacts your treatment and the prognosis for recovery. A number of different staging systems can be used to classify tumors. The TNM staging system assesses tumors in three ways: size of the primary tumor (T), whether it has spread to lymph nodes (N), and whether it has spread (metastasized) to other organs (M). Once the T, N, and M are determined, a number of I, II, III, or IV is assigned, with stage I being early stage and IV being advanced. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, denotes a more serious case. Your doctor will review your test results and tell you the stage of your cancer.

Treatment Options

The Van Elslander Cancer Center provides the following options for treatment of prostate cancer, all of which will be discussed with you by your urologist or multidisciplinary team. Treatments include:

  • External beam radiation oncology – A linear beam accelerator is focused on the exact location of the prostate cancer. Each treatment lasts just a few minutes and is painless (it is non-invasive, meaning your skin is not cut or punctured). You will usually be treated five days per week in an outpatient center over a period of 7 or 8 weeks. The treatment is given to a specific area in order to limit damage to healthy tissue.
  • Permanent seed implant – a tiny radioactive seed is implanted in the prostate gland. It delivers a calculated dose of radiation to surrounding tissue for a specified length of time.
  • HDR remote afterloading – a clinical trial evaluating the effectiveness of high-dose radiation in the treatment of prostate cancer.
  • Hormone therapy (also called androgen suppression) – female hormones help control progression of the disease by lowering levels of the male hormones, which can cause prostate cancer cells to grow. This procedure may also be used to shrink the prostate in order to make radiation or surgery more effective. This treatment will not cure cancer.
  • Surgery (offered at St. John Hospital and Medical Center) – called a radical prostatectomy, this curative surgery involves removal of the prostate gland plus some surrounding tissue, as well as a biopsy of nearby lymph nodes to be sure the cancer has not spread. This surgery is generally recommended for cancers that appear not to have spread beyond the prostate gland.

Pathology

We designed the Van Elslander Cancer Center’s team and processes to help you assess your best treatment options and begin fighting your cancer quickly – usually within two weeks of your diagnosis:

  • If a screening shows an abnormality, we will contact you to return within a week to consult with a urologist.
  • Often that same day an ultrasound and biopsy will be conducted, and our pathologists will determine whether the abnormality is cancer. You will generally get these results within two working days.
  • If the results determine you have cancer, you will receive a referral to our radiation oncologist.
  • The multidisciplinary team (see the Who’s on Your Team section, above) meets every week to review patients’ cases. This means that your case will be presented to this team at their next meeting (usually within 10 working days of the original diagnostic procedure), providing input of all the team members at once and access to information on any clinical trials for which you may be eligible.
  • Once you have met with your multidisciplinary team, you and your doctor will develop the best plan for your treatment.
  • Within two weeks of your diagnosis, your action plan for care can be developed and treatment can begin.

Follow-Up Therapy

Once you have received treatment, your radiation oncologist or urologist will follow up with you to check your healing progress and address any concerns.

For six months following your treatment, monthly PSA tests and Digital Rectal Exams (DREs) will be conducted to ensure your prostate gland and PSA levels remain normal.

At six months, if the PSA and DRE results are normal, you will be moved to an annual PSA and DRE schedule.

Your follow-up care can also include other services offered through the Van Elslander Center, such as the Healing Arts Center.

Reducing Your Risk

Here are a few of the ways the Van Elslander Cancer Center can help you prevent prostate cancer:

  • Screening (see the Specialized Services Section, above: According to the American Cancer Society, men 50 and older should receive both a Prostate-Specific Antigen (PSA) and Digital Rectal Examination (DRE) annually. Men at high risk (such as African Americans and men who have a first-degree relative diagnosed with prostate cancer at a young age) should begin testing at age 45. The Van Elslander Cancer Center provides a full range of screening services.
  • Lifestyle choices: Current information suggests that some prostate cancer cases can be prevented. You may be able to reduce your risk of prostate cancer by eating a diet low in fat and high in vegetables, fruits, and grains. A Van Elslander Cancer Center nutritionist can consult with you about cancer-preventing lifestyle changes, such as reducing fat intake, reducing alcohol intake, not smoking and exercising three times each week. For further nutritional information, click here.
  • Risk assessment: Van Elslander Cancer Center staff can work with you to determine your personal risk for prostate cancer. Risk factors include race, genetic factors (we offer genetic testing), lifestyle, family history, age and diet.
  • Clinical Trials (see the Clinical Trials section, below): Ask your physician about participating in clinical trials, which offer access to promising new treatments.

Clinical Trials

The Van Elslander Center is one of only 13 facilities nationwide whose patients have access to all national clinical trials. In addition, qualified Van Elslander Cancer Center patients can participate in private trials sponsored by The University of Michigan Cancer Care Center Network.

Clinical trials are conducted to study promising new treatments that have shown potential value to patients. While there can be risks, these studies offer the most leading-edge treatment options and are often found to have great benefits to patients. Taking part in a clinical trial is up to you, and once you have joined the study, you are free to leave it at any time, for any reason.

A few examples of the many clinical trials for currently available to qualified prostate cancer patients at the Van Elslander Cancer Center are:

  • Evaluation of a drug called finasteride, which prevents the prostate from using male hormones, in reducing prostate cancer risk.
  • Selenium and Vitamin E to prevent prostate cancer.
  • Comparison of radiation regimens in treating patients with localized prostate cancer.
  • External-beam radiation therapy plus implanted radiation therapy in treating patients with prostate cancer.

For a list of current clinical trials, click here or call the National Cancer Institute at 1-800-4-CANCER.

Other services

At the Van Elslander Cancer Center, we believe the strength of your mind and spirit is essential to your body’s healing process. Our Healing Arts Center is available for you to use, providing services such as massage, reflexology, mediation, music and art therapies and holistic assessment.


 

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