How aggressive is my cancer?
Prostate cancer actually describes a spectrum of cancers, from slow growing
to very aggressive. The pathologist will determine this grade or level
of aggressiveness by using the Gleason scoring system, which assigns a
numerical grade to the cancer based on its microscopic appearance. Gleason
grade scores typically range from 6 to 10. Gleason 6 cancers are thought
to be the least aggressive and Gleason 10 the most lethal.
How do you estimate what stage it’s at?
The stage of a man’s cancer describes how far the cancer has traveled
from the prostate gland. This is determined initially by combining imaging
tools (bone scan, CT or MRI) with clinical variables such as the Gleason
grade, PSA level, and DRE findings. Staging can be further delineated
if surgery is performed to remove the prostate.
What are my treatment options?
Active Surveillance Management
For men diagnosed with non-aggressive prostate cancer (Gleason 6 or less),
active surveillance management should be considered. Active surveillance
(AS) is the clinical observation of cancer without treatment, thus avoiding
potential side effects associated with radiation or surgery. The cancer
is monitored with biomarker testing, imaging and repeated biopsy for signs
cancer progression. It is estimated that 80% of men on AS will not require
future treatment.
Hoag Family Cancer Institute’s prostate cancer active surveillance
program combines state-of-the-art cancer surveillance with improved health
and wellness to optimize a man’s oncologic outcome. A man’s
lifestyle habits can have a major impact on the status of his prostate
cancer. Therefore, men enrolled in the program will have regular comprehensive
nutritional assessment and monitoring and will have access to assistance
with smoking cessation, weight loss and exercise. Please contact
949-722-6237 for more information about this program.
Radiation Therapy
Radiation therapy is a standard treatment option for the treatment of low
risk to high risk prostate cancer, and can be used in the treatment of
regionally advanced prostate cancer, or metastatic prostate cancer.
Hoag Family Cancer Institute’s
Radiation Oncology Program is another example of its commitment to excellence in personalized prostate
cancer treatment. Hoag offers radiation oncology services in both Newport
Beach and Irvine where its highly specialized team of medical experts
delivers the latest in state-of-the-art radiation therapy to patients.
The most progressive options are available for prostate cancer patients
including image guided IMRT-VMAT, IMRT by Tomotherapy or SBRT (entire
treatment in five fractions over approximately two weeks).
SpaceOAR® hydrogel is the first FDA cleared spacing device to protect
the rectum in men undergoing radiation therapy for prostate cancer. Hoag
is the first hospital in Southern California, and west of Mississippi,
to offer this revolutionary product.
Hoag’s Radiation Oncology Program offers a full spectrum of leading-edge
radiation treatment options.
Visit us for a complete list of radiation oncology services.
Surgery
Surgery is a vital component in the successful treatment of prostate cancer.
Hoag Family Cancer Institute medical team includes experienced surgeons
and the latest techniques and technology in the surgical management of
prostate cancer.
Hoag surgeons utilize the da Vinci® Surgical System to perform robot-assisted
minimally invasive radical prostatectomy. Technological advantages, which
include a high-definition optical magnification system and endo-wrist
capability, afford a post-operative recovery during which patients experience
less pain, less blood loss and quicker return to normal activities. Other
potential benefits may include a faster return of urinary continence and
sexual function.
Jeffrey Yoshida, M.D., Hoag Urologic Cancer Program Director and fellowship-trained
urologic surgeon, is an expert in robotic surgery and has performed more
than 2,000 robotic prostatectomies.
Hormone therapy
Hormone therapy (also called androgen deprivation therapy) utilizes different
medications to lower a man’s androgen levels. This is effective
because androgens stimulate the growth of prostate cancer. This type of
therapy is commonly used together with radiation therapy or in treatment
of advanced stage prostate cancer.
Chemotherapy
Chemotherapy involves the use of anti-cancer medications in treatment of
advanced prostate cancer.
What are the survival rates for prostate cancer?
The superior care provided to Hoag prostate cancer patients is most clearly
illustrated by having a relative five-year survival rate of 100 percent
since the early 1990s.
Hoag was a leader in the use of prostate specific antigen to screen for
prostate cancer. This is one of the reasons that more than 90 percent
of Hoag prostate cancer patients have only localized disease at the time
a diagnosis of prostate cancer is made.
How can I get a second opinion?
Hoag’s expert physicians are available to provide second opinion
consultations. For a comprehensive evaluation, please call
949-722-6237 to schedule an appointment.