Prostate Treatments

There are several treatment options available for prostate cancer patients. Treatment options may be utilized alone or in conjunction with other treatments, depending on the stage of your cancer. Your doctor at Somerset Urological Associates will come up with a custom treatment plan to ensure the best treatment route is taken.  

Many patients and doctors choose Robotic Surgery to treat prostate cancer. Robotic surgery is a minimally invasive, computer assisted surgery in which your surgeon controls very small tools attached to a robotic arm. The robotic arm is able to make smaller and more precise movements than the human hand. Because Robotic Surgery is minimally invasive, it results in quicker recovery period, minimal scarring, a reduced risk of complications, and minimal blood loss. With any surgery, there are some side effects and risks. These include higher complications when complications are present, involuntary leaking of urine or fecal matter (Incontinence), sexual dysfunction, and risk of transfusion.

Radioactive Seed Implantation, also known as “Brachytherapy” can also be utilized to treat prostate cancer. It is a form of radiation therapy for prostate cancer. Radiation therapy involves the placement of radioactive material into the affected tissue. There are two types of Brachytherapy, permanent and temporary. Permanent Brachytherapy, Low Dose Rate, is when a doctor or clinician implants radioactive (iodine-125 and palladium-103) seeds into the prostate gland using an ultrasound for guidance.  A custom computer generated program determines the number and placement of seeds to be implanted. Anywhere from 40 to 100 seeds are implanted in to the patient. The implants remain in place permanently, and become biologically inert after a period of months. This permanent technique allows a high dose of radiation to be delivered to the prostate with limited damage to surrounding tissue.

Temporary Brachytherapy is the technique in which hollow needles are placed into the prostate gland and filled with radioactive material (iridium-192) for 5-15 minutes at a High Dose Rate. After the treatment both the iridium and the needles are removed. This is repeated two to three times over a period of several days. Patients choose this therapy over external radiation because of the convenience of finishing in a few days, compared to eight to nine weeks. According to the American Cancer Society, patients of Brachytherapy report side effects such as the low rate of sexual dysfunction, frequent urination, and inability to achieve or maintain an erection (Erectile Dysfunction), difficulty urinating (Dysuria), blood in urine (Hematuria), painful and swollen scrotum (Epididymitis). Advantages include a usually painless treatment, quick recovery, and fewer complications. The procedure does not require major surgery, and requires minimal hospital stays.

Patients also have the prostate cancer treatment option of Cryosurgery. Cyrosurgery is conventionally a gynecological treatment that uses liquid nitrogen gas to destroy noncancerous (benign) and cancerous (malignant) skin lesions in the cervix.  For the treatment of prostate cancer, an ultra-thin metal probe or needle is inserted into the prostate gland through an incision between the anus and scrotum. Any living tissue, healthy or unhealthy, cannot tolerate the extremely cold temperatures. As heat is drawn out, there is an instantaneous swell of ice crystals which results in cell death. Cyrosurgery is preferred by many because it is minimally invasive, requires no radiation, results in lower instances of incontinence compared to invasive surgery, and minimal hospital stay is required. This procedure can also be repeated if necessary. Side effects tend to be worse in men who have already had radiation therapy and may include blood in urine and a painful and swollen scrotum.  Freezing damages nerves near the prostate and causes impotence in 4 out of 5 men. Less than 1% of men develop a fistula or abnormal connection between the rectum and bladder.

For patients who wish to find a balance between eliminating cancer and maintaining quality of life, they may choose High-Intensity Focused Ultrasound (HIFU). HIFU is a minimally invasive treatment option for localized prostate cancer. During the procedure, precisely focused ultrasound waves raise the temperature of the targeted prostate tissue to 195 degrees Fahrenheit in just 2-3 seconds. This rapid heat destroys the targeted tissue while leaving structures outside of the targeted tissue unharmed. Advantages of this treatment are that it is minimally invasive, there is no blood loss, no radiation, it is non-surgical, requires minimal hospital stays, and it can be repeated if necessary. Side effects and risks include difficulty urinating, production of protein in the urine (Proteinuria), urinary tract infection, blood in urine, prostate infection (Prostatitis), painful and swollen scrotum, blood in semen, and the inability to achieve or maintain an erection.

Prostate cancer is a serious life event and health issue. Fortunately, with all of the advanced technology available at Somerset Urological Associates, prostate cancer is relatively curable. Your doctor at Somerset Urological Associates will guide you to the right, customized treatment plan to eliminate the cancer and hold on to your quality of life. Make an appointment today to discuss your options by calling us at 908-927-0300.