Prostate Cancer : Doctor Discussion Guide

Jay Motola Health Pro
  • So now that you have been diagnosed with prostate cancer what’s next? Obviously you have met with your Urologist who has informed you of this diagnosis, however do you have enough information to proceed with treatment.


    There are numerous things that the patient needs to be made aware of.  A thorough awareness of your disease will help you to make an educated decision regarding treatment options.


    First what is the stage of your cancer?   Is it limited to the prostate or has it spread outside of the prostate. Disease that has progressed outside of the prostate is usually not curable and undergoing definitive treatment with either surgery or radiation therapy would not be the ideal treatment. If the disease has spread, hormonal therapy would be the best option.

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    Next, what is the grade of the tumor? Urologist use the Gleason score to describe the pathology that is present in the biopsy. Gleason scores are numbers that are assigned to the cancer based on the pattern of the cancer. Two scores are assigned ranging from 1 to 5, and then the scores are added for a total Gleason score.  Tumors that are very high grade 8, 9 or 10, although possibly curable, may require combination therapies such as a definitive treatment a well an adjuvant treatment with a hormonal blockade.


    The most important question that needs to be answered is whether or not you need to be treated.  Patients who have low level or disease, have a relatively shore life expectancy, or who are very advanced in age, may not need to be treated.  A course of active observation with serial PSA testing may be suited for you.


    Once you have this information then better decisions can be made with regards to selecting the treatment that best suits your disease.  Options of therapy include surgery, both traditional as well as Davinci robotic prostatectomy, radiation therapy including various forms of external beam therapy, seed therapy, or possibly a combination of different forms. Short-term or long –term hormonal ablation may also be part of the treatment.   Cryotherapy may also be an option for some patients as a form of definitive therapy.


    When making a decision about treatment, discussion regarding the degree of experience that your surgeon has with these various technologies is advised. Be sure to discuss the various risks of the procedures such as incontinence, and erectile dysfunction post-operatively.  Be sure to inquire about recurrence rates, and what plan of action would the surgeon undertake if you were to have a recurrence.   Inquire if you will be required to stay overnight in the hospital, and if so for how long. Will you require a catheter? How about post-treatment medications? A plan of follow-up care should also be outlined.


    Don’t be afraid to ask questions. If you are not satisfied with the answers that you are receiving or do not feel comfortable with your caregiver, obtain a second opinion.


    The more educated that you are with regards to the disease process the easier the transition will be to convert you from someone who was just diagnosed with cancer, to someone who will be cured of their disease. 


Published On: August 15, 2010