Is Radiation-recurrent prostate cancer different from my original tumor that I had before my radiation?
Radiation-recurrent prostate cancer is a deadly disease. Prostate cancer that has recurred after radiation is often times more aggressive than the original tumor the patient had before the radiation. This means that patients should seek targeted local treatment to prevent the cancer from spreading, without needless delay.
How are most men with Radiation-recurrent prostate cancer diagnosed and treated?
Radiation-recurrent prostate cancer is indicated by a rising PSA after radiation. While 75% of men with radiation-recurrent prostate cancer are treated, most of them are placed on hormone therapy (chemically castrated). Only 7% are treated with therapies directly to the prostate gland, in an effort to cure the patient. The large majority as a result are being "mis-managed".
I have been placed on hormone therapy. Is that a cure for Radiation-recurrent prostate cancer?
No. Hormonal therapy is NOT A CURE for radiation-recurrent prostate cancer. Moreover, it increases the risk of cardiovascular disease and is associated with other significant side effects which can effect a patient's health and quality of life.
Why can’t I just have surgery and have the gland removed using the Da Vinci Robot® ?
Radiation causes the tissues around the prostate to get stuck together making it very hard to remove the prostate gland, without causing extensive damage. Radical prostatectomy is therefore usually NOT performed in Radiation-recurrent prostate cancer because of poor cancer control results and very high complication rates. The Da Vinci Robot® has not been proven to help with this situation.
Can I have more radiation to treat my recurrent cancer?
Usually No. Radiation therapists try to give the maximum dose possible the first time you are treated using radiation. Once you have reached that maximum dose no more radiation can safely be given. Additional radiation is usually NOT performed in Radiation-recurrent prostate cancer because of high complication rates.
Is freezing of my prostate cancer (cryoablation) an option after radiation?
Yes. Cryoablation (freezing of the tumor) has been approved for Radiation-recurrent prostate cancer since 2001 and is part of the NCCN 2011 (National Comprehensive Cancer Network) recommendations for patients with Radiation-recurrent prostate cancer. It is the only ablation modality approved for this indication (HIFU is not FDA approved or available in the US.) It works very well and has the lowest complication rates of any of the “salvage” treatments.
Do I have to have my whole gland frozen?
No. Focal Therapy using cryoablation (by which we destroy only the the tumor within the prostate, not the whole gland ), is an option now being offered that has less complications than a full gland treatment and appears to have equal chance of success in treating your prostate cancer.