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Treatment Options

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Prostate cancer can be very aggressive or very slow-growing, and treatment can involve side-effects. Before choosing a treatment it is important to establish how likely it is that the cancer is serious (aggressive vs. slow-growing).


Overview of Diagnosis | Risk Groups | Treatment Consultations

"If you know the enemy and know yourself, you need not fear the result of a hundred battles."

-Sun Tzu, the Art of War

Overview of Diagnosis
To begin exploring what treatment options might be right for you, start with reviewing information about your diagnosis. To do this, you will need:

  • a history of all prior PSA blood test results (your primary care doctor should have this information);
  • documentation of clinical stage; and the diagnosing pathology report (your urologist should be able to provide this information).
Once gathered, print this workbook for newly diagnosed men (847KB-PDF)
  This tutorial accompanies the workbook. Simply click on the black box (the tutorial will open up in a new window), review the introductory information, then click on the screen to begin. Once you've entered the tutorial, click the arrows in the lower right hand corner to advance. The tutorial takes about 20 minutes to complete.

Many survivors recommend this guide developed by the National Comprehensive Cancer Network (NCCN). The NCCN is the premier organization focused on supporting high quality evidence-based cancer care.

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Risk Groups
Refer to the table below to see what "risk group" aligns with results from tests used to diagnose cancer. Appropriate treatment options usually correspond with risk outlined in this table. If any of markers are in the high risk row the prostate cancer is high risk. If the highest marker value is in the intermediate risk row, cancer may be intermediate risk. If all marker values are in the low risk row, cancer may be low risk.


Source: This table was adapted from the Prostate Cancer Research Institute (PCRI)
"What's Your Type" brochure.

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Multidisciplinary Consultation
An important aspect of high quality prostate cancer care is a multidisciplinary treatment evaluation. Since 2004 this has been an evolving standard of care for medical professionals specializing in the care and treatment of men with prostate cancer. Download the American Urological Association (AUA) TEAM approach to care flier for more information.

The prostate is an important part of a man's urinary and reproductive systems (click here to learn more about the prostate), so you may want to give careful consideration to your treatment options. Because prostate cancer can be slow growing in comparison to other forms of cancer, it is important to have a good understanding of your overall health and general life expectancy. This means seeing your primary care physician for a complete check-up. Bring along a copy of this Check-Up Checklist to help support that discussion. You may also want to explore your biological age, which may not be the same as your age in years.

After a complete physical with your primary care doctor, it is a good idea to talk to at least one urologist, one radiation oncologist, and one medical oncologist. Be sure to ask one of these three doctors to present your case at the local tumor conference, and to share what was discussed with you after that. Commission on Cancer (CoC) requires that all community cancer centers host a community tumor conference for multidisciplinary discussion of cancer cases. This is a quick and easy way to have a multidisciplinary consultation with your own hand picked team of local doctors. Major Academic Cancer Centers such as Duke, UNC, and Wake Forest have one stop multidisciplinary second opinion clinics. Presbyterian Cancer Center in Charlotte also has a multidisciplinary second opinion clinic.

These doctors will usually discuss standard options for newly diagnosed men based on risk. In no particular order, the following options are generally presented for consideration based on cancer risk.

Low Risk
 
Medium Risk
 
High Risk
   
Please note that additional imaging may be required to further define risk. Cryosurgery, High Intensity Focused Ultrasound (HIFU), and proton therapy are new / experimental approaches. If you are interested in newer experimental approaches, click here to search the NCI database for clinical trials. Click here for a listing of prostate cancer clinical trials available in NC.

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Prostate Cancer Coalition of North Carolina (PCCNC)
5905 Shamrock Road
Research Triangle Park, NC 27713
919.321.0365
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