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Tuesday, May 21, 2013
Prostate Cancer Treatments That Would Help Other Cancers?
I had a prostatectomy two months ago. The disease was staged at T4N0M0 Gleason 8, with seminal vesicle involvement and positive margins including at the bladder neck. I am interested in aggressive followup. Because of my ulcerative colitis, consultants have been reluctant to do anything while my PSA remains undectable. I am now scheduled for a pancolectomy for newly discovered colon cancer with an ileostomy. What kind of treatment for the prostate cancer would increase my survival rate - especially now that radiation might be possible? Thank you.
If you are destined to die of prostate cancer it will be from metastases not from local recurrence of the tumor in the pelvis. That said, when your surgeon removes your colon there might be a possibility to more widely excise the tissue in the pelvis where your prostate used to reside, so have that done if possible and of course if lymph nodes have not been aggressively removed (a common situation) remove many more.
To see whether or not you have residual prostate cancer, have a Prostasint which is a nuclear medical test done to attempt to find the presence and site of residual cancer (these are not the most reliable of tests but are used in the setting that you find yourself).
If more local tissue and lymph nodes are removed and you are found to have metastatic prostate cancer, the standard therapy is to administer treatment to lower your male hormone level (testosterone). There are protocols wherein chemotherapy is given and you should see a medical oncologist familiar with prostate cancer for advise regarding chemotherapy alone or in combination with hormone deprivation therapy.
It is very important to remember that you will live for years regardless of the treatment that you choose, so it is wise not to panic, but to get the best advise that you can to help you to live both as long and well as you can.
R Bruce Bracken, MD
Professor of Surgery
College of Medicine
University of Cincinnati