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Prostate Cancer

No alternative to treatment for prostate CA

12/04/2008

Question:

In 1999 I had a seminoma, after removal (1-right) I had preventive old fashion radiation to lymph nodes in my pelvis. Now I have been diagnosed with prostate cancer localized and under control. Due to the radiation received in 1999, Urologists say I cannot have seeds implanted, IMRT, removal, freezing, or regular radiation. Prostate size at present is 12.5 cm and Radiation Oncologist said is too small for either seeds or freezing. They recommend LUPRON for the rest of my life. I am a 62 years old male with history of seminoma, adenocarcinoma in right lower lung lobe (removed). Another Urologist is recommending Ultrasound, a $25,000.00 treatment outside US. Although my PSA is .03 at present, I`m very much concerned about the side effects of LUPRON. Arthritis has already begun affecting my hands. My family doctor blames the LUPRON. I will appreciate your comments. Thank you.

Answer:

While prior radiation may limit some further radiation treatment options, depending on the doses used and the exact location of the radiation, certain types of radiation may still be an option. Surgery should definitely still be an option, either open, laparoscopic or robotically. You may want to seek another opinion at a large referral center for prostate cancer.

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Response by:

Lee E Ponsky, MD Lee E Ponsky, MD
Associate Professor of Urology
School of Medicine
Case Western Reserve University