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Suggest Treatment For Prostate Cancer

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Posted on Tue, 17 Mar 2015
Question: Hi Doctor,

Please advice me by seeing my father reports as how should treatment should be given to cure prostate cancer. Through reports, cancer is present only in prostate area as I came to know through doctor.

Your help is appreciated.

Thanks,
XXXX.
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
I feel hormone therapy and radiotherapy is appropriate

Detailed Answer:
Hi

Thanks for your query.

His reports suggest a localized prostate cancer but the PSA is quite high, which makes it high risk. Hence rather than surgery, I would recommend 3 months of hormone therapy (by injection), then repeat PSA and start radiotherapy, while continuing the hormonal injections.

Hormone therapy continues for total 2-3 years with regular PSA monitoring.

He also has anemia (low hemoglobin), probably due to iron deficiency, which needs to be corrected.

Overall, the outcome should be good.

Hope this helps. I will be available to answer further followup queries, if any.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (20 minutes later)
Thank you doctor for your answer.

My father went through one surgery on 6th of Feb when his PSA was 55. Post surgery, his PSA is 48.
Moreover, I have read that in case of prostate cancer which are localized, surgery is a good option which actually removes complete cancer. Also, I read about radiotherapy where people suffer from lots of side effects.
When I was having discussion with one oncologist, she said there are sever side effects among which bleeding & not able to control motions are some of the known side effects. Also, due to radiation exposed, other exposed cells are burnt which are not cancerous in nature.

Since his age is below 70, surgeon has suggested surgery with radiotherapy.

Please let me know which stage my father is in currently and if it is curable completely.

I am clueless about which one option I should take for betterment for my father health.

Thanks,
XXXX.


doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
Surgery second choice for me

Detailed Answer:
Thanks for followup. I understand your concerns.

The surgery which your dad has undergone is just to create channel for urine and take a biopsy. It is not the cancer surgery. The cancer surgery (radical prostatectomy) is a major surgery and not without its own share of side effects. Also, as it is a high-risk cancer, chances of him requiring RT after surgery is very high. So he will probably not be able to forego RT totally. Hence, why give him the burden of a major surgery?

And there is also no reason to believe that in this stage of prostate cancer (stage IIB/III high-risk), surgery gives any better long-term control than RT. Many studies have shown that RT is equivalent. Here is one study you can go through http://jnci.oxfordjournals.org/content/96/18/1358.full.

Even in NCCN guidelines (USA), RT+hormone is preferred above surgery though it also an option.

Being high-risk (though localized at present), complete cure is possible in some but not all. However, 5 year survival is expected to be >90% and 10 year >70%.

Regards
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Suggest Treatment For Prostate Cancer

Brief Answer: I feel hormone therapy and radiotherapy is appropriate Detailed Answer: Hi Thanks for your query. His reports suggest a localized prostate cancer but the PSA is quite high, which makes it high risk. Hence rather than surgery, I would recommend 3 months of hormone therapy (by injection), then repeat PSA and start radiotherapy, while continuing the hormonal injections. Hormone therapy continues for total 2-3 years with regular PSA monitoring. He also has anemia (low hemoglobin), probably due to iron deficiency, which needs to be corrected. Overall, the outcome should be good. Hope this helps. I will be available to answer further followup queries, if any. Regards