Staging the cancer is one of the most important factors in choosing the best alternative for treatment. Staging of prostate cancer is based on the extent of cancer (using T, N, and M categories) and the PSA level and Gleason score (Grade Group) when first diagnosed.
For prostate cancers that have not spread (Stages I to III), Patients are divided into risk groups (based on prostate tumor growth, PSA level, and prostate biopsy results) to help determine treatment options. Risk groups range from very low risk to very high risk; Low-risk group cancers have a lower chance of growth and spread compared to high-risk groups. While looking at treatment options, the stage of the disease, PSA value and risk group should be taken into account, as well as the medical team's obligation to consider other factors when deciding on treatment options. ;
The following are also taken into account when deciding on treatment and treatment options:
-
The patient's age and life expectancy,
-
Whether she is still sexually active,
-
Whether there are other diseases that impair quality of life
-
Socio-cultural and economic level of the patient
-
Stage of prostate cancer (TNM and Group stage) and degree of cancer horniness (Gleason score)
p> -
Existing technical infrastructure,
Treatment of Stage I Prostate Cancer
This stage is prostate cancer mass and tumor The burden is relatively small (T1 or T2) and has not protruded and enlarged outside the prostate. They have low Gleason scores (6 or less) and low PSA levels (less than 10 ng/mL). They usually grow very slowly and never cause any symptoms or other health problems.
Treatment Options:
p>
-
For men with no complaints and/or other serious health conditions that could limit their lifespan, it's usually just i Monitoring (Wait-See) or active monitoring may be recommended. Radiation therapy (external beam therapy -EBRT or brachytherapy) or radical prostatectomy (Open or Robotic) may be options for patients who insist on starting treatment.
-
Active monitoring in younger and healthy patients Radical prostatectomy (Open or Robotic) or radiation therapy (external beam or brachytherapy) may be considered. In some patients, radiotherapy and/or short-term hormone therapy can be added according to the pathology result after radical prostatectomy.
Stage II Prostate Cancer Treatment
Stage II cancers still have not protruded or overflowed from the prostate yet, but they are larger in volume, higher than stage I cancers Have Gleason scores and/or higher PSA levels. Stage II cancers that do not undergo surgery or receive radiation therapy; Compared to stage I, it is more likely to spread outside the prostate and cause prostate complaints.
Treatment Options:
-
As in stage I cancers, cancer that does not cause any symptoms and that is elderly and For patients with / or other serious health problems, only follow-up (Wait-See) or active surveillance is an option. Alternatively, hormone therapy and/or external radiation therapy or brachytherapy (internal radiation therapy) may be an option.
-
Treatment options for younger and healthier patients include:
p>
-
Radical prostatectomy (Removal of prostate, seminal sac and tracts, pelvic lymph nodes together). If the pathology report obtained after the surgery is beyond the prostate, if the PSA level does not fall to the desired level a few months after the surgery, external beam radiation can be given.
-
Only external beam radiation can be sufficient
-
Brachytherapy only (for selected patient groups)
-
Combination of brachytherapy and external beam radiation
-
Only active monitoring structure There may be patient groups that may be eligible
-
There may be clinical applications of some experimental new treatments that are not yet in routine use
-
PSA level and/or Gleason If the cancer is more likely to recur depending on the score, all radiation options can be combined with hormone therapy, which may take several months to 2 years.
Treatment for Stage III Prostate Cancer
Stage III cancers may have grown outside the prostate and have spread to the bladder or rectum (T4). however, they have not spread to lymph nodes or distant organs. These cancers are more likely to recur after treatment than early-stage tumors.
Treatment options at this stage include:
-
External beam therapy plus hormone therapy
-
Hormone therapy
plus external beam therapy and internal beam brachytherapy -
In some selected patients, radical prostatectomy plus external radiation therapy and/or hormone therapy.
-
Hormone therapy alone, external beam therapy, and even active surveillance in patients older or with other medical conditions Less aggressive treatments such as />
Treatment for Stage IV Prostate Cancer
Stage IV cancers have spread to nearby areas such as regional lymph nodes or distant organs such as bones. Most stage IV cancers are not completely curable. The aim of treatment is to keep the cancer under control for as long as possible and to improve the patient's quality of life.
Treatment options at this stage are:
-
Hormone therapy
-
Chemotherapy plus hormone therapy
-
External radiation therapy plus hormone therapy
-
Chemotherapy
-
Relieving symptoms such as bleeding or urinary obstruction for surgery (TUR-P)
-
Bisphosphonates such as Denosumab (Xgeva), zoledronic acid (Zometa) targeting bone metastases, external radiation to bones or strontium-89, samarium-153, or Treatments involving injections of radioactive material such as radium-223
-
Observation (for those who are older or have other serious health conditions and no major symptoms of cancer)
-
Taking part in clinical trials of newer treatments
-
Treatment of stage IV prostate cancer may also include treatments that help prevent or relieve symptoms such as pain.
The above options are initial treatment options for different stages of prostate cancer. However, these treatments do not work, if the cancer continues to grow and spread, or if the cancer recurs, secondary and other treatments come into play.
Read: 0
-
