According to the American Cancer Society, the incidence of prostate cancer peaks in men between the ages of 65 and 75. Approximately one in nine men are diagnosed with prostate cancer in their lifetime. This makes prostate cancer the most common male cancer, excluding skin cancer. African American males and men with a strong family history are at an increased risk for developing prostate cancer.
Prostate cancer screening remains a controversial issue. This is because most men with prostate cancer never experience symptoms, and without screening would never know they have the disease. Knowing how to classify these patients and decide between screening, surveillance and aggressive treatment is an area of ongoing research. In the end, we don’t want to subject men to the side effects of surgery or radiation if their disease can be monitored without risk. Currently, most national guidelines recommend screening with a simple blood test called PSA for men between the ages of 55 and 69. The decision to proceed with screening should follow a discussion with their doctor about the potential benefits and harms.
Multiple studies have shown no difference in outcomes between surgery and radiation in men with localized prostate cancer. Understanding the side effects of different treatments and how they can impact quality of life has become an essential component to the decision-making process. The ultimate goal for urologists and oncologists is to detect and treat high-risk cancers, but also make sure they are not over-treating patients with low-risk disease that may not impact an individual’s life. As such, this requires comprehensive input from multiple specialists.
“As is true to life, prostate cancer is not a one size fits all approach,” says Dr. Mark Stavas, Southeast Nebraska Cancer Center (SNCC) radiation oncologist. “Our job is to align a patient’s goals and wishes with their unique disease characteristics in order to find a treatment that works, whether that is surgery, radiation, chemotherapy or active surveillance.”
Radiation therapy is one common treatment. This option uses non-invasive doses of radiation to destroy cancerous cells and shrink tumors. Treatment is usually delivered in an outpatient clinic and takes 15-20 minutes a day. Radiation research over the past decade has looked at offering shorter courses of treatment with fewer, larger doses. Improved technology has enabled better targeting and the ability to deliver higher doses faster while sparing normal tissues.
In 2018, SNCC became the first medical facility in Nebraska to offer SpaceOAR®, which is a hydrogel that separates the prostate gland from the bowel and has been shown to reduce acute and late toxicities.
“Offering a treatment plan that is less burdensome on the patient, family and medical system - while achieving comparable results - is the true definition of value-based health care,” says Dr. Joseph Kam Chiu, SNCC radiation oncologist.
When it comes to options for prostate cancer, the SNCC physician care team enjoys discussing the many different treatment plans available to help patients make an informed decision.
“We need to meet the unique needs of our patients and the demographics of our state,” says Dr. Stavas. “Nebraska’s population is aging, and many patients travel long distances from rural towns to receive daily treatments.” Shorter courses can alleviate the transportation and financial strain on patients and their families.
“Knowledge is power,” says Dr. Chiu. “Understanding the nature of your disease and the spectrum of treatment options are the essential first steps. It all begins with a conversation.”
SNCC provides comprehensive cancer care in Lincoln and 12 communities in Southeast Nebraska. It is composed of seven medical oncologists and two radiation oncologists along with multiple supportive care services, combining advanced medical oncology and radiation oncology at two locations in Lincoln. For more information about SNCC, visit LeadingCancerCare.com.