Prostate

Question 1

Low-risk localized prostate cancer

Answer 1

Active surveillance: is an option for patients with certain criteria.

• Life expectance <10 years
• T1-T2 stage tumour
• Gleason score: 2-6
• PSA <10ng/L

Surgery: available for people in good medical condition

• Life expectancy > 10 years
• PSA < 10ng/L
• Gleeson score: 2-6
• T1-T2 stage tumour

Radiation therapy: can be offered instead of a radical prostatectomy or after a prostatectomy.

• External beam may be offered with the CTV encompassing prostate + base of seminal vesicles.
• Brachytherapy may also be an option gives similar results to prostatectomy.
• PSA <10ng/L
• Gleason score <3+4
• Postate volume <50cc
• no evidence of distant metastasis

Question 2

Medium-risk localized prostate cancer

Answer 2

Surgery: available for people in good medical condition

• Life expectancy > 10 years
• PSA < 10ng/L
• Gleeson score: 2-6
• T1-T2 stage tumour

Radiation therapy: can be offered instead of a radical prostatectomy or after a prostatectomy.

• External beam may be offered with the CTV encompassing prostate + base of seminal vesicles.
• Brachytherapy may also be an option gives similar results to prostatectomy.
• PSA <10ng/L
• Gleason score <3+4
• Postate volume <50cc
• no evidence of distant metastasis

Hormonal therapy: may be offered before, during or after radiation therapy.

Question 3

High-risk localized prostate cancer

Answer 3

Surgery: available for people in good medical condition

• Life expectancy > 10 years
• PSA < 10ng/L
• Gleeson score: 2-6
• T1-T2 stage tumour

Radiation therapy: can be offered instead of a radical prostatectomy or after a prostatectomy.

• External beam may be offered with the CTV encompassing prostate + base of seminal vesicles.
• Brachytherapy may also be an option gives similar results to prostatectomy.
• PSA <10ng/L
• Gleason score <3+4
• Postate volume <50cc
• no evidence of distant metastasis

Hormonal therapy: may be offered before, during or after radiation therapy.

Question 4

Locally advanced disease

Answer 4

Radiation therapy: often used to treat prostate cancer. Typically given with hormonal therapy.
Radiation therapy: can be offered instead of a radical prostatectomy or after a prostatectomy.
- External beam may be offered with the CTV encompassing prostate + base of seminal vesicles.
- Brachytherapy may also be an option gives similar results to prostatectomy.
- PSA <10ng/L
- Gleason score <3+4
- Postate volume <50cc
- no evidence of distant metastasis

Hormonal therapy: offered before, during and after radiation. May also be used as the only treatment for those who can not undergo radiation or surgery.

Surgery: may be offered.

• Radical prostatectomy can be offered before radiation therapy.
• Transurethral resection of the prostate (TURP): removed part of the prostate through the urethra.
• used to relieve urinary problems caused by an enlarged prostate
• reduce the size of the tumour before radiation therapy or hormonal therapy.