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Prostate cancer

What is prostate cancer?

Prostate cancer is one of the most common malignancies in older men where most patients are diagnosed at age older than 60. In year 2010, more than 4,300 men were diagnosed with prostate cancer in Taiwan, and that number is rapidly increasing. Prostate cancer usually develops slowly, so you could have no symptoms for many years. Symptoms of prostate cancer include a weak flow of urine and/or frequent urination, but these symptoms might also occur in patients with benign prostatic hyperplasia or other problems of the prostate.

Treatment of prostate cancer

Treatment options depend on many factors including the stage of the cancer which is determined by PSA levels, the Gleason score, the local extension of cancer and whether the cancer has spread to other places in the body, the patient’s general health condition, and the patient’s wishes. Treatment might not immediately be necessary for some patients. If the cancer is at an early stage and not causing symptoms, a policy of "watchful waiting" or "active surveillance" may be adopted for patients older than 65. For localized prostate cancer, the treatment is aimed at curing this disease. However, if the cancer has already spread to other parts of the body, the treatment policy focuses mainly on prolonging life and providing a better quality of life. Treatments include surgically removing the prostate, radiotherapy, and hormone therapy.

Radiotherapy of prostate cancer

Radiotherapy can be used in almost all stages of prostate cancer. In early stage patients, radiotherapy is as effective as surgery in curing the disease. Locally advanced prostate cancer is more often treated by radiotherapy, as complete surgical removal of the disease may be difficult. Advances in radiotherapy technology, such as intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), or brachytherapy, have led to a remarkable improvement in the control rate of prostate cancer. In addition to X-ray based radiation therapy, there is also the latest in proton therapy. The physical properties of proton therapy make it possible to reduce unnecessary radiation doses to normal tissues, resulting in reduced treatment side effects.

Article author: Dr. Din-Li Zan