Prostate con't:

Signs of Prostate cancer:

• Decreased urinary stream
• Frequency in urination
• Difficulty in starting urination
• Dysuria – painful or difficult urination
• Nocturia – frequent urination at night
• Hematuria
• These are also signs of prostaic hypertrophy

Gleason Grading :   degree of differentation of cells

• How far removed from normal the cells are in the tumor
• Appearance (morphology) of cells
• Grading is done from 2 parts of the tumor and the 2 numbers are added together
• Less than 4 means cells are well differentiated
• Less than 6 Is still a good prognosis
• Greater than 6 means aggressive disease where IMRT cannot be done

Treatment of Choice for Prostate Cancer : whatever treatment the patient wants:

• Surgery
• EBRT
• Seed implants
• Hormones

200 cGy stops sperm production (50 cGy will effect sperm production)

orchiectomy – removal of the testicles

Brachtherapy for Prostate :

• Can be done if the PSA is 10 or less
• Palladium 103 or Iodine 125 is used
• Patient is put in the lithotomy position
• Radiation safety precautions are taken in the Emergenct Room and the patients room
• No young children or pregnant woman near the patient till 1 half life has passed
• Seed verification is done before the patient is released (CT scan or X-rays)
• Patients should wait 2 years after treatment have children (this is for all prostate and testicular patients)

Metastases :

• Bone Mets are the most common (given 3000 cGy in 10 fractions)
• Treatment for Mets is palliative to reduce pain
• Treatment deystroys the osseous cells which takes 6 months for recovery
• 60 – 70 % pain reduction is seen
• other places it will spread to is : lung, breast, liver, brain