Prostate cancer stands as one of the most common types of cancer affecting men, with
statistics indicating that about 1 in 8 men will be diagnosed with it in their lifetime.
Despite its prevalence, the outlook for those diagnosed is often positive, particularly when caught early. Survival rates for prostate cancer are encouraging, with nearly 100% of men diagnosed at an early stage surviving for at least 5 years and many living well beyond 10 years post-diagnosis.
If you’re a man facing this diagnosis, know that you are not alone. Dr. Bevan-Thomas from Urology Partners of North Texas is dedicated to guiding you through every step of this journey, demystifying the process, and empowering you with a clear understanding of your prostate cancer treatment in Arlington, TX.
801 West I-20, Suite 1 (first floor USMD Hospital) Arlington, TX 76017
Understand how Prostate Cancer begins.
Prostate cancer begins when cells in the prostate undergo a transformation from their normal, healthy state. This change is characterized by an uncontrolled growth and division of cells, leading to the formation of a tumor.
What sets prostate cancer apart is that not all cancerous cells in the prostate behave uniformly. Some prostate cancer cells may grow slowly and remain localized, posing a minimal threat and often require no immediate treatment. Others, however, can be more aggressive, growing more rapidly and potentially spreading to other parts of the body.
Understanding the Gleason Grading System
The Gleason grading system is a vital tool used by doctors to evaluate the aggressiveness of prostate cancer. After the prostate biopsy, the prostate tissue is analyzed by the pathologist. The pathologist will examine the prostate tissue under a microscope and make the determination whether prostate cancer is present or not. If cancer is present, the pathologist will then assign the cancer a Gleason grade.
In the modern-day era, prostate cancer is given a grade according to how aggressive the cells appear under the microscope – from a Gleason 3 (lower grade) to a Gleason 4 and up to a Gleason 5 (higher grade). The Gleason scale originally ranged from 1-5, however Gleason grades 1 and 2 were removed from the system many years ago to simplify it.
But wait, there’s more! Two grades are given for the two areas that make up the majority of the cancer found in that area of the prostate– these are then added together to give a Gleason score. The scores range from 6 to 10, with lower scores (6-7) indicating less aggressive cancer and higher scores (8-10) indicating more aggressive cancer.
Understanding your Gleason score is crucial, as it helps determine the best course of treatment. A lower Gleason score routinely suggests a slow-growing cancer which routinely calls for an active surveillance approach. A higher Gleason score routinely requires treatment to prevent the cancer from spreading beyond the prostate to the lymph nodes and bones.
Here is the abbreviated version. Gleason 6(3+3) low grade cancer, Gleason 7(3+4) or (4+3) intermediate grade cancer and Gleason 8, 9 or 10 is high grade prostate cancer.
Active Surveillance Treatment for Prostate Cancer in Arlington, TX
Active surveillance is a treatment strategy for low-risk, non-aggressive prostate cancer in Arlington, TX. It involves closely watching the cancer’s progression through regular PSA tests, rectal exams, and sometimes biopsies, without immediate invasive treatments like surgery or radiation.
This approach aims to delay or avoid the side effects of aggressive treatments while ensuring the cancer remains under control. If signs of progression are detected, more active treatment options may be considered. Active surveillance is a valuable option for men with early-stage, lower grade prostate cancer, balancing patient safety with minimal intervention.
Focal Therapy for Prostate Cancer
Focal therapy represents a newer, targeted approach to treating localized, low to intermediate-risk prostate cancer. This method concentrates on eradicating only the cancerous cells in the prostate, preserving the rest of the gland.
.Techniques in focal therapy include cryotherapy (freezing cancer cells), high-intensity focused ultrasound (HIFU), laser ablation, and Irreversible Electroporation (IRE), commonly known as NanoKnife.
IRE is notable for its precision in destroying cancer cells through electrical pulses, minimizing damage to surrounding healthy tissues. These focal treatments aim to reduce the side effects typically associated with radical procedures like surgery or radiation, thus maintaining the patient’s quality of life. By focusing treatment on the affected areas, these methods strive for effective cancer control with fewer complications.
It’s crucial for patients to consult with their Urologist to determine if focal therapy, and specifically techniques like IRE, are appropriate for their individual case. Dr. Bevan-Thomas offers focal therapy for appropriate patients in Arlington, Texas.
The da Vinci Robotic Prostatectomy
The system’s high-definition 3D vision allows for meticulous removal of cancerous tissue, minimizing damage to surrounding areas. Dr. Bevan-Thomas was among the earliest surgeons in the country to perform the DaVinci robotic prostatectomy in 2002 and has over 21 years’ experience at the helm of the DaVinci robot and routinely performs several of these procedures per week on appropriate patients.
Radiation Therapy for Localized Prostate Cancer
Radiation therapy is a common treatment for localized prostate cancer, offering several techniques to target cancer cells effectively.
External beam radiation therapy (EBRT) uses high-energy rays from outside the body to destroy cancer cells, with advanced forms like Intensity-Modulated Radiation Therapy (IMRT) and Image-Guided Radiation Therapy (IGRT) enhancing precision. .
Another option is brachytherapy, where radioactive seeds are implanted directly into the prostate, delivering radiation over a period of time while attempting to minimize impact on surrounding tissues Proton therapy, a newer form of radiation, uses proton beams instead of X-rays, aiming for even greater accuracy in targeting tumors while reducing side effects. Stereotactic body radiation therapy (SBRT) delivers highly focused radiation doses in fewer sessions, suitable for certain cases of localized cancer. Each radiation therapy option has its specific benefits and considerations, and the choice depends on the cancer’s characteristics, patient health, and preferences.
The general rule is the higher the dose of radiation and the faster it is delivered, the higher the risk of side effects. Regardless, Dr. Bevan-Thomas works closely with several of his partners, who are Radiation oncologists in Arlington, TX, to help patients find the most effective treatment for their particular prostate cancer.
801 West I-20, Suite 1 (first floor USMD Hospital) Arlington, TX 76017
Hormone Therapy in Prostate Cancer Treatment
Androgen deprivation therapy (ADT), a form of hormone therapy, targets the male hormones, primarily testosterone, that can fuel prostate cancer growth. It works by either lowering the levels of these hormones in the body or by blocking their effects on prostate cancer cells. This treatment is a cornerstone in managing prostate cancer in various stages. In localized cases, ADT is often paired with radiation therapy to enhance its effectiveness, increasing the likelihood of eliminating the cancer. The hormones’ reduction makes the cancer cells more vulnerable to radiation.
For advanced prostate cancer, ADT helps to slow down the growth and spread of the disease, contributing to symptom relief and extending survival. The specific role of hormone therapy, whether in conjunction with radiation or as a separate treatment, is determined based on the cancer’s progression and the patient’s overall health.
Managing Advanced Prostate Cancer
Advanced prostate cancer refers to cases where the cancer has progressed or returned after initial treatment, such as surgery or radiation. This progression can involve the spread of cancer to other parts of the body, including the bones or lymph nodes, or a rise in PSA levels indicating the cancer’s return or growth. Managing advanced prostate cancer often requires a combination of treatments, tailored to the individual’s specific condition and the extent of cancer spread.
Hormone therapy remains a cornerstone in controlling advanced disease by targeting testosterone, which prostate cancer cells often rely on. In addition to ADT, treatments may include chemotherapy, newer hormonal agents, immunotherapy, or targeted therapy, especially if the cancer is resistant to initial hormone treatments. Bone-directed therapy is also considered for those with bone metastases to help manage symptoms and prevent complications.
The approach to advanced prostate cancer is multifaceted, aiming not only to slow the progression of the disease but also to maintain quality of life and manage symptoms. Ongoing research continues to improve the options and outcomes for men with advanced prostate cancer.
Dr. Bevan-Thomas: Navigating Prostate Cancer Treatment Together
Dr. Bevan-Thomas is one of the best urologists in Arlington, TX. He brings to the table a comprehensive range of options, from advanced focal therapy to the precision of robotic surgery, ensuring that each patient’s treatment is as unique as their diagnosis.
His expertise extends beyond employing state-of-the-art techniques; it involves crafting a treatment plan that resonates with each patient’s specific needs. In collaboration with eminent radiation oncology doctors in Arlington, Texas, Dr. Bevan-Thomas ensures a multidisciplinary approach, thoroughly exploring all available treatments to find the most effective strategy for each case. This collaborative effort allows for a well-rounded treatment plan addressing both early-stage and advanced prostate cancers. With Dr. Bevan-Thomas, patients receive a combination of expert medical care and genuine support, empowering them to make informed decisions and face their prostate cancer journey with confidence.
Grading
The lowest score is (3+3), and the highest is (5+5). For example, a score of (3+5) means that there were two different grades of cancer in that specimen on that spot on the prostate. The first number on the score, i.e. (3+5), means that Gleason 3 was found, and Gleason 5 cancer was also found. But there were fewer Gleason 5 cells than Gleason 3 (thus it is placed second in the parentheses). Because a biopsy samples tissue from several locations on your prostate, you can have a (3+4) and a (4+3) on different specimens from the same biopsy.
These numbers add up to a total score. Gleason 3+5=8 means your Gleason score (combined Gleason grades) is 8. Your score will help to determine if you need further imaging studies, such as a bone scan. A bone scan will show if the cancer has spread beyond your pelvis. Dr. Rich Bevan-Thomas also uses the prostate MRI routinely as this is the most helpful imaging study to evaluate whether the cancer has spread outside of the prostate or potentially into the local lymph nodes.
Your Gleason score also determines your risk category according to National Comprehensive Cancer Network (NCCN) guidelines.
- A score of 6 is low-risk.
- A score of 7 means intermediate-risk.
- A score of 8, 9, or 10 is considered high-risk.
From here, Gleason scores have grade groups which differentiate the risk between the different numbers. So a Gleason score 7 (4+3) is in a higher-grade group than a Gleason 7 (3+4) because there are more higher-grade cells in the (4+3) sample, and those cells have a higher risk of growing faster and beyond the prostate.
Staging
Cancer staging is expressed as a number from I through IV. Stage I is a small tumor that hasn’t spread beyond your prostate. Stage II and III tumors are larger and may or may not have spread to nearby organs. A stage IV tumor is one that has spread to lymph nodes, bone, or more distant parts of your body.
As you can see, the staging process is a little more complicated than grading, but Dr. Rich Bevan-Thomas will make sure you understand how both pertain to your situation. For now, keep in mind that the lower your cancer’s stage, the better your outcome is likely to be.
So What's The Next Step?
A Final Word
Treatment Options for
Prostate Cancer
Active Surveillance for
low risk cancer
Prostate Cryoablation
