At Home Christian Jessen 2014 - 203

Prostate
| slug
cancer |
guide

had negative or inconclusive results from other biopsy
methods will be more effectively diagnosed with
prostate cancer using this procedure.'
Performed under general anaesthetic, it involves the
insertion of many fine needles though the skin between
the scrotum and the anus in order to obtain tissue
samples from the prostate for testing. Where possible,
it is usally preceded by magnetic resonance imaging
(MRI) scanning, which allows specific targeting of the
cancer identified by the MRI during the transperineal
template biopsy. According to Nuada Medical services
(www.nuadamedical.co.uk): 'A 3T MRI scanner has
the best capabilities for tumour identification and
characterisation during all steps of disease management
- screening, surgery planning, therapy monitoring and
follow up. By providing metabolic and diffusion
information, MR goes beyond pure imaging. People
have a better chance of receiving an accurate diagnosis
which will help decide the most appropriate treatment.'
It is used specifically for men who have a raised PSA
and may be followed by a prostate biopsy if necessary,
or if a patient has a raised PsA or other risk factors
for developing prostate cancer, but biopsies have
not detected any cancer so far.

5-10%
of prosTaTe cancers are
ThoughT To be sTrongly
linked To an inheriTed risk

Tr e aT i T

Depending on what stage the cancer is, the doctor will
discuss the best course of treatment and the possible
side effects. For some men, an option may be to have
no treatment but to monitor the cancer closely. Doctors
call this 'active surveillance' or 'watchful waiting'.
Radiotherapy uses high energy rays to treat cancer
- radical radiotherapy is used on the prostate gland and
is used for localised prostate cancer mainly, when it has
not spread. Internal radiotherapy (brachytherapy) is
when radiotherapy is used inside the prostate gland.
Hormone treatment therapy is another treatment
for prostate cancer. Hormones control the growth and
activity of normal cells but cancer of the prostate gland
depends on the male hormone testosterone to grow.
That means that lowering the amount of testosterone
in the body can reduce the chance of an early prostate
cancer coming back after treatment. Or it can shrink
an advanced prostate tumour down or slow its growth.

dr
chrisTian
says

'Very early prostate
cancer generally
does not cause any
symptoms at all,
but important
things to look out
for include having
to rush to the loo
to pee, going more
often, especially
at night, difficulty
stopping or starting
peeing, pain, and
blood in the
urine or semen
- although the last
two are very rare
in prostate cancer.'

Cryotherapy, when cancer cells are frozen away, is
another treatment method and steroids and chemotherapy
are often used if the cancer has spread out of the
prostate gland into other parts of the body.
surgery is another option. The prostate gland may
be removed - this is called total prostatectomy or radical
prostatectomy or the testicles may be removed in
a procedure called orchidectomy. This operation
removes both testicles so that they cannot produce
testosterone any more. This can shrink a locally advanced
cancer, which has spread into the area around the
prostate gland, or stop it from growing. A transurethral
resection (TuR) is when part of the inner area of the
prostate gland is removed from around the urethra and
this can relieve symptoms such as being unable to urinate.
High intensity focused ultrasound or HIFu has been
in use by doctors for nearly 50 years but it is only
recently that they have been investigating it as a
treatment for prostate cancer. The treatment is given
using a machine that gives off high frequency sound
waves. These waves deliver a strong beam to a specific
part of a cancer. some cells die when this high intensity
ultrasound beam is focused directly onto them.
One advantage of this type of treatment is that
because it only uses sound waves to kill the cancer cells,
it doesn't have as many side effects as other types of
cancer treatments already in use. When it comes to
prostate cancer HIFu has been hailed a major step
forward in fighting the disease. The procedure, which
sees patients leave hospital the same day, allows surgeons
to focus high frequency beam of ultrasound wave
directly on to tumours in the prostate gland without
affecting healthy surrounding tissue. While conventional
treatments such as invasive surgery to remove the whole
prostate or radiotherapy can effectively treat tumours,
men often suffer side effects such as incontinence or
impotence. And, unlike radiation, HIFu uses clean

'high inTensiTy focused
ulTrasound only uses
sound waves, so iT doesn'T
have as many side effecTs as
oTher Types of TreaTmenTs'
energy, so the procedure can be repeated, if necessary,
without damaging healthy tissue.
Tim Dudderidge, consultant urological surgeon at
southampton general Hospital, who treats appropriate
patients with HIFU, says: 'This technique is truly
revolutionary in that it acts in such a targeted way, where
we are able to focus sound waves of up to 80oC heat on
areas the size of a grain of rice. Early study data has
shown the treatment to be very effective at treating
tumours while also minimising damage to surrounding
tissue and, as a result, reducing the risk of serious side
effects such as impotence and incontinence.' At the
moment, this treatment can only be offered to patients as
part of a clinical trial, according to NICE guidelines.
www.athomemagazine.co.uk JULY 2014 | 203


http://www.nuadamedical.co.uk http://www.athomemagazine.co.uk

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