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Prostate Cancer Treatment

Lawrence A. Fish, M.D., F.A.C.S. Felix L. Badillo, M.D., F.A.C.S. Leonard Mondschein, M.D., F.A.C.S. Gary Goldberg, M.D., F.A.C.S. Christopher Johnson, M.D. Keith D. Bloom, M.D.

Prostatic Ultrasound & Biopsy Instructions

Prostate Cancer

When your PSA Level goes up, or your doctor feels an abnormality of your prostate gland, a biopsy needs to be done. It is an office procedure done under local anesthesia in which an ultrasound probe is placed in the rectum, pictures of the prostate are taken, and then 8 to 12 samples of the prostate are taken. If the biopsy is positive, your doctor may want to do a bone scan and a computerized tomography (CAT) scan of your abdomen and pelvis to rule out any spread to the bones or lymph nodes. This will also help rule out any other abnormalities.

The discussion you have with your doctor after the diagnosis is made is most important. You should know the following information:

1. PSA Level
2. Gleason grade of cancer
3. Stage of cancer
4. Of the number of biopsies, the number that are positive

Your age and general health are also important in having a proper discussion about treatment. Based on all of this information, you are placed in one of the following categories:

1. Low risk
2. Intermediate risk
3. High risk

The next discussion should be about a treatment plan. There are four main areas of treatment for prostate cancer.

1. Watchful waiting
2. Hormonal therapy
3. Surgery
   1. Radical prostatectomy (nervesparing)
   2. Robotic radical prostatectomy
4. Radiation Therapy
   1. External beam conformal radiotherapy or intensity-modulated radiation therapy
   2. Radiation seed implantation (brachytherapy)
      I- 125
      Pd-103
   3. Combination external beam with seeds and hormonal downsizing

You should ask your doctor about the complications for each of these treatments and the degree to which they can occur with each treatment. Complications include:

1. Incontinence
2. Impotence
3. Voiding symptoms (burning, frequency, urgency)
4. Urinary retention
5. Rectal bleeding

Pictured below is an example of a "treatment concerns" form that we have created. Please download a copy to print out, fill in, and bring with you to your appointment.

Features
Robotic Surgery	CAT Scan	Sexual Dysfunction	Male Infertility
Vasectomy	Pathology Lab	Female Incontinence	Clinical Trials

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Urology Associates, P.C.
535 Plandome Rd.
Manhasset, NY 11030
Tel: 516.627.6188
Fax: 516.627.9397
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www.urologyassociatespc.com

Urologists on Long Island, New York

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