HYANNIS – After age 50, prostate cancer becomes a worry for most men, but screening and treatments have improved, according to Hyannis urologist Evangelos Geraniotis, MD.
Treatment depends on the stage of the cancer and how aggressively it is growing, he said.
“Even for advanced cancer, new medications are now available that offer treatment options with good success. We see many men with advanced cancer –men in their 50s to well into their 80s – who are now in remission because of the availability of these new medications.”
For any stage of prostate cancer, treatment is tailored to the individual patient and may involve other specialties, like radiation and medical oncology, said Dr. Geraniotis, who is member of Urology Associates of Cape Cod and practices at Cape Cod Hospital.
“The patient might be managed by three different offices,” he said. “It’s a team approach.”
Several Treatment Options
When treatment becomes necessary, the urologist will recommend the best course, which may involve surgery, radiation or hormone therapy. Treatment options often depend on the patient’s age, the stage of cancer and sometimes the desire of the patient to either have surgery or to avoid surgery, Dr. Geraniotis said.
“Side effects, especially sexual side effects, are often a big concern to many men with prostate cancer who are facing treatment decisions,” he said. “Advances in surgical and radiation technology over the last 10 years have been successful in reducing the incidence of these side effects, another benefit to men who face the challenge of dealing with a newly diagnosed cancer.”
In the early stages, prostate cancer often can be treated and cured with surgery or radiation alone, Dr. Geraniotis said.
“We now have robotic surgery that can be done to remove the prostate and has a high rate of cure,” he said.
Other options are external beam radiation therapy and prostate seed implant therapy, also known as brachytherapy. In an advanced cancer stage – when it has spread beyond the prostate – surgery alone may not be curative, Dr. Geraniotis said.
“Those men will often require additional treatment, such as radiation, hormone therapy and chemotherapy.”
Screening is Still Important
Despite the new and effective treatment options, Dr. Geraniotis fears that many local men are lax about having their prostate checked.
“While it’s true that many prostate cancers are early-stage, low grade tumors that may grow slowly, or not even at all, as urologists, we still feel that men over the age of 50 should be checked on a regular basis. The checkup and exam are very simple and straightforward,” he said.
Prostate screening save lives, a significant fact considering that 30,000 men die of prostate cancer every year, he added.
Because prostate cancer often presents with no symptoms in the early stages, regular testing is crucial.
“Men may have no symptoms at all,” Dr. Geraniotis said.
When there are symptoms, it might be a change in urinary pattern, more difficulty passing urine or sometimes pain with urination or pain in the lower back or pelvic area, he said.
In some cases, such as in those men who have small amounts of slow-growing early stage cancer, treatment may not be required at all. But they still have to be watched closely, Dr. Geraniotis said.
“Many of these low-grade cancers can be monitored with active surveillance, instead of being treated aggressively,” he said. “So instead of radiation or surgery, the man comes in for a checkup every six months, and has periodic biopsies done to make sure the cancer is not growing.”