Prostate Cancer FAQs

A: There are several options for the treatment of prostate cancer that you can explore and discuss with your prostate cancer doctor. Ultimately, you should focus on the best treatment for you and your family. Our advice is to ask questions, get a second opinion if you are uncomfortable with any recommendation, and become an informed patient.

Learn more about treatment options for prostate cancer.

A: The best time to do research is before treatment, so you know what questions to ask. There are several treatment options for prostate cancer that you can explore and discuss more fully with your physician.

A: When the pathologist looks at your prostate cells under a microscope, he or she assigns the Gleason score. The Gleason score determines how aggressive the cancer appears: a score of 2 being the least aggressive and 10 being the most. It is one of the parameters used to determine the best treatment for you. For example, in a patient with a Gleason score of 8 or greater, surgery is no longer considered appropriate.

Learn more about why is a Gleason score so important to prostate cancer patients.

A: Staging considers the tumor size, lymph node involvement, and whether it's spread to other areas of the body. There are two other factors used to determine prostate cancer stage: grade grouping and PSA levels.

PSA is an enzyme that is produced by both normal and cancerous prostate cells and is secreted into the semen. A small amount of PSA is continually leaked into the blood stream, which is measured by the PSA test. A PSA level of 10 usually means your tumor is confined to the prostate. If your PSA is 20, it is more advanced, and surgery is usually not the best option.

Learn how to understand a prostate cancer pathology report.

A: Any treatment for prostate cancer must destroy or remove the entire prostate gland and the prostate cancer cells within, including any cells which may have gotten outside but remain near the prostate gland. The physical exam, the Gleason score, PSA level, as well as your age and overall health, determine which therapies are best for you.

A: Radiation therapy, or radiotherapy, is noninvasive and painless. Radiation treatment kills prostate cancer cells while minimizing damage to healthy cells. Several radiation techniques are used to treat prostate cancer:

• External Beam Radiation Therapy: High-energy X-rays are produced by a machine called a linear accelerator and aimed at the prostate from outside the body. Modern techniques such as ARC therapy, IMRT, and TruBeam precisely target and deliver radiation to the prostate and surrounding high-risk tissues while minimizing the dose to normal tissue. During treatment, the accelerator is turned to the correct angle, and the beam is shaped according to the patient’s prostate shape and size. After treatment is given through one location, the accelerator is turned to a different angle, and this process is repeated until the prostate gland has been crossfired from multiple directions. After the daily treatment is finished, which usually takes less than 10 minutes, the patient can return to normal daily activities.
• Hypofractionated Radiation Therapy: Our radiation oncologists also offer a more advanced approach called hypofractionated radiation therapy that gives the same dose of radiation in a shorter time period. The shorter course of treatment is made possible through the more advanced delivery methods used with this method of radiation. The technology precisely aims the rays of radiation where the cancerous cells are treated with a higher dose while sparing nearby organs and tissues.The same results can be achieved in a 4-5 week course of radiation therapy, rather than 6-8 weeks, by giving a higher dose of radiation at each treatment. The exact number of treatment sessions depends on where the cancer is located, its size, and the patient’s overall health condition.
• Brachytherapy: This type of treatment delivers internal radiation through radioactive “seeds” that are placed directly into or near the tumor. Brachytherapy allows a controlled dose of radiation within a specific region, allowing more radiation where needed while protecting normal tissue.
• Combination of Therapies: Sometimes, a combination of external beam radiation therapy and brachytherapy is the best treatment choice for intermediate or higher-risk cancers.

Your radiation oncologist will explain what type of radiation treatment would be the best fit for you. Cancer Care Centers of Brevard offers radiation therapy for prostate cancer treatment across Brevard County, including Melbourne, Merritt Island, and Palm Bay, Florida, so that it’s convenient for local residents to receive this type of cancer treatment.

A: During a radical prostatectomy, a muscle that controls urine could be cut. This is the primary cause for men experiencing urine leakage after radical prostatectomy, whether the urologist performs traditional or robotic surgery.

With radiation, there is no urinary leakage because the muscle at the apex of the prostate is not cut or removed. Men who had a TURP (“’roto-rooter”) procedure or who have severe urinary urgency, such as leaking urine before they get to the toilet, may have a higher risk of urinary leakage after radiation. In general, urinary leakage is not common after radiation therapy. A highly skilled radiation oncologist, using targeted radiation, can maximize your chance of maintaining sexual function.

A: There are no limits on your activity during treatment, and you may continue your usual lifestyle, which may include work, golf, the gym, or anything else you would like to do.

A: Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. It is a possible treatment option for men with low-risk, early-stage prostate cancer who cannot have surgery or radiation therapy. Cryotherapy is less invasive than surgery and involves a shorter hospital stay, shorter recovery period, and reduced pain. However, there is less information available on its long-term effectiveness compared to other treatments, including radiation therapy.

A: At Cancer Care Centers of Brevard, we use external beam radiation therapy, including TruBeam stereotactic radiation therapy, IMRT (intensity-modulated radiation therapy), and IGRT (image-guided radiation therapy). We also use brachytherapy or HDR brachytherapy (permanent or temporary seed implants) to treat prostate cancer.

A: One of our financial counselors will help you navigate through your insurance coverage and answer any financial questions about the treatment.

A: It is critical that you learn as much as you can about prostate cancer before you begin treating it. We strongly recommend that men employ the following decision-making process:

Post-Diagnosis Recommendations

• Get a copy of your prostate biopsy pathology report and ask your doctors what it means.
• Consider getting a second opinion on your prostate biopsy from a pathologist who is an expert in prostate cancer.
• Learn about prostate cancer from books, magazines, and the internet. Your doctor will help you understand the information you find.
• Consult with both a radiation oncologist and urologist, and do not hesitate to ask for more than one opinion regarding treatment if you have any doubts.
• Select the doctor you are most comfortable with and the treatment that gives you the best chance of cure with the least chance of complications.