Page 202 - Urological Health

What to do if the cancer comes back after radiation therapy

Hormone therapy is often considered the standard treatment for cancer recurrence after radiation
therapy. Again, if the recurrence is slow-growing, you may choose to delay treatment.

In rare cases, treatment of the prostate may be suggested and this may include radical
prostatectomy or other newer therapies, such as cryotherapy or HIFU, but only if the doctor is
convinced that the recurrence is limited to the prostate gland. These approaches cause more
pronounced side effects than when used as first-line treatment.

Since the long-term effectiveness of these treatments are still unknown, they are offered in only a
few Canadian health centres. Other forms of investigational therapy are being tested, so there may be
more choices in the future.

Quick definitions

Cryotherapy
• When your doctor uses an extremely cold liquid or instrument to freeze and destroy abnormal
skin cells that need to be removed.
• The procedure involves inserting probes containing liquid nitrogen through the perineum (the
UNDER REVIEW
area between the testicles and the rectum) into the prostate to freeze the gland and destroy
the cancerous cells.
HIFU
• HIFU means high-intensity focused ultrasound surgery.This is a method that focuses ultrasound
to heat/vaporize target tissue without injuring the surrounding structures or organs.
• HIFU involves an ultrasound probe that sends intense heat to the prostate in the hope of
destroying the prostatic tissue and the cancer within.

ADVANCED PROSTATE CANCER

Advanced prostate cancer includes patients whose cancer has come back after initial therapy or
patients who already have cancer that has spread beyond the prostate.
In most cases the best treatment for advanced prostate cancer is still hormone therapy
(elimination of androgens [the male sex hormone] or androgen deprivation therapy).When the cancer
still grows while you are on hormone therapy, this means that your cancer is at its most advanced
stage. Until recently, few options were available but over the last three years new effective therapies
have become available that have given hope to patients.

Interesting fact
In the early 1940s, Dr. Charles Brenton Huggins discovered that prostate cancer depended
on male hormones to grow. He discovered that destroying these hormones would induce
remission of the disease.This breakthrough profoundly changed the treatment of prostate
cancer and earned him the Nobel Prize for Medicine in 1966.

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