Prostate Cancer

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When the diagnosis is prostate cancer, North Knoxville Medical Center understands that men may have particular physical, emotional and sexual health issues and concerns. We are committed to addressing these issues and concerns, while providing services tailored to your needs:

• Dedicated staff focused on treating men's medical issues with quality, compassion and integrity
• Patient-centered care combining medical treatments, technology and techniques
• Physicians in constant pursuit of excellence with a commitment to improving outcomes
• Multidisciplinary prostate cancer team: urologists, radiation oncologists and a patient advocate
• Adherence to proven best practices and protocols of care
• Patients and families empowered with information and knowledge about choices

Active Surveillance
The concept of active surveillance, or watchful waiting, has increasingly emerged in recent years as a viable option for men who decide not to undergo immediate surgery or radiation therapy. During active surveillance, prostate cancer is carefully monitored for signs of progression. A PSA blood test and digital rectal exam (DRE) are usually administered periodically along with a repeat biopsy of the prostate at one year and then at specific intervals thereafter. If symptoms develop, or if tests indicate the cancer is growing, treatment might be warranted.

Robotic-assisted Prostatectomy
A prostatectomy using robotic-assisted surgery is a minimally invasive procedure that removes the cancerous prostate gland and related structures. This type of prostatectomy offers patients many potential benefits over traditional open surgery. Robotic-assisted surgery refers to minimally invasive procedures that utilize and combine robot technology and 3D imaging. The controls and surgical tools are guided by the skilled hands of a qualified surgeon, and provide pinpoint robotic precision. With the aid of high-definition 3D imaging, the surgeon is able to perform highly complex procedures with greater accuracy. Robotic-assisted surgeries require much smaller incisions and significantly reduce pain, scarring, blood loss and recovery time, while improving patient outcomes.

Open Radical Prostatectomy
A radical prostatectomy is the traditional operation to remove the prostate gland for cancer treatment. During this surgery, a single incision is made in the lower abdomen to reach the prostate gland.

Bracytherapy
Brachytherapy treats cancer by placing radioactive sources directly into or next to the area requiring treatment. This enables clinicians to deliver a high dose with minimal impact on surrounding healthy tissues. Brachytherapy has proven to be a highly successful treatment for cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, head and neck, as well as soft tissue sarcomas and several other types of cancer.

External Beam Radiation Therapy
External beam radiation therapy (EBRT) remains one of the primary treatments for patients with localized or locally advanced prostate cancer. With the evolution of improved computer-based treatment planning, conventional radiotherapy techniques have largely been supplanted by modern techniques such as 3-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and image-guided radiotherapy (IGRT). The advantages of the modern approaches lie in their ability to escalate the tumor dose (thus enhancing disease control) while minimizing toxicity to normal tissue.

Cryosurgery
Cryosurgery (also called cryotherapy or cryoablation) is sometimes used to treat early stage prostate cancer by freezing it. As with brachytherapy, this may not be a good option for men with large prostate glands. In this approach, several hollow probes (needles) are placed through the skin between the anus and scrotum. The doctor guides them into the prostate using transrectal ultrasound (TRUS). This type of procedure requires spinal or epidural anesthesia (where the lower half of your body is numbed) or general anesthesia (where you are asleep).

Hormone Therapy
Hormone therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to prevent them from reaching prostate cancer cells. The main androgens are testosterone and dihydrotestosterone (DHT). Androgens, which are made mainly in the testicles, stimulate prostate cancer cells to grow. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. However, hormone therapy alone does not cure prostate cancer.

Hormone therapy may be used:

• If you are not able to have surgery or radiation or can’t be cured by these treatments because the cancer has already spread beyond the prostate gland.
• If your cancer remains or comes back after treatment with surgery or radiation therapy.
• Along with radiation therapy as initial treatment if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level and/or growth of the cancer outside the prostate).
• Before radiation to try to shrink the cancer to make treatment more effective.