Prostate Cancer Program Offers Breadth of Treatment
Abstract: The Prostate Cancer Program at Wake Forest Baptist complements a full spectrum of therapies with translational research trials exploring future diagnostic and therapeutic options. Diagnosed early, prostate cancer is highly curable with numerous treatment options.
From Clinical Update, Spring 2008
When facing prostate cancer, having access to a comprehensive Prostate Cancer Program helps to assure patients of the best possible outcome. Wake Forest Baptist offers a comprehensive and collaborative program with a full spectrum of treatment options and integrates research with clinical care.
Members of the program monitor the results of each approach and discuss patient cases during bi-weekly multidisciplinary conferences to provide better clarity for future decisions. They also conduct research leading to new therapies and better diagnostic methods, and make experimental treatments available to high-risk patients through clinical trials.
If diagnosed and treated early, it is a cancer that is highly curable—and one for which there are many treatment options, each with its own pros and cons when it comes to efficacy and quality of life impact.
“Our belief is that there is no one therapy that is right for everyone, and that it is very important to tailor treatment to the patient’s grade and stage of the tumor, age, functional status, expectations, personality and lifestyle,” said Ashok K. Hemal, M.D., professor of urology and director of robotic surgery.
For many men with early-stage prostate cancer, the robotically assisted laparoscopic radical prostatectomy has emerged as an attractive option. Hemal, who has performed several hundred of these surgeries, is achieving results that are equivalent to the traditional open surgical approach to nerve-sparing radical prostatectomy.
“The ability to achieve outcomes that are comparable to conventional surgery in eliminating the cancer while preserving sexual function and urinary continence makes this modality an attractive option for many patients with localized prostate cancer,” said Hemal. It offers the additional advantages of shorter hospital stay and recuperation and less blood loss and pain.
In addition to Hemal, the urologic oncology surgeons include Drs. Karim Kader, Joseph Pettus and John Smith.
Radiation oncology serves a critical role in treating prostate cancer patients either as the primary therapy or in concert with surgery. Wake Forest Baptist offers the most technologically advanced therapies available, including Intensity Modulated Radiation Therapy (IMRT), Image Guided Radiation Therapy (IGRT) and High Dose Rate (HDR) brachytherapy.
Since the prostate is not a static organ and moves within the pelvis, IGRT allows accurate placement of the radiation beams to spare tissue in the bladder, rectum and penile bulb. Implantation of three gold chips in the prostate enables technicians to pinpoint the exact location of the prostate prior to each treatment.
For appropriate patients, HDR brachytherapy can be used alone, as an adjunct to external beam radiation or as salvage brachytherapy for patients who have failed external beam radiation or have recurrent disease. Salvage brachytherapy offers the advantage of maintaining more erectile function and urinary continence than other therapies such as cryotherapy.
“The beauty of our program is that we offer a full spectrum of therapies and we also are actively involved in translational research trials exploring future diagnostic and therapeutic options,” said radiation oncologist Daniel Fried, M.D.
From hormonal therapy studies, to the study of preventive therapies like soy and vitamin D, to imaging studies focusing on better staging of prostate cancers, the goal of the prostate cancer team at Wake Forest Baptist is to improve the outcomes and quality of life for all prostate cancer patients.