Localised prostate cancer Toowoomba

Localised prostate cancer

diagnosis, treatment and side effects

What is localised prostate cancer?

Diagnosis

When we use the term ‘localised prostate cancer’ it means the cancer has not spread beyond the prostate. It’s discovered before it has grown outside the prostate gland.

In many cases, you won’t experience any symptoms. However, some men develop urinary symptoms and are usually caused by an enlarged prostate.

These symptoms may not be caused by cancer. They include a sudden need to urinate, or having to urinate more often, finding it difficult to urinate, or feeling discomfort when urinating.

Typically, early or localised prostate cancer is discovered during a routine blood test, called PSA or Prostate Specific Antigen test.

If your test results come back high, it doesn’t necessarily mean you have prostate cancer. It simply means you need to undergo more tests and you may be referred to see a urologist who may order more tests.

There’re a few more tests we can do. However, a biopsy is the only way to be sure. We remove small tissue from your prostate, using a very thin, hollow needle guided by an ultrasound scan.

To reach the prostate, there are two options:

Transperineal: through the perineum (the area between the anus and scrotum) – commonest type of procedure. At Toowoomba specialists, we use a robotic biopsy system (Mona Lisa) which fuses the MRI and USS images to direct accurate biopsies resulting in fewer biopsies and even less requirement for repeated biopsies.
Transrectal: through the rectum – usually done for MRI guided biopsy

Treatment

Depending on your individual circumstances, there are a few treatment options.

No treatment or ‘watchful waiting’: if the risks and side-effects outweigh the potential benefits, and the cancer is not aggressive, this approach is often recommended.

Active surveillance: if you have a low-risk for prostate cancer, and the cancer is not growing rapidly or is small in volume. In this case, you are regularly monitored with the PSA test, digital rectal examination test, MRI and occasionally repeated biopsies.

Surgery: if the cancer has not spread, and it’s aggressive, surgery might be recommended.

Radiotherapy: if the cancer has not spread, and it’s aggressive and you may not be suitable for surgery, then radiotherapy may be suggested. This can also be used post-surgery to make sure all cancer cells are removed.

Localised prostate cancer surgery

During prostate cancer surgery, the entire prostate is removed, as well as some tissues surrounding it. This type of surgery is called a Radical prostatectomy. It’s typically offered to healthy men whose cancer is localised.

A Radical prostatectomy can be done in different ways:

Open radical prostatectomy: An incision is made below the belly button towards the pubic bone.
Robotic assisted radical prostatectomy: Small incisions are made, similar to laparoscopic surgery, but more advanced surgical instruments are inserted. These are controlled using a robotic console. At Toowoomba Specialists we offer this service.

Pros and cons of prostate cancer surgery

Pros:

Less chance of urinary incontinence than with surgery
Radiation can kill cancer cells that may have spread beyond the prostate (locally advanced prostate cancer).

Cons:

You will have to make regular visits to hospital over several weeks (for EBRT)
Some side effects may get worse with time
Greater risk of bowel problems than with surgery
Risk of infertility and erectile dysfunction
Need for concurrent hormonal therapy

Side effects of prostate cancer surgery

Temporary or ongoing incontinence: Your ability to control your bladder may be affected. We use pelvic floor exercises to assist with recovery of continence.
Erectile difficulties: The nerves responsible for allowing an erection are on either side of the prostate. If these nerves are removed, erectile difficulties may be ongoing or permanent. If cancer has not spread near these nerves, your surgeon will perform a ‘nerve-sparing’ procedure. Active penile rehabilitation is used to assist with this.
Change in penis size: It is possible that your penis is reduced in length and width, while soft or erect.
Infertility: Surgery will cause infertility. If you still want a family or extend your current family, we will discuss sperm freezing.

Localised prostate cancer radiotherapy

During radiotherapy the cancer cells are targeted and destroyed using a high-energy radiation beam.

There are two main types of radiotherapy:

External beam radiotherapy (EBRT): High-energy X-ray beams are used from outside the body. Typically, the treatment in the hospital lasts 7 weeks.
Brachytherapy: Tiny, radioactive seeds or pellets are implanted directly into the prostate tissue. They emit radiation that kills the cancer cells.

Pros and cons of radiotherapy

Pros:

Less chance of urinary incontinence than with surgery
Radiation can kill cancer cells that may have spread beyond the prostate (locally advanced prostate cancer).

Cons:

You will have to make regular visits to hospital over several weeks (for EBRT)
Some side effects may get worse with time
Greater risk of bowel problems than with surgery
Risk of infertility and erectile dysfunction
Need for concurrent hormonal therapy

Side effects of radiotherapy

Bowel and urinary problems: Radiation can affect the bowel and bladder as they are located close to the prostate
Fatigue (EBRT only): Your energy levels may drop during and shortly after therapy
Skin changes: Your skin may become dry and itchy, sometimes you may see it gets darker too
Sexual difficulties: The treatment can damage the nerves responsible for having erections. Ejaculation may become painful and you may notice less semen or no semen at all
Infertility: Radiotherapy may damage the cells that produce the semen. If you want a family or extend your family, we will talk about sperm freezing.

Access support groups and multidisciplinary services

It is normal to feel angry, frustrated, resentment or anxious. Being diagnosed with prostate cancer is distressing and overwhelming. Chances are that you are not the only one going through a range of emotions and feelings.

Many people in your circumstances join a support group to feel a sense of belonging and be in a community of people who are going through the same.

There are other forms of support available as well. Under the Medicare Benefits Schedule (MBS), people who have a chronic medical condition such as cancer and who need a multidisciplinary approach are able to access the following services (see www.health.gov.au):

Aboriginal and Torres Strait Islander health practitioner,
Aboriginal health worker,
Diabetes educator,
Dietitian,
Exercise physiologist,
Mental health worker,
Occupational therapist,
Physiotherapist,
Psychologist

Toowoomba Specialists for localised prostate cancer

At Toowoomba Specialists, our team of experienced urologists, specialise in the diagnosis and treatment of prostate cancer. We offer advanced medical interventions, including open, minimally invasive procedures and robot assisted procedures. Ask your GP for a referral and contact Toowoomba Specialists today to schedule a consultation.

Request an appointment

Previous slide

Next slide

Call reception to make an appointment

Abi and Chloe are Toowoomba Specialists’ receptionists.

They will be happy to arrange an appointment over the phone. Call her today.

Request an appointment via email

"*" indicates required fields

Personal details*

First name Last name

Email*

Email address

Phone*

Phone

Your date of birth*

Preferred contact method*

Phone

Upload your referral*

Accepted file types: jpg, png, pdf, Max. file size: 3 MB.

Help us prevent spam*

Before you can send the form, please answer this question. A Panda is black and .....

Localised prostate cancer Toowoomba