Surgical Treatment for Prostate Cancer
SAH offers patients a range of surgical options. The best option for you should be determined in discussion with your surgeon.
Our state-of-the-art da Vinci Surgical Robot is the next evolutionary step forward from Laparoscopic Surgery. The Robot enables surgeons to perform traditional open procedures such as radical prostatectomy through a minimally invasive route. Surgeons operate through just a few small incisions, with magnified 3D high-definition vision and tiny wristed instruments that translate surgeons hand movements into smaller, precise movements of tiny instruments. As a result, da Vinci enables surgeons to operate with enhanced vision, precision and control allowing surgical precision and meticulous preservation of important nerves and blood vessels.
Open Radical Prostatectomy
The traditional method of radical prostatectomy is a surgical procedure through which the prostate gland is removed through an incision in the abdomen. The aim is to remove as much of the tumour as possible, therefore the entire prostate gland, both seminal vesicles, pelvic lymph nodes as well as surrounding tissue affected by the tumour can be removed.
Radiation therapy is the use of high energy x-rays to eliminate or reduce cancer cells. Modern radiation therapy techniques focus on accurately and precisely targeting the cancer while sparing the healthy tissue and organs around the cancer as much as possible.
The Radiation Oncology Centres at the San has 4 bunkers with cutting edge technology – making it NSW's largest private radiotherapy treatment centre and providing patients with access to the most advanced radiation treatment in Australia.
The TomoTherapy Edge equipment provides treatment in just a few short minutes, greatly minimises side effects and can treat multiple tumours simultaneously. TomoTherapy technology allows the retreatment of patients who otherwise could not have further radiation treatment on standard equipment. It is highly accurate for prostate cancer treatment as a CT image is taken prior to every treatment which allows for much greater precision.
The ROC is also home to two Varian Silhouette machines providing Stereotactic (focussed radiation beams to target specific areas with extreme accuracy so that other tissues are not impacted), Volumatic Modulated Arc Therapy (VMAT) which increases speed of treatment and delivers the treatment helically across many beam angles. Intensity Modulated Radiation Therapy (IMRT) allows for a more conformal dose to the tumour by modulating or controlling the intensity of the radiation beam in multiple small volumes.
Radiation Oncology Centres provides High Dose and Low Dose Brachytherapy for prostate patients with a dedicated brachytherapy bunker.
Low Dose Rate (LDR) / 'Seed' Implant Brachytherapy
LDR or 'seed' implant brachytherapy involves the insertion of permanent radioactive 'seeds' directly into the prostate. The 'seeds' give off a localised radiation to the entire prostate with the aim of destroying the cancer cells, and the radiation is limited to the prostate and only a few millimetres around it. LDR brachytherapy is generally a treatment for men with localised prostate cancer.
High Dose Rate (HDR) Brachytherapy
HDR brachytherapy provides a very precise high dose radiation treatment, given over a shorter time-frame than when a course of external beam radiation therapy (EBRT) is used alone. It reduces the exposure of surrounding tissues to radiation. HDR treatment involves having a procedure to place implant catheters into the prostate gland through the perineum. Radiation is then transmitted through these implant catheters directly into the prostate gland. Unlike LDR brachytherapy, the placement of the material is temporary and for shorter periods.
Medical Treatment for Prostate Cancer
Hormone Replacement Therapy
Hormone therapy is used to supress the progression of prostate disease, and in the treatment of cancers that have spread beyond the prostate. Hormone therapy aims to limit the cancers access to hormones that stimulate growth, such as testosterone, and therefore reduce the growth of, or shrink, the tumour. Patients receiving hormone therapy may experience a reduction in their symptoms and possibly in the size of their tumour that may last for a number of years. Reducing the size of the tumour is also used when planning radiation therapy or for surgical removal.
Your doctor may recommend medication (which can be oral or intravenous) to attack cancer cells. Some cancers can be cured by chemotherapy alone or chemotherapy can be used before or after other treatments and for palliative treatment.
Comprehensive day infusion services are provided for a range of chronic illnesses at our Day Infusion Centre. Located in the San Integrated Cancer Centre this new centre is spacious and restful, overlooking the Healing Garden. Specialist nursing teams care for day infusion patients in luxurious comfort with the most up to date equipment and treatments.
Clinical Trials can offer suitable patients access to the most up-to-date treatments which aren’t currently publicly available. Working with oncologists and MDTs, patients are referred to a clinical trial where appropriate. The San Clinical Trials Unit has many trials currently underway and in recruitment, and works with leading specialists and academics to remain at the forefront of research and treatment options.
Other Treatments for Prostate Cancer
During active surveillance a doctor monitors the tumour and its growth on a strict schedule. At each visit tests are done to check PSA (prostate-specific antigen) levels in the blood, and patients switch to other treatment options if there are signs that the disease is progressing. Active surveillance is a treatment pathway for patients with localised, low-grade prostate cancer.
Watchful waiting is a way of monitoring prostate cancer that isn't causing any symptoms or problems. The aim is to keep an eye on the cancer over the long term, and avoid treatment unless patients get symptoms.
Orchidectomy (or Orchiectomy) is method of surgical castration in which both testicles are removed. It is a form of hormone therapy to stop the production of testosterone.
Surgical Treatment for Enlarged Prostate (Benign Prostate Hyperplasia / BPH)
GreenLight Laser Prostatectomy allows vaporisation of tissue and simultaneously seals the tissue resulting in an almost bloodless procedure with advantages including a significant reduction in the likelihood of bleeding, significant reduction in catheterisation times, hospital stay and complication rates.
Bipolar Transurethral Resection (TURP)
TURP is a common procedure for surgical management of lower urinary tract symptoms associated with BPH. The Gyrus PlasmaKinetic system uses bipolar technology and saline solution, and has been seen to significantly reduce complications seen with the traditional monopolar system, such as bleeding and TUR syndrome. It allows patients with serious medical conditions and comorbidities, and those on certain medications such as blood-thinners to undergo the TURP procedure with fewer complications.
However, the traditional Monopolar TURP is still performed if it is deemed by surgeons to be the best treatment option for patients.
UroLift is a new minimally invasive treatment for men suffering urinary symptoms related to BPH. The UroLift system involves the insertion of small permament implants that create a passage in the middle of an obstructed prostate, resulting in a significant improvement in urinary function. The benefits appear to be significantly stronger than medical therapies whilst potentially avoiding some of the complications associated with surgery, bleeding, retrograde ejaculation or erectile dysfunction.