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September 19, 2006 > Menís Health Starts with Awareness

Menís Health Starts with Awareness

Seminar Focuses on Radiation Treatment for Prostate Cancer

by Washington Hospital

The fact is that a high percentage of men will die with prostate cancer, but here is the key: most men do not die from it. Awareness of the second most prevalent form of cancer in men – second only to skin cancer – is important because it is highly treatable, especially in early stages. In fact, during the last 20 years, according to the Centers for Disease Control and Prevention (CDC), the survival rate for prostate cancer has increased from 67 percent to 97 percent.

On September 26, Dr. Michael Bastasch, a radiation oncologist at the Washington Radiation Oncology Center, will present a free Health & Wellness seminar about prostate cancer and one of its primary forms of treatment, radiation therapy.

“Most men, if they live long enough, are at a very high risk of developing prostate cancer, which is not the same as dying of it,” Dr. Bastasch says.

“It’s a cancer that is driven by the male hormone testosterone. As the gland grows under the influence of testosterone, combined with genetic errors that develop over time, it can lead to prostate cancer.”

Unlike women, who undergo menopause, men for the most part do not experience a reduction in hormones. This constant exposure to testosterone, Dr. Bastasch explains, puts them at a higher risk for prostate cancer.

An early diagnosis means a better prognosis

A majority of men, he says, are very aware of the prostate – thanks to digital rectal examination (DRE) and the prostate-specific antigen (PSA) test. In the case of the DRE, which has been used for many years, the physician inserts a gloved finger into the rectum to feel for abnormalities. The prostate-specific antigen test is a blood test that measures a blood marker produced by the prostate.

“With routine PSA testing, patients are diagnosed earlier with less advanced disease, similar to routine screening mammograms for breast cancer in women,” Dr. Bastasch says. “You catch the disease earlier, which gives patients more choices in terms of treatment.”

There are three main avenues of treatment after diagnosis: surgical removal of the prostate, radiation therapy and observation. Since no single option is universally superior or inferior, Dr. Bastasch says it’s important for men to understand fully the advantages and disadvantages of each treatment. To do this, he highly recommends talking to both a surgeon and a radiation oncologist about surgery and radiation treatment, respectively.

“It’s useful for patients to meet with physicians who are familiar with the different forms of treatment,” he says. “Patients should talk to a surgeon and talk to a radiation oncologist since these are completely different therapies.” The third option, which many men – depending on their age and medical history – choose, is to track the progression of the cancer under the supervision of a physician.

Understanding the risks

In the case of surgery, the prostate is removed and the urethra is reconnected to the bladder. The patient is discharged several days later with potential complications that include surgical risks, bleeding, infection and risk of suffering incontinence, Dr. Bastasch says.

Radiation treatment involves daily treatment for about two months with the risk of suffering mild to acute side effects to the rectum and the bladder, impaired rectal function and/or rectal bleeding.

Erectile dysfunction (ED) has been linked to both radiation and surgery. Dr. Bastasch says it’s difficult to compare the rates of ED between the two treatments because patients who opt for surgical intervention tend to be younger, while those who choose radiation usually fall within an older age group that often reports a higher incidence of impotence due to age. “With technology in both radiation and surgery advancing – remember, nothing is static – the rates of side effects will decrease across the board for both treatments,” Dr. Bastasch says.

With the outcomes of both surgery and radiation therapy being very similar, Dr. Bastasch says this often makes the decision of which treatment to pursue more difficult for the patient.

Early signs of potential trouble Early symptoms of prostate cancer can include benign prostatic hypertrophy, also known as enlarged prostate, which can lead to difficulty urinating, increasing episodes of waking up at night to urinate, and difficulty eliminating all the urine in the bladder.

“In early stages, prostate cancer is very curable,” says Dr. Bastasch. “It could take up to 10 years before someone dies from prostate cancer. It’s a very different disease from breast cancer, for instance.”

Generally, a rectal exam and PSA testing (e.g., those without family history of early prostate cancer) is recommended for men beginning at age 50. The rectal exam, according to Dr. Bastasch, also helps to screen for low rectal cancers too.

Radiation therapy, which Dr. Bastasch will discuss in detail during his seminar, involves different approaches.

Brachytherapy, also known as interstitial radiation therapy or seed implant therapy, is ideal in early stage patients, he says. This treatment is a minimally invasive procedure in which the physician implants permanent radioactive seeds into the prostate where they irradiate the cancer from inside the gland. As small as a grain of rice, they are not felt by the patient.

Another form of radiation therapy, external beam radiation therapy, is used oftentimes in more advanced stages of the disease, according to Dr. Bastasch, when there is higher risk that the disease has spread outside the prostate gland.

Local cancer care for more than two decades

“The goal of radiation therapy is to eliminate the prostate cancer cells,” he says. “The physician can monitor progress using the PSA level. It can take up to two years to hit its lowest point,” Dr. Bastasch explains with the following disclaimer: “When you undergo treatment with radiation you should never take one PSA value in a vacuum. You should take it in the context of multiple other values, spaced apart. You need to say, ‘This level is elevated so let’s wait a month or two and check it again.’ It’s always necessary to take into account lab error.”

The Washington Radiation Oncology Center has been treating patients for more than 20 years, and having local cancer treatment services is of the utmost importance, especially in the case of radiation therapy, because it requires long-term daily treatments, according to Dr. Bastasch. “Prostate cancer affects many people,” he says. “Simply out of convenience, it’s not realistic to have people travel long distances for treatment. It’s important to have local resources available.”

Knowledge is power To learn more about prostate cancer and its treatment, plan on attending the free Health & Wellness seminar being presented by Dr. Bastasch on Tuesday, Sept. 26, from 1 to 2 p.m., in Rooms A & B of the Conrad E. Anderson, M.D. Auditorium in the Washington West building located at 2500 Mowry Avenue in Fremont across the street from the main hospital. To register for this class, call Washington Hospital’s toll free Health Connection line at (800) 963-7070.

To view past Health & Wellness classes, visit, click on “For Our Community,” select “Health Classes & Support Groups” and choose “Videostream of Past Classes.” You can also tune into Washington Hospital’s InHealth Channel, Comcast Channel 78, to view original programming about your local community hospital.

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