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PROSTATE CANCER (**TREATMENTS (Hormonal (Advanced age, Poor health,…
PROSTATE CANCER
**TREATMENTS
Watchful Waiting
Low grade & stage
Low PSA velocity
Low PSA
Hormonal
Advanced age
Poor health
Metastasized (spreaded)
Injection
Oral
Radiotherapy
External beams
IMRT/IGRT
Low radiation dosage
Sessions 35 to 41
Internal beams (Brachy)
High radiation dosage
Targetted radiation
Less sessions
SBRT (new)
Singapore trial, 2016
Only 5 sessions
Low stage & grade
Incontinence & impotency risks
Chemotherapy
Cancer has metastasized to other organs
Infusion
Oral
HIFU (new)
tumour within prostate
Low grade & stage
Immunology (new
)
Under trial
Prostatectomy (Surgery)
Da Vinci (Robotic)
Shorter recovery time
Health & age (<70 yrs)
Incontinence & impotency risks
Open surgery
Not suitable for robotic
Health & age
Long recovery time
Tumour within prostate
Incontinence & impotency risks
**TESTS
DRE
Blood
PSA
30% reliable
Other causes
PHI (new)
Low PSA (4 to 10)
Better biopsy decision-making
Biopsy
TRUS
Transperineal (Mona Lisa)
PI-RADS with MRI (new)
Stage & Grade
Gleasons Score
ISUP (new)
**SYMPTOMS
Abnormal urination issues
Frequent nocturnal urination
December 2017_TTJ