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New Treatments for Prostate Cancer

Prostate cancer strikes almost 200,000 men a year in the United States, and kills 40,000 a year. Now there are new developments in targeting and treatment of the disease that are improving the odds for those who do get it. Our health correspondent Dr. Emily Senay explains.

Prostate cancer is one of the more treatable cancers, isn't it?

Yes. Prostate cancer has an excellent cure rate for those cases that are detected early. And with a routine blood test called a PSA test, detection is not difficult these days. Once a patient is diagnosed, the next step is for doctors to find out exactly where in the prostate the cancer is, and how far it's spread.

A new test, known as 'prostascint,' uses several imaging techniques combined, including the injection of a radioactive liquid that binds specifically to prostate cancer cells and highlights their exact location. A computer generates a 3D image, which allows doctors to target the cancer more accurately, even if it has spread beyond the pelvic area.

What are the best ways to treat prostate cancer?

There are different kinds of treatment available for prostate cancer. The most common is surgery to remove the prostate and radiation therapy. From either an external beam, which is directed at the cancer from outside the body, or little seeds, which are implanted in the prostate to burn the cancer away from within.

These are the first-line defense against prostate cancer, but in some cases the cancer comes back; and for many of those people, further surgery or radiation is not an option anymore.

For those men, hormone therapy or chemotherapy can slow down the spread of the cancer, but a treatment that's gaining a lot more attention these days as a second line of defense is cryosurgery.

It's a procedure that's been around for a while, where instead of burning the tumor cells away with radiation, the surgeon injects super-cool gas that forms a bubble around the tumor to freeze the cancer cells to death. Doctors monitor the progress using ultrasound.

It's a procedure that's making a comeback because of new minimally invasive techniques. Incisions are much tinier than they were in the past. And better imaging techniques make it possible to deliver the freeze much more accurately. So it's more attractive for patients and doctors.

Can cryosurgery be used as a first line of defense?

Medicare will pay for it when it's a localized cancer that hasn't spread and as a second-line treatment when the others fail. It all depends on the individual case. For instance, patients who are much older and have a localized, slow-growing cancer don't always get immediate radical treatment. That's because the cancer may not as big a risk for them as other health issues, and surgery can be very debilitating for older folks. But because the cryosurgery is less radical with a short recovery time, it might be a good option for those patients who eventually do require reatment.

How well does cryosurgery work and where is it available?

It doesn't work in all cases, and it still needs to be studied further to make any firm conclusions. But recent studies have shown that the treatment is very effective. You need to ask your doctor or a cancer center near you. It's not as widely available yet, but now that it's less invasive and insurance pays for it, the hope is that someday soon you won't have to travel too far to get it.
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