Prostate Cancer – Treatments

HIFU treatment involves destroying cancer in the prostate by destroying the cancerous cells with focused ultrasound.A probe is inserted into the patient’s rectum under spinal or general anesthesia. The probe can both visualize the prostate and generate focused ultrasound. Treatment can be total (whole prostate is treated), partial (part of the prostate is treated) or focal (only the prostate area affected by the cancer is treated). With focal treatment, the physician will determine the area to be destroyed thanks to the elastic fusion of the diagnostic images (MRI or biopsy) with the real-time ultrasound images allowed by the probe. HIFU treatment lasts between 1:30 and 2:30 and can be performed on an outpatient basis or with a short stay in hospital (1 or 2 nights). This non-invasive technique preserves patient’s quality of life by decreasing the side effects associated with conventional radical treatments (incontinence and erectile dysfunction).

Radical prostatectomy (or total prostatectomy) involves surgically removing of the prostate and the seminal vesicles. It is a major surgery under general anesthesia which requires one or more incisions (cutting of the skin and tissues to reach the organ) according to the technique used (open abdominal or laparoscopic prostatectomy). Hospitalization time varies between 5 and 7 days, then it takes about 3 to 4 weeks to recover. The main side effects are impotence (inability to have or maintain an erection) and incontinence (inability to retain urine).

The patient is subjected to high-dose rays directed at the prostate. These rays destroy the cells by causing lesions in their DNA. The treatment is divided into approximately 40 sessions over a period of 6 to 8 weeks, working on the basis of a five-day week. During each session, which lasts around 20 minutes, the patient remains immobile on the treatment table while the machine delivers the rays. The treatment is painless. The main side effects are impotence (i.e. an inability to achieve or maintain an erection), which can occur even several months after treatment, and intestinal disorders such as pain, colic and bleeding.

Radium therapy, also known as brachytherapy, involves temporarily or permanently implanting between 50 and 100 tiny seeds of radioactive material into the affected area. These seeds constantly emit rays that destroy prostate cells by causing lesions in their DNA. This procedure is performed under general anesthesia. When implanting the seeds, the surgeon is guided by an ultrasound scanner (with a probe inserted into the patient’s rectum). The potential side effects are essentially the same as with external beam radiotherapy.

Cryotherapy is a technique that freezes the prostate by inserting needles that generate temperatures below 0°C. The operation is performed under spinal or general anesthetic. When implanting the seeds, the surgeon is guided by an ultrasound scanner (with a probe inserted into the patient’s rectum)