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Description
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An estimated 50,400 new cases of prostate cancer were diagnosed in France in 2018. Prostate cancer is the most common cancer in men.
Despite a high incidence rate, the majority of prostate cancers can be detected earlier and earlier and treated, giving patients a better chance of recovery, with fewer after-effects. The majority of prostate cancers are adenocarcinomas (90%); they develop from the cells that make up the lining tissue of the prostate (epithelial cells). The tumor is initially limited to the prostate. Over time, the tumor grows and can extend beyond the prostate capsule. |
Treatments
Prostate cancer can be treated in different ways depending on its characteristics. Several modalities can be proposed, alone or in combination: surveillance, surgery, external radiotherapy, brachytherapy, hormone therapy, and chemotherapy.
ACTIVE SURVEILLANCE
A surveillance strategy may be suggested when the tumor is localized and not causing symptoms. This is most often called active surveillance. Its goal is to delay treatment, and the side effects that accompany it, until it is necessary. Indeed, some prostate cancers progress slowly, sometimes for a long time.
SURGERY
It is one of the standard treatments for localized prostate cancer. For low-risk localized tumors, it can be combined with lymph node dissection. This dissection is routine for intermediate-risk tumors and those at high risk of recurrence.
The proposed procedure is a total prostatectomy. It aims to remove the entire prostate gland as well as the seminal vesicles.
RADIOTHERAPY
External radiotherapy, used alone, is one of the standard treatments for low-risk localized prostate cancers. For intermediate-risk localized forms, external radiotherapy may be combined, in certain cases, with short-term hormone therapy (up to 6 months). External radiotherapy is one of the possible treatments for high-risk localized forms; it is the standard treatment for locally advanced cancers.
BRACHYTHERAPY: CUTTING-EDGE TECHNIQUE AT CGFL
The CGFL is one of the few French centers to offer prostate brachytherapy using permanent implants on an outpatient basis to patients with prostate cancer.
This technique involves permanently implanting radioactive seeds into the prostate, under general or spinal anesthesia and in a quantity proportional to the volume of the prostate. These seeds (the size of a grain of rice and as fine as a criterium mine) are composed of a titanium capsule which contains radioactive iodine 125 emitting radiation which will destroy the cancer cells. The radioactivity will gradually decrease over time (6 to 12 months) and the seeds will thus become inert. They will therefore remain permanently in place in the prostate, without danger.
The radiation dose decreases very rapidly as one moves away from the radioactive source, which makes it possible to minimize the dose delivered to nearby healthy organs and therefore limit side effects.
Thus, the radiation emitted at a distance from the prostate and outside the body is practically non-existent, lower than natural radiation or that perceived during a plane trip or a stay in the mountains.
HORMONE THERAPY
Prostate cancer is a so-called hormone-sensitive cancer, meaning its development is stimulated by male hormones. Hormone therapy involves preventing the stimulating action of testosterone on cancer cells to stop the cancer from growing.
CHEMOTHERAPY
Several chemotherapy drugs are available to treat prostate cancer. They can be used successively: these are called treatment lines. When the cancer progresses after an initial hormone-based treatment, new drugs, particularly chemotherapy, may be prescribed to treat it.
