Published on January 10, 2018
When is surgery used to treat prostate cancer? Leading expert Dr. Celestia Higano from Seattle Cancer Care Alliance explains the different stages of prostate cancer, including localized, locally advanced and metastatic disease. Watch to hear Dr. Higano's opinion on surgery's role treating different types of prostate cancer.
This is a Patient Empowerment Network program produced by Patient Power in partnership with Seattle Cancer Care Alliance. We thank Astellas and Sanofi for their support.
Transcript | The Role of Surgery in Treating Prostate Cancer
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We’ve got this slide up right now for our audience to see. What is on this slide is what we do now. Is it safe to say this is the standard of care? Let’s talk about the first one, doctor. “A surgical approach to advanced prostate cancer”—what does that mean, and what does that entail?
Well, that’s a little bit of a loaded question because it depends on what you mean by “advanced prostate cancer,” and I think it’s important to distinguish what that means when you’re talking about it. If you mean that “advanced” means locally advanced, so there’s cancer in the prostate and perhaps in the neighboring lymph nodes, that’s one kind of advanced.
But if you’re talking about “advanced” as meaning metastatic disease that’s outside of that neighborhood, that’s a whole different thing. So would you like to tell me which “advanced” you’re referring to?
Let’s start with the first and then talk about metastasis just a little bit. From everything that I have been exposed to, advanced cancer is considered—it’s more serious than “just prostate cancer,” and I know that I’m using generalizations here, but that is pretty much how the general public is looking at things. “Okay, I have something that’s bad, I have something that’s worse, I have something that’s horrible.” So how does surgery relate to those different stages?
Well, for localized prostate cancer, you not only have surgery as the option, but also radiation. So, that’s an important thing to understand. There have not been any clinical trials that have actually shown one is better than the other—in certain instances, so I want to preface my statement by saying that. There’s a lot of detail that goes into deciding when you have those options.
And so, for advanced—when it’s advanced, meaning locally advanced outside of the prostate area, you still have those two options, but at the moment, I would say that we’re really looking at treating the primary cancer aggressively, whether it’s locally advanced or metastatic. We don’t know if that’s helpful or not, but—so, surgery, it turns out, may be playing an important role, whether it’s locally advanced or metastatic—radiation as well, by the way, I shouldn’t rule that out.