Prostate Cancer Program at Fox Chase Cancer Center


One of the great things about the GU
team here is that a lot of us are involved on a national level on creating
the guidelines of care, doing the research and then being involved in the
panels and decision making that set up what standard of care is for the cancers
that we treat. The people I work with are national and international leaders in
genitourinary malignancies. I mean, they write the textbooks, they write the
papers, they do the research that sort of moves to feel forward. For me, it’s a
privilege that I get to work with people who are experts in prostate medical
oncology and prostate surgery. As a urologic oncology group, would do over a
thousand complex neurologic cancer cases a year, which is really a tremendous
volume – everything from their routine cases to very very very complex cases.
Prostate cancer is the most common cancer in men with nearly 200,000
cases diagnosed in the u.s. each year. Fortunately, most prostate cancer is
discovered when it hasn’t spread and is still confined to the prostate. For
patients who have low-risk disease, there is a really great opportunity to forego
treatment and to go on what is called active surveillance. Active surveillance is an
option for some men whose prostate cancer is growing slowly, or for those
whose cancer is unlikely to cause complications. This process involves
actively monitoring the cancer and only starting treatment of the cancer becomes
more aggressive. Doctors may recommend active surveillance because it allows
patients to avoid, or delay the side effects of treatment, although not every
patient chooses this course of action. The most important decision, I believe,
when you first are told you have cancer is to figure out where you need to be
treated and where you need to be seen. At a Comprehensive Cancer Center, you can
get multiple opinions from different people such as surgeons, radiation
oncologists, medical oncologists, pathologists, radiologists, and all of
that comes together to give you the best option. So prostate cancer care is
incredibly nuanced. This is where a center like Fox Chase comes in. The
pathology, the biopsies need to really be examined by
world-class pathologists to make sure that the disease that was diagnosed is
appropriately-categorized treatment. Options for prostate cancer can vary
from patient to patient. At Fox Chase, we work with you to determine the best
course of action. In some cases, surgery will be your best option. When it comes
to prostate removal, or the surgical management of various cancers, our
philosophy that we established as a team first is a safe operation. The second is
curing the cancer, and then the third is if we can do that safely with a robot
with a laparoscope, with a new technology and the quality of life is improved –
that’s a home run. We really developed a special practice in minimally invasive
surgery. We’ve been doing robot-assisted surgery for more than 10 years here.
Robotic surgery, meaning using the robot to remove the organ. It affords you
smaller incisions, quicker recovery time. My patients after this operation have
had an excellent recovery of their urinary function and their sexual
function, and that’s really a huge benefit for the patients. One of the nice
parts of working at Fox Chase Cancer Center is the fact that the urologist
worked well with the radiation oncologists and medical oncologists and
really provide a team approach to taking care of the patients, where we’re
figuring out how to thread that needle a little bit better. When do we actually do
surgery? When do we do a medical therapy? When do we do radiation therapy, and how to combine those when that’s needed? When I’m developing my treatment
recommendations for a patient, I’ve had the opportunity to speak to the other
physicians that day, so they’ve not only gotten recommendations from me, but from my partners in the department of surgery, as well as radiation oncology, radiology,
pathology, and medical oncology. Radiation therapy uses high-energy radiation to
shrink tumors and destroy cancer cells. I’m a radiation oncologist who
specializes in the treatment of both prostate cancer and bladder cancer, and
today we have so many different ways of treating these different cancers.
We can use external beam radiation. We have intensity-modulated radiation
therapy. We have the ability now to give shorter courses of treatment. So over the
years I’ve treated thousands of men with prostate cancer. Fox Chase, in particular
the department of radiation oncology, has been a leader in the field with
developing new treatments and new ways to deliver treatments that give our patients a lot of new treatment options that aren’t otherwise available. It used to be
that most every man would go through about 7 to 8 weeks of daily
radiation. What we found is there are some disease processes that we can
manage in as little as 5 weeks, some maybe even in two and a half weeks now,
by increasing the dose of radiation that we give each day in select patients,
taking into account their needs and realizing that you don’t have to take
two months out of your life to do this. We may be able to do this in as little
as two weeks. We really do a lot of high dose rate brachytherapy for prostate
cancers. We implant the the radiation source into the tissue and deliver
radiation therapy from inside out. Men that receive brachytherapy really do
well and are very pleased with that. For patients whose prostate cancer has
spread beyond a confined area, or patients who have high-risk localized
disease, medical oncologists at Fox Chase employ some of the latest systemic
therapies. These include chemotherapy, immunotherapy, targeted therapy, and
hormone therapy. For prostate cancer, it’s really our job to pinpoint which area of
the spectrum each man is at with prostate cancer, and then select from a
wide variety of treatments which makes the most sense. Men with prostate cancer have new treatments available that weren’t available three or four years
ago, and many of them can live a very normal lives for many years. We use
hormonal-reacting treatments, chemotherapeutics, immunotherapy, and all this in conjunction with both surgery and radiation to give our patients the
best chance at the longest and best quality of life. With prostate cancer,
one of the most exciting areas has really been the advent of immunotherapy
and using them to allow the patient’s own immune system to act against the
cancer. And that’s a great way to treat patients because it can often allow for
less side effects and toxicities that we’ve seen with prior therapies that
we’ve used in addition to the latest treatments for prostate cancer. Fox Chase has an active and widely respected clinical trials program. Our doctors and
researchers are developing and evaluating a number of new therapies. I
will always believe in trying to do better and in doing that through
clinical trials. Coming to a place like this were it’s bursting with innovation,
bursting with new ideas, it can be sometimes a huge game-changer for
patients. This place often can offer them something that nobody else can.
Together, we’re actually creating some of those newer techniques and newer
technology that will make a difference in our patients lives. You know, patients
that honestly I wasn’t expecting to be alive just you know six, seven years ago
are still coming in. They’re still rocking their grand kids on their laps,
and we’re keeping them healthy, keeping them strong, so it’s a really
exciting time in oncology. We are a world-class cancer center, but we’re very
approachable at the same time. The patients really feel that they’re on a
personal level, that they’re really getting one-on-one treatment and
one-on-one care which, I think, they really are, and that’s unique to Fox
Chase. To learn more about Fox Chase’s
multidisciplinary treatment options for prostate cancer, contact us today at 888-
Fox-Chase, or visit FoxChase.org

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