This is Steve Jones’ story of his successful battle with prostate cancer. Jones opted for Intensity Modulated Radiation Therapy (IMRT) to treat his prostate cancer under the guidance of Andrew Kennedy, MD, one of the country’s leading experts in IMRT, 3D conformal therapy, liver and prostate cancer treatment. IMRT uses an advanced 3-D system that spares normal tissue. The procedure has resulted in the eradication of cancer from Jones’ prostate.

September is recognized as National Prostate Cancer Awareness Month.

Cary, NC – Steve Jones’ life was going along just as he had planned. He and his wife, Donna, were in the process of building a new house in Fuquay-Varina that would accommodate them, along with their daughter, son-in-law and their six children. Then Jones received the news from his family physician that he had prostate cancer, something that he was not expecting.

“My PSA (Prostate Specific Antigen) jumped to 4.7 in August 2006, while it had only been 1.7 nine months earlier,” explained the 60-year-old Jones. “My doctor prescribed a two-week regimen of antibiotics, just in case I had an infection, but unfortunately, it turned out to be cancer.”

In the United States, prostate cancer is the most common cancer, other than skin cancers. This year, nearly 220,000 men in the United States and more than 6,800 North Carolinians will be diagnosed with the disease. While very curable if the cancer is found locally or regionally, meaning it is confined to the prostate or spread to regional sites, it becomes more difficult to cure once it has spread to distant sites in the body. Prostate cancer is the second leading cause of cancer deaths in American men, behind lung cancer. One in six men will be diagnosed with prostate cancer during his lifetime. Men who are diagnosed in the early stages of the disease have nearly a 100 percent five-year survival rate, while men who are diagnosed once the cancer has spread to organs or bones have a 34 percent five-year survival rate.

IMRT Treatment for Prostate Cancer

Jones was referred to a specialist in September 2006, who confirmed through a biopsy that he had cancer. The physician laid out what Jones thought were all of his options – surgical removal of the prostate, implantation of radiation seeds or what is known as “watchful waiting,” to see if the PSA number would continue to rise.

“I remember thinking that I didn’t like those options, especially since I am the primary care giver for my wife, who has Parkinson ’s disease,” noted Jones. “I knew that whatever treatment we selected, it had to allow me to continue being her main support.”

That’s when Jones called Andrew Kennedy, MD, at Wake Radiology Oncology Services. Dr. Kennedy met with Jones and reviewed all of his options, including a new one – IMRT.

“When we heard about IMRT, it didn’t take long for us to decide on that course of treatment,” explained Jones. “At the same time of diagnosis, I also fired the general contractor on the house we were building, and I was taking on that role. I was juggling a lot of balls, so I needed a treatment that would work, but would not result in a lot of down time.”

IMRT focuses the most intense beams of radiation on the cancerous cells to improve coverage and control tumors, while lessening the side effects on patients. The higher doses of radiation can be used to increase the chances for a full recovery. It is effective in treating head and neck cancers and is also used for prostate, thyroid, lung, liver, brain and gynecologic tumors, lymphomas and sarcomas.

Patients undergoing IMRT and 3DCRT are first scanned using CT, PET or MRI to determine the exact size, shape and location of the tumor. With the 3-D image of the tumor, a treatment plan is developed, which includes computerized radiation dosage calculations. It requires precise planning to deliver the radiation to the exact spot of the cancer. Modulated radiation beams from different directions are then delivered specifically to the tumor site. Jones underwent 38 treatments for his prostate cancer that extended into the Thanksgiving and Christmas holidays. He received the treatments on his way to work each morning, with each treatment taking about 20 minutes. Some patients can have side effects from IMRT, including fatigue, skin reactions at the treatment site, frequent and painful urination, upset stomach, diarrhea, rectal irritation or bleeding and impotence. Jones said that he only experienced minor fatigue, causing him to miss three half days at work.

“While I was checked periodically during and after the treatments, the real test came in August, when I had a full check up, digital rectal exam and repeat PSA to see if the treatment had worked,” said Jones. “The results could not have been better.”

Jones’ PSA dropped to .7, and there was no palpable sign of cancer in his prostate. “He achieved the best possible results from this treatment,” explained Dr. Kennedy. “IMRT minimizes radiation exposure to the rectum and bladder, which typically means fewer side effects that can occur with conventional radiation therapy. We are able to control the dose of radiation very accurately so that we can actually deliver a stronger dose to the tumor, while sparring nearby organs. This typically translates into a better outcome for the patient.”

Dr. Kennedy said that the best candidates for IMRT are patients whose cancer is encapsulated in the prostate and has not spread to the surrounding area or in other organs.

Jones said his main message to other men is simple: “Don’t put off seeing your doctor and getting regular screening for prostate cancer. And if you do have it, realize that you have excellent treatments now that weren’t available five years ago, and these options allow you to continue living your life without debilitating side effects.”

About Wake Radiology Oncology Services

Wake Radiology Oncology Services is the Triangle’s first freestanding, full-service, outpatient radiation therapy center. Its state-of-the-art facility combines the newest technology in three-dimensional radiation therapy with the expertise of highly trained professionals to provide thorough, quality care for each patient. The practice was the first to offer Intensity Modulated Radiation Therapy (IMRT) to treat prostate cancer in the Triangle. For more information about Wake Radiology Oncology Services, please visit the website at www.wakeoncology.com.

For more information about prostate cancer, please visit these sites:
www.cancer.org – American Cancer Society
www.pccnc.org – Prostate Cancer Coalition of North Carolina

FACTS ABOUT PROSTATE CANCER

Risk Factors for Prostate Cancer

Age: The chance of getting prostate cancer goes up as a man gets older. About 2 out of every 3 prostate cancers are found in men over the age of 65. Race: For unknown reasons, prostate cancer is more common among African-American men than among white men. And African-American men are twice as likely to die of the disease. Prostate cancer occurs less often in Asian men than in whites.

Nationality: Prostate cancer is most common in North America and northwestern Europe. It is less common in Asia, Africa, Central and South America. Family history: Men with close family members (father or brother) who have had prostate cancer are more likely to get it themselves, especially if their relatives were young when they got the disease.

Diet: Men who eat a lot of red meat or high-fat dairy products seem to have a greater chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors are not sure which of these factors causes the risk to go up. The best advice is to eat 5 or more servings of vegetables and fruits each day and to eat less red meat and high-fat dairy products. Exercise: Although most studies have not shown a link to exercise, one recent study found that men over the age of 65 who exercised vigorously had a lower rate of prostate cancer.

Testing Guidelines

The American Cancer Society believes that doctors should offer the Prostate Specific Antigen (PSA*) blood test and digital rectal exam (DRE*) yearly, beginning at age 50 to men who do not have any major medical problems and can be expected to live at least 10 more years. Men at high risk should begin testing at age 45. Men at high risk include African Americans and men who have a close relative (father, brother, or son) who had prostate cancer before age 65.

Men at even higher risk (because they have several close relatives with prostate cancer at an early age) could begin testing at age 40. Depending on the results of the first tests, they might not need more testing until age 45. Doctors should talk to men about the benefits and risks of testing, and men should take an active part in the choice about whether or not to have tests. Prostate cancer can often be found early by testing the amount of PSA (prostate-specific antigen) in the blood. Another way prostate cancer is found early is when the doctor does a digital rectal exam (DRE). Because the prostate gland lies just in front of the rectum, during the exam the doctor can feel if there are any bumps or hard places in the prostate. These might be cancer. If found during routine yearly exams and either one of these test results becomes abnormal, the cancer most likely is in an early, more treatable stage. * PSA or Prostate Specific Antigen is a protein originating from the prostate that can be detected in the blood. PSA testing detects elevated or rising PSA levels, which can signal that there is something wrong with the prostate. Since the prostate is an internal organ, a physician cannot loot at it directly. However, the doctor can feel the prostate. This simple procedure, called a digital rectal examination (DRE) is done with a gloved, lubricated finger. The physician presses gently on the lower wall of the rectum. It can be a little uncomfortable, but the potential benefits by far outweigh any discomfort. The examination allows the physician to estimate whether the prostate is enlarged or has lumps or areas of abnormal texture. The prostate gland is next to the rectum, and most cancers begin in the part of the gland that can be reached by a rectal exam. The exam takes about 5 minutes and there are no risks associated with the procedure.

Source: The American Cancer Society

Media Contact: Kim Parker 919-303-4458 (office), kpparker@wakeradiology.com