Clinical SurgeryQuestion Bank

Adjuvant and Salvage Radiotherapy after Prostatectomy

Adjuvant and Salvage Radiotherapy after Prostatectomy

Adjuvant and Salvage Radiotherapy after Prostatectomy

 

Prostrate cancer
Prostrate cancer

Adjuvant and Salvage Radiotherapy after Prostatectomy

#1 Do patients with localized prostate cancer undergoing radical prostatectomy at higher risk of cancer recurrence ? and what preoperative counselling should be offered them ?

Answer :

Yes, they are at higher risk of cancer recurrence

Preoperative counselling :

This should include discussion of the potential benefits of additional therapy after surgery depending on the post operative pathological findings.

#2 Which pathological findings after surgery are associated with higher risk of prostate cancer recurrence ?

Answer :

a) Presence of invasion of seminal vesicle

b) Extension of cancer outside the prostate gland

c) Positive surgical margins

#3 Which post surgical therapeutic intervention should be offered to prostate cancer patients with adverse pathological findings ?

Answer :

Adjuvant radiotherapy – studies have shown this might be beneficial

#4 What are the advantages of adjuvant radiation therapy in prostate cancer patients when compared to radical prostatectomy only option ?

Answer :

a) It reduces the risk of biochemical (PSA) recurrence

b) It reduces local recurrence

c) It reduces clinical progression of cancer

#5 What is the impact of adjuvant radiotherapy in patients with prostate cancer ?

Answer :

Clinical trials have shown that the effect of adjuvant radiation therapy on subsequent metastastic disease and overall survival is currently less clear from the results of two randomized control trials.

 

#6 What is the clinical evidence supporting adjuvant radiation therapy in the management of patients who have prostate cancer ?

Answer :

High-quality evidence from a long-term clinical trial and studies indicates that using adjuvant radiation therapy in prostate patients with unfavorable pathological findings decreases the risk of recurrence of PSA, recurrence of local disease, and clinical progression of cancer

 

#7 Who should decide which patient with cancer of the prostate is to receive adjuvant radiation therapy following surgery ?

Answer :

a) Multi-disciplinary medical team

b) The patient with the cancer

c) The family of the cancer patient

 

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