2701, 2014

PSA Testing – To screen or not to screen?

Below is an article I presented on PSA screening for the General Practice Education Day.

1608, 2013

Salvage Radiotherapy Post Radical Prostatectomy

Up to 30% of patients who undergo radical prostatectomy as treatment of their prostate cancer, will develop elevation of PSA levels in the post operative period, consistent with recurrence of their prostate cancer.

This prostate cancer recurrence is from either recurrent disease around the area were the prostate was removed, or alternatively be due to the prostate cancer spreading to other parts of the body before the prostate was removed.
When a urologist feels the prostate cancer is most likely due to recurrent local disease, the addition of radiotherapy to the prostate bed and pelvic area can be used to control or […]

1608, 2013

High Dose Rate (HDR) Brachytherapy


The high dose rate prostatic brachytherapy program at the Wesley Hospital combines external beam radiation treatment with temporary transperineal insertion of brachytherapy needles directly into the prostate gland. Via these needles 3 fractions of high dose rate radiation treatment are delivered in 3 separate fractions, separated by a minimum of 6 hours.

Results of HDR brachytherapy at the Wesley Hospital

Wesley Hospital first commenced the HDR prostatic brachytherapy program in August 2000. By June, 2010 over 860 patients have been treated with HDR brachytherapy at the Wesley Hospital. Traditionally high dose rate brachytherapy has been used to treat patients with high risk […]

708, 2013

Current treatment options for localised prostate cancer

In Australia prostate cancer is the most prevalent non skin cancer in men with 1 in 7 men diagnosed with prostate cancer by the age of 75 years. (1)  PSA screening has led to a stage shift into a lower volume prostate cancer with a marked decline in the presentation of high volume or metastatic prostate cancer upon diagnosis. This has been associated with a decline in prostate cancer death (2).  PSA has also led to an increased risk of diagnosis of a low volume, potentially clinically insignificant prostate malignancy.

Current options for management of localised prostate cancer in Australia will […]

708, 2013

Lose Dose Rate Prostatic Brachytherapy Implant

A low dose rate prostatic brachytherapy implant involves the insertion of radioactive pellets (seeds) directly into the prostate via a transperineal approach (the needles are inserted through the muscle between the scrotum and rectum).  These radioactive seeds slowly emit their radiation over a long period of time with a half life of approximately two month.  In other words the total radiation dose is usually delivered over a 10 month period (5 half lives).

It is possible that the constant delivery of low dose radiation over this period of time may improve outcome, as the constant radiation dose does not allow for […]

1706, 2013

Radical Prostatectomy

A radical prostatectomy remains the gold standard for management of localised prostate cancer in Australia and the world.

Why would I choose a radical prostatectomy to treat my prostate cancer?

Radical prostatectomy offers excellent long term local control of prostate cancer.  Removal of prostate will also improve any associated symptoms from bladder outflow obstruction, such as a slow stream or straining to pass urine.

A radical prostatectomy also offers patients the option of excision of the pelvic lymph nodes which does offer prognostic information for long term outcome and possibly a small therapeutic benefit.  Radical prostatectomy also avoids the potential complications of radiation […]