Long Valley cancer specialist: Complexity of prostate cancer requires complex treatments

WASHINGTON TWP. The first signs of prostate cancer should be closely monitored but a leading prostate cancer researcher said treatment must be personalized and can range from surveillance to surgery and many treatments in between.

Prostate cancer can behave very differently in different men and treatment, diagnosis and whether surgery or radiation is needed is very individualized, said Dr. Robert S. DiPaola of Long Valley, director of The Cancer Institute of New Jersey. When you get a diagnosis of prostate cancer, fortunately most wont die because the cancer either progresses so slowly or is cured.

DiPaola, whose specialty is prostate cancer, was one of 10 physicians at the cancer institute who were recently named Top Docs in the nation by U.S. News & World Report.

The National Cancer Institute has reported that one in six men will be diagnosed with prostate cancer in their lifetimes. Most of the prostate cancer patients are diagnosed with a form of the disease that has not spread beyond the prostate. But the institute reports that between 30 and 40 percent of those patients will have disease progression within 10 years after having received initial treatment.

DiPaola said there are many treatment options for people who are diagnosed with a less aggressive grade of prostate cancer.

In many patients, active surveillance without local therapies could be sufficient, DiPaola said.

More aggressive forms may, however, require more aggressive therapy that can include surgery, chemotherapy and newer types of radiation that more specifically targets the prostate and even vaccine and hormonal therapy.

A significant problem with surgical removal of the prostate is that the nerves that run along the prostate also must be removed, resulting in impotency. Research is also focusing on ways to restore potency.

A promising area of treatment of early stage prostate cancer involves using a high-intensity focused ultrasound (HIFU), to heat and destroy cancer cells. The treatment is the subject of clinical trials and studies also are ongoing on the safety and effectiveness of the method.

Clinical trials also are underway for several types of vaccines to help treat, not prevent, prostate cancer.

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Long Valley cancer specialist: Complexity of prostate cancer requires complex treatments