Choosing the Right Prostate Cancer Treatment

A few years ago, I sat down with Dr. Geo to discuss a variety of subjects that matter greatly to our XY Wellness community. The following excerpt is just as pertinent today and pertains to those initial, confusing days following a prostate cancer diagnosis:

David: In my opinion, there is such a wide range of choice in treatment options that newly diagnosed men need to take the time to properly profile their prostate cancer, examine the various treatment alternatives, and then make an informed choice based on prognosis and quality of life.

Dr. Geo: Yes. When you were going through this same decision process way back in 2004, the range of options was more limited than it is today. What did you end up choosing?

David: Based on the profile of my cancer, I opted for ADT to first reduce tumor mass, followed by a round of EBRT, and then Brachytherapy. I was fortunate to be able to tap into the expertise at UCSF, and I owe a lifetime of gratitude to Mack Roach, M.D. and Katsuto Shonohara, M.D.

Dr. Geo: On top of this, you followed a lifestyle roadmap that we now call the XY Wellness Approach.

David: And nine years later, I feel great and am fortunate to be in a position to give back to other men who are now beginning this journey. Knowing what I chose, what are some of other treatment options that men may want to consider?

Dr. Geo: Even within individual treatment modalities, there is now a significant range of choice. For example, the surgical option, known as Radical Prostatectomy, is delivered in either Open or Robotic form. Within Radiation Therapy, in addition to the combination that you chose, options include IMRT, 3D-CRT, and Proton Therapy. There are also promising developments with HIFU and with Virus-based treatments. In other words, there is no shortage of good choices.

David: Looking back, I feel that what helped me was to take the time to build a profile of my disease and to then find the expertise that was then appropriate to treat it. In other words, I avoided the “knee-jerk, get it out now” reaction that is unbelievably understandable. Instead, I met with a number of great specialists to review the profile and get their insights and recommendations. I was then able to make my choice based on both survival probabilities and quality of life considerations.

Dr. Geo: That is the best approach. The goal is to find the best match and provider for you. If you are newly diagnosed, I encourage you to seek out the best prostate cancer specialists that you can find, share your complete diagnostic information with them, and hear what they have to say. Your goal is to make an informed decision.

David: And never forget that you are not just a prostate! No matter what course of treatment you opt for, you will need to do the work that is needed to rebuild your overall health and quality of life.

Dr. Geo: I help a number of my patients to navigate their range of treatment choices, and I work with men following their surgery or radiation therapy. I provide post-treatment men with a guided, integrative roadmap that includes diet, exercise, and condition-specific supplementation.

David: Which is our mission here. And we are making a difference for those who are willing and able to follow this roadmap. It takes work, but cancer is an incredible motivator.

Dr. Geo: Well said. So, in a nutshell, if you are newly diagnosed, your right course of treatment depends on the profile of your prostate cancer. We encourage you to take the time to understand what you are dealing with, and to then find a course of treatment and a provider that you feel are the best match for you. A prostate cancer diagnosis is a life-changing event, and you need to approach it as such.

David: Yes, and cancer is a life-long event, so please get to work on making the lifestyle changes that will support your full recovery and return to health. You will never be the same as before you were diagnosed, but with a daily commitment to living a cancer-smart lifestyle, the “new you” that emerges may turn out to be even better.

Dr. Geo: We are here to help you. If you are newly diagnosed with prostate cancer, speak to your urologist and request referrals to one or more experts in prostate cancer treatment. And do not hesitate to contact me at NYU Langone. You are not alone. Far from it.