NCCN Guidelines for Patients® | Prostate Cancer - page 51

51
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 5: Initial treatment by risk group
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• Cancer in the seminal vesicle(s), and
• Detectable PSA levels.
If test results find no high-risk features or cancer in the lymph nodes, no more
treatment is needed. You may start observation. The options for when there
are high-risk features but no cancer in the lymph nodes are radiation therapy
or observation. Radiation therapy with EBRT is given to the areas where the
cancer cells have likely spread. Treatment is started after you’ve healed from the
operation.
There are two treatment options if cancer is found in lymph nodes. The first
option is to start ADT now. Radiation therapy may be added to ADT. ADT can
be given on an intermittent schedule to reduce its side effects. However, the
benefits of ADT in this case are unclear. For adjuvant ADT after prostatectomy,
an LHRH antagonist or LHRH agonist is recommended. If your PSA levels are
undetectable, a second option is to start observation and then have treatment
when the levels rise.
Acronyms:
ADT
= Androgen
deprivation therapy
CAB
= Combined androgen
blockade
DRE
= Digital rectal exam
EBRT
= External beam
radiation therapy
HDR
= High-dose rate
LHRH
= Luteinizing
hormone-releasing hormone
LDR
= Low-dose rate
PLND
= Pelvic lymph node
dissection
PSA
= Prostate-specific
antigen
!
ReadPart 2 for testing
information andPart 4
for treatment details.
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