Columbus CyberKnife presents an overview of prostate cancer, its different stages and possible treatment options.

1. STAGES OF PROSTATE CANCER
495 Cooper Road Suite 125, Westerville, OH 43081 (614) 898-8300www.columbusck.com

2. A
prostate
cancer
diagnosis
can
be
scary.
Learn
more
about
prostate
cancer
and
how
we
can
help.
Please
note:
The
informa1on
presented
here
is
not
all-­‐inclusive.
Rather,
it
represents
a
star1ng
point
to
learn
more
about
medical
condi1ons
and
treatment
op1ons.
There
is
no
subs,tute
for
consul,ng
a
medical
professional.
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

3. Prostate Cancer Overview
Possible Signs of Prostate Cancer:
Weak or interrupted flow of urine
Frequent urination
Trouble urinating
Pain or burning during urination
Blood in the urine or semen
Persistent pain in the back, hips, or pelvis
Painful ejaculation
¨ The prostate is a
walnut-sized gland
located in a man’s
lower abdomen that
controls the flow of
urine and semen.
¨ Prostate cancer is a
leading cause of
cancer death among
American men, second
only to lung cancer.
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

4. Diagnosing Prostate Cancer
Prostate cancer can be diagnosed by:
¨ Digital Rectal Exam (DRE) – examination of
the rectum.
¨ Prostate-specific antigen (PSA) test –
measures the level of PSA in the blood. PSA
may be found in an increased amount in the
blood of men with prostate cancer.
¨ Transrectal Ultrasound – provides a picture of
the prostate for the doctor to analyze.
¨ Gleason Score – determines how likely
prostate cancer is to spread.
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

5. The TNM Staging System
A staging system describes how far a cancer has spread.
The most widely used staging system for prostate cancer is
the American Joint Committee on Cancer (AJCC) TNM
system.
The TNM system for prostate cancer is based on 5 key
pieces of information:
¤ The extent of the primary tumor (T category)
¤ Whether the cancer has spread to nearby lymph nodes (N
category)
¤ The absence or presence of distant metastasis (M category)
¤ The PSA level at the time of diagnosis
¤ The Gleason Score, based on the prostate biopsy (or surgery)
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

6. Prostate Cancer - Stage I
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Cancer is found in the prostate only.
¨ Cancer is microscopic and cannot be felt during the
DRE or seen on imaging tests.
¨ Cancer is found in one-half or less of one lobe of
the prostate.
¨ PSA level is lower than 10 ng/mL.
¨ Gleason Score is 6 or lower.

7. Prostate Cancer - Stage IIA
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Cancer is more advanced than
Stage I but has not spread outside
the prostate.
¨ The cells are usually more
abnormal and may tend to grow
more quickly.
¨ Cancer is found in more than half
of one lobe of the prostate.
¨ PSA level is lower than 20 ng/mL.
¨ Gleason Score is 7 or lower.

8. Prostate Cancer - Stage IIB
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Cancer is found in opposite sides of the prostate.
¨ Cancer cannot be felt during a DRE and is not
visible by imaging.
¨ The tumor has not spread outside the prostate.
¨ PSA level is 20 ng/mL or higher.
¨ Gleason Score ranges from 2 to 10.

9. Prostate Cancer - Stage III
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Cancer has spread beyond the
outer layer of the prostate.
¨ Cancer may have spread to
nearby tissues like the seminal
vesicles.
¨ PSA can be any level.
¨ Gleason Score can range from
2 to 10.

10. Prostate Cancer - Stage IV
¨ Cancer has spread
(metastasized) beyond the
seminal vesicles to nearby
tissues or organs such as
the rectum, bladder or
pelvic wall.
¨ Cancer has spread to
distant parts of the body,
which may include other
lymph nodes or bones.
Prostate cancer often
spreads to the bones.
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Cancer has spread to
nearby lymph nodes
¨ PSA can be any level.
¨ Gleason Score can range
from 2 to 10.

11. Prostate Cancer Treatment
Treatment Options
Active Surveillance
Surgery
External-Beam Radiation Therapy
Brachytherapy
Proton Therapy
Stereotactic Body Radiation Therapy
¨ Treatment options depend on:
¤ The stage of the cancer
¤ The patient’s age and health
¤ The patient’s Gleason Score
¤ Whether the cancer is recently
diagnosed or recurring
¤ The patient’s prostate-specific
antigen (PSA) levels
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

12. CyberKnife® Treatment Process
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
¨ Prior to stereotactic body radiation therapy with CyberKnife, small
tissue markers known as fiducials are implanted in the prostate to
help pinpoint the tumor location throughout each treatment.
¨ About a week later, patients are fitted with a custom body mold of
soft material that they lie on during treatments. The fitting process is
painless.
¨ This treatment process
includes
¤ Consultation appointment
¤ Pretreatment procedures
¤ CyberKnife treatment
¤ Follow-up

13. Additional Resources
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com

14. Our Center
Opened in 2010, Columbus CyberKnife has treated approximately 140
prostate cancer patients, about 30% of cases treated at the center. If you or a
loved one is diagnosed with prostate cancer, contact Columbus CyberKnife to
schedule a consultation with our physicians to determine the best next step for
your treatment needs.
Medical Director/Radiation Oncologist: Dr. Douglas Widman
Radiation Oncologist: Dr. Abhay Gokhale
495
Cooper
Road
Suite
125,
Westerville,
OH
43081
(614)
898-­‐8300
www.columbusck.com
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