When Portland resident Harold Briggs was diagnosed with prostate cancer in February 2011, he didn’t waste time getting treated. He was found to have locally advanced prostate cancer as a result of his rising prostate-specific antigen (PSA) level. After eight weeks of radiotherapy and a year of hormone therapy, the 57-year old professor feels thankful that he sought the advice of his physicians. He had radiotherapy with Eric Hansen, MD, who is one of nine radiation oncologists with The Oregon Clinic.
Dr. Hansen sees about 100 men with prostate cancer each year, in addition to patients with other types of cancer. As a notable clinician, researcher, and author of a top-selling radiation oncology book, he believes it is important to educate his patients about all their options. Of prime concern is the recent recommendation from the U.S. Preventive Services Task Force (USPSTF) that healthy men should no longer receive PSA screening— a guideline that the American Urological Association, American Society of Radiation Oncology, and American Society of Clinical Oncology believe is misguided.
Despite the USPSTF recommendation, prostate cancer remains the second-leading cause of cancer deaths in men, surpassed only by lung cancer. “The new guidelines give the impression that men don’t need to worry about prostate cancer, but that’s certainly not the case,” said Dr. Hansen. “In fact, what is often overlooked is that the guidelines still recommend that men have a discussion with their physician about risk factors to determine whether screening is right for them. I believe that screening is important and that treatment can save lives for men with high-grade cancers. The key is that there are some low-grade prostate cancers that don’t require immediate treatment; those men can be encouraged to pursue active surveillance.”
The American Cancer Society estimates that 241,740 new cases of prostate cancer will occur in the U.S. during 2012. Of those, 28,170 will die. Detection of prostate cancer, while it is localized and highly curable, remains critical.
When asked about the recent recommendations on prostate cancer testing, Dr. Hansen’s patient Harold Briggs stood firm: “I think that’s dangerous. All too many men are not socialized to go to doctors in the first place. This kind of report may reinforce this attitude. That’s not what we should be doing. Men need to go yearly for assessment.”
Screening for prostate cancer involves measurement of prostate-specific antigen (PSA), a marker in blood that is secreted by the prostate. If prostate cancer is diagnosed, treatment options may include active surveillance, surgery, or radiation therapy. Many patients at The Oregon Clinic (including Briggs) receive the latest form of radiation called intensity modulated radiotherapy (IMRT) with daily image guidance (IGRT). Treatments typically last only three to five minutes during the brief daily sessions over about eight weeks. “IMRT and IGRT have improved cure rates and reduced side effects for men with prostate cancer,” said Hansen. “They allow us to more accurately target the tumor and minimize dose to adjacent normal tissues. For certain men, radioactive implant can be a good alternative radiation treatment method. We offer both low-dose-rate permanent seed implant and high-dose-rate temporary implants to appropriate men.”
Another patient of Dr. Hansen, 69-year old Monte Crawford, decided on IMRT/IGRT after being diagnosed with prostate cancer after a positive PSA test. The oncology team at The Oregon Clinic gave him other options too, including surgery or continued surveillance. Other than some fatigue during his radiation course, Crawford said he had very few side effects. Today tests show he has an extremely good chance of a long-term cure.
“If caught early, patients now have more options and a greater chance for cure,” said Dr. Hansen, who advises that men should speak with their primary care physician about prostate cancer screening. This is especially true for groups at higher risk, including men with life expectancy more than 10 years, a family history of prostate cancer, and men of African American descent.
Dr. Hansen also stresses the importance of being a good consumer to his patients. He encourages patients to ask questions. Questions a patient might ask when considering radiotherapy include:
- Is my radiation oncologist board certified by the American Board of Radiology?
- Do the physicians participate in multidisciplinary tumor boards?
- What procedures are in place so that the radiation treatment team is able to treat me safely?
- Does the treatment team have weekly chart rounds where they review patient-related information in a peer review format?
- Will the radiation oncology team take imaging regularly during my treatment to verify position of my treatment?
- Who reviews those scans?
- Does the treatment team participate in continuing medical education?
About Eric K. Hansen, MD
Dr. Hansen is a board-certified radiation oncologist with a special interest in treating prostate cancer, lung cancer, head and neck cancer, breast cancer, gastrointestinal cancers, brain tumors, and other sites. After receiving an undergraduate degree magna cum laude from Yale University, he completed medical school with highest honors at Oregon Health & Science University (OHSU). He completed radiation oncology residency at University of California San Francisco (UCSF), where he was appointed chief resident and clinical instructor of radiation oncology. President Clinton named him a United States Presidential Scholar. In addition to numerous articles in leading scientific journals, Dr. Hansen is the editor of the “Handbook of Evidence-Based Radiation Oncology,” an internationally top-selling radiation oncology medical text used by most radiation oncology training programs around the world. Dr. Hansen’s office is located at Providence St. Vincent Medical Center, 9205 SW Barnes Road, Lower Level, Portland 97225. To schedule an appointment with Dr. Hansen, call (503) 216-2195.
In addition to Dr. Hansen, other radiation oncologists with The Oregon Clinic are Drs. Stephen Bader, Christine M. Cha, Marka Crittenden, David Gannett, Jeannie Louie, Steven Seung, Matthew Solhjem, and Alice Wang-Chesebro.
For more information about The Oregon Clinic’s Radiation Oncology division visit http://www.oregonclinic.com/specialties/oncology-radiation