Stephan L. Werner, M.D., F.A.C.S.

Combined therapies are attempts to improve the results of  the various forms of radiation therapy.  The term refers to combinations of external and seed radiation, and combinations of hormonal therapy with external beam, seed therapy or both.

Hormonal Therapy is based on the fact that prostate cancer cells frequently use the male hormone, testosterone, as fertilizer, and the absence of testosterone leads to the death or weakening, (apoptosis),  of many, but not all, prostate cancer cells.  Neo-adjuvant therapy involves pre-treating the prostate cancer with testosterone deprivation , weakening the cancer prior to radiation or brachytherapy.  Short term data seems to support this, but the final answer is not in.  To induce hormone deprivation, injectable and/or oral medication is given for 2 to 8 months before starting  radiation, during the radiation therapy and for two months to three years afterwards, depending on the aggressiveness of the cancer.   The hormonal therapy keeps the cancer in check during this time.

Combined Radiation therapy is based on the fact that combining external beam and brachytherapy (seeds), give a more homogenous therapy to the gland, and deliver some radiation to the area surrounding the prostate. There is good rational for this therapy, and we use it especially in high risk patients: with extensive cancer within the prostate , or who have a high likelihood of having local extension of the cancer, (stage C). Newer research suggests that combined external beam radiation, brachytherapy, and both neo-adjuvant and adjuvant therapy improves survival and delays recurrence in patients with moderate to high risk prostate cancer.  During and for about 6 months after any form of radiation you should avoid taking antioxidants such as Vitamin E, Vitamin D, Selenium etc...  as they may counteract some of the beneficial effects of radiation.

Dr. Stephan Werner  does all the seed implants/brachytherapy for the practice.

Rev: 04/03

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Werner - Francis Urology Associates llc - Mid Atlantic Urology Associates llc

Greenbelt - Bowie - Laurel     Maryland

(301) 441-8900               Fax (301) 982 0453

7500 Hanover Parkway   Suite 206    Greenbelt, MD   20770

e-mail: wfurology@gmail.com

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Rev:03/08