Ashley Beck: Tell men then about detecting prostate cancer.
Dr. Kris Gast: Well the usual course for most of our patients is that they’ll go in for their annual physical examination with their primary care physician and they’ll have
their blood test checked and that’s the screening for prostate cancer is to have their PSA checked. If that comes back elevated or if their examination is abnormal then they’re referred to the urologist. And the urologist will generally recommend an ultrasound at the time of the biopsy. Based on those results they’ll either proceed with additional x-rays to stage the cancer or they’ll just make recommendations in terms of treatment options.
Ashley Beck: Once you hear the words “You have prostate cancer.” then you start talking about your options. Curative treatment options is what we wanted to cover. Explain to us what this is, what this means.
Dr. Kris Gast: There are several curative options, and those are, if you look at just the treatments and you don’t factor into the patient age, their overall health, you have the surgery, seeding implantation and external beam radiation which is what you see here. At our center we use the external beam intensity modulated radiation therapy which is ultrasound guided and we use the ultrasound unit every day to localize the prostate and make minor adjustments in terms of where the prostate is actually located that day. So the therapist will actually make millimeter adjustments in the treatment on a day to day basis based on the ultrasound that day of where the prostate is located.
Ashley Beck: Now that piece of equipment looked like a really large piece of equipment, so what does it do while the patient is laying there basically.
Dr. Kris Gast: That particular piece of equipment is a linear accelerator. Most of the centers throughout the country have linear accelerators. The treatment planning that goes with that is what makes it unique in terms of being intensity modulated therapy. That’s what gives us the more focused treatment where you can use that ultrasound to focus the radiation a lot tighter which allows the patient to experience less side effects.
Ashley Beck: Which is exactly what I was going to ask you, “How does this” and you refer to it as FSRO treatment, how does it differ from other things that people might
choose on a different path then.
Dr. Kris Gast: Well to have different options in terms of the surgery and seed implant and most generally have kind of a whole different set of side effects. The intensity modulated radiation therapy is actually very well tolerated. Patients come every day and take about 10-15 minutes to get their treatment, they’re kind of in and out and they generally have very minimal side effects.
Ashley Beck: That’s what everyone always wants, the less side effects the better. Heard wonderful things from your patients about you Dr. Kris Gast. Let’s put all the information up on your screen so you can visit, make a phone call, do what you need to do. It is Fort Smith Radiation Oncology at 8500 South 36th Terrace, you can visit them online at fsro.net or you can call Dr. Gast and her crew at 648- 1800.
Ashley Beck: Thank you for being here, important topic to talk about.
Dr. Kris Gast: Thank you, we’ll see you next month.
Ashley Beck: We’ll see you then! This is 5 Sunday Morning, we’ll be right back.
Ashley Beck: Dr. Kris Gast is back with us for the third time with Fort Smith Radiation Oncology which is the only independent locally owned and operated radiation cancer treatment facility in the river valley. She joins us this morning with much more and we’ve been talking, this time we say, it is specifically geared toward the men.
Dr. Kris Gast: That’s correct
Ashley Beck: Now, there’s been a scary headline for a lot of people, new information just coming out this week, it’s regarding agressive prostate cancer. Researchers found that men who died of prostate cancer were half as likely to have taken a staten than a control group. Now, sounds scary, set the record straight for exactly what they did and what this means.
Dr. Kris Gast: Right. It is very scary, it makes you think that you need to run out and start taking staten’s just off the shelf, that it needs to be started right away but when you look at the actual study and the information in that, the researchers did a chart review, it wasn’t an actual randomized study. They reviewed 380 charts for patients who had prostate cancer and died from the prostate cancer and then they reviewed 380 charts for patients who had prostate cancer and had not died from the prostate cancer and then they looked to see who had taken statins and who hadn’t. And they found that men who had died of their prostate cancer were half as likely to have taken the statins. Now when they looked at the information in the study they’re not able to tell us whether they started taking the statins before their diagnosis or after. So it’s very limited, it’s very difficult also to separate out numerous other factors. Were the men when they were placed on their statins, did they change their diet and start exercising as well and did that play a factor in changing their overall incidence of dying from prostate cancer. So it’s a very limited study, not necessarily one that would change what we would be doing with our patients right now.
Ashley Beck: You would assume there would be much more research, more in depth rather than as you called it, a chart review. Is it possible statins do not prevent cancer at all.
Dr. Kris Gast: That’s correct. Some of the leading researchers in prostate cancer have reviewed it and have really commented at this point in time that they don’t feel that this is an indication to do anything different. They really don’t feel that it’s a factor taking statins will have any impact at this point. It is a factor in terms of looking at that and perhaps setting up a study which would require a large number of men who would be randomized to either take the statins or not take the statins, they would be followed for many years and you would see which group did better. And then that would be the basis for recommending statins for patients.
Ashley Beck: And I know another big question that people have is “How could we determine if statins did protect against agressive prostate cancer?”.
Dr. Kris Gast: Right, you really would have to proceed with a study that would be prospective randomized which in very good trials, patients are put on double blind trials where even the doctor and nurses that are working with them don’t even know whose getting the medication and who is not. And they have to be followed for many years. And I think with the drug that we’re looking at, that category of drug isn’t without side effects and it would be something that patients would have to really be followed in terms of determining if it was an important factor or not. It is costly both side effect and money wise.
Ashley Beck: This is just the tip of the iceberg here now, researchers recommendations are men who are heart healthy should not be placed on statins for the purpose of lowering prostate cancer, what do you say to that.
Dr. Kris Gast: I think that’s exactly right.
Ashley Beck: SO there is all the information on this new study which Dr Kris Gast says more of a chart review, we’re not running out and taking statins off the shelf.
Dr. Kris Gast: No, not right now.
Ashley Beck: And of course there will be a lot more to come out of this hopefully a lot more research done as well. Now today we’re just talking about statins but it’s also linked to the prostate, you’re going to come back and give us a lot more details in the next month or so
Dr. Kris Gast: Right, I think in two or three weeks I’ll be back, as long as there’s no other studies that come out between now and then, maybe we can just review basic standard treatment for early prostate cancer.
Ashley Beck: We hope that you will come back and meet us up here for that. Dr. Kris Gast is located at 8500 South 36th Terrace in Fort Smith, it’s the Fort Smith Radiation Oncology. There are the phone numbers that you can call, also the toll free number right there, you can also find them online Dr. Kris Gast and everyone online at fsro.net. We always learn so much when you’re here Dr. Gast, thanks for being here.
Dr. Kris Gast: Thank you
Ashley Beck: This is 5 Sunday Morning, we’ll be right back.