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• Cardiac Medico-Surgical Department
• Digestive Disease’s Department
• Mother-child department
• Ophthalmology
• Orthopaedic surgery
• Thoracic
• Urology
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  • The Medical Staff
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  • Treated Diseases

The treatment of localized prostate cancer 

The different treatments

• Laparoscopic radical prostatectomy and robotic
• The brachytherapy
• The radiotherapy
• High Intensity Focused Ultrasounds (HIFU - Ablatherm)
• Cryotherapy

Which treatment to choose ?

Laparoscopic radical prostatectomy 

This technique is performed in the Department of Urology, where it was invented in January 1998. It is currently the reference technique in our department.

Brachytherapy 

Brachytherapy is performed in the context of the IMM-Institut Curie network. Professor JM Cosset manages patients requiring this modality.
This technique, performed under anaesthesia, consists of visualizing the prostate by ultrasound, then placing radioactive implants in the prostate via the perineum. It is reserved for small prostate cancers and is currently under evaluation in France. For more information, consult the Institut Curie website.

Conformal radiotherapy 

This technique is performed in the context of the IGR-IMM network. Doctor Pierre Wilbault, at the Institut Gustave Roussy, treats patients requiring conformal radiotherapy.
Treatment with this type of radiotherapy takes about 6 weeks and consists of delivering rays via various portals on the body after the zone to be treated has been defined by the computer.

Treatment with focal ultrasound 

This technique is used to treat localized prostate cancer by ultrasound delivered across the rectum.
It was created in Lyon 7 years ago by Dr Albert GELET, in Prof. DUBERNARD's department at Edouard Herriot hospital. It has been under evaluation for  years in our department.
The results obtained in European and American protocols encourage us to propose this treatment when the cancer is localized inside the prostate in elderly men. One thousand patients have been treated by this technique to date.
For more information on this technique, consult Ablatherm

Cryotherapy 

The technique uses freezing probes. It is not yet certified and is few and it is little practised in France.

Which treatment to choose? 

Which elements count to choose the treatment?
Patient age, global patient health state, medical and surgical pas history, the medical treatments he takes.
For the cancer treatment we take in account:

• PSA level
• Digital rectal examination
• Biopsies results :

• number of positive biopsies,  
• the localization
• gleason score

• Complementary test :

• CTScan
• RMI
• Bone scan

The surgery is feasible in almost all the cases until 75 years.
The brachytherapy is feasible in the localized prostate cancer with a PSA level at 6 or under and a prostate volume less than 40g.
The focused ultrasounds (ablatherm) are used in prostate cancer for men older than 75 years.