Wolf has cancer treatment options in York

Katherine Ranzenberger

One in seven men is diagnosed with prostate cancer in his lifetime. Pennsylvania Gov. Tom Wolf announced Monday he is that one.

Dr. Gregory Fortier, MD, a radiation oncologist with WellSpan Health, discusses treatment options for prostate cancer at the York Cancer Center, Wednesday Feb. 24, 2016. John A. Pavoncello photo

However, his early-stage cancer is extremely treatable, according to Dr. Gregory Fortier, radiation oncologist with WellSpan York Hospital Cancer Center.

“You can choose your therapy option based on which will be best for you,” Fortier said. “The cure rates are high for early- or intermediate-stage cancer. The natural history of this disease varies person to person, and some treatments are less invasive than others.”

Wolf said his treatment will start in the coming weeks and will take place in the York area.

Options: Fortier said he has three main options for treating his prostate cancer: brachytherapy, external beam radiation and surgery.

“All three are good options,” he said. “There are pros and cons to each one. Surgery has a long downtime after. External beam therapy is a daily thing. The brachytherapy is very effective with very little downtime.”

Men should talk with their doctors about which option is best for them, Fortier said.

The easiest option for some is brachytherapy, or radioactive seeds, that are implanted at the top side of the prostate gland near the bladder. Fortier said a series of 16 to 18 needles are used to implant the seeds.

The needles are about 20 centimeters long and can contain anywhere from two to five seeds in the end of each. A 3-D image is made of the man’s prostate through a CT scan and MRI.

“We use a machine to make a grid and use that to place the seeds in surgery,” Fortier said. “The rectum has an ultrasound probe to help guide us. We’ve already programmed the image of their prostate into the machine, and then we hit the end of the needle to place the seeds.”

Most men are back to work within a day of the procedure.

External beam radiation therapy can also be used for the treatment of prostate cancer. A 3-D image of the prostate is made again through a CT scan and MRI.

Doctors then determine where the radiation should be focused, getting within 2 millimeters of target area, Fortier said.

“Traditionally, external radiation is done with photons,” he said. “We put the patient through a simulation of the process. The machine rotates 360 degrees around the patient to spread a little radiation to every part of the prostate.”

WellSpan York Hospital Cancer Center has three radiotherapy machines that perform the procedure. Fortier said the center can treat about 43 patients a day with the machines there. The group also has other centers it works with as well.

Early detection: Early detection of prostate cancer is key for treatment, Fortier said. Men over the age of 50 should talk with their doctor about testing.

“If they’re a higher risk, they should get tested before age 40,” he said. “You have to be judicious with the PSA test.”

The PSA test measures the level of prostate-specific antigen, a protein produced by the prostate, in a man's blood, according to the National Cancer Institute. The PSA blood level is often elevated in men with prostate cancer.

Men who are at a higher risk for prostate cancer tend to have a family history of the disease, are African-American or have family members that have tested positive for the BRCA1 or BRCA2 gene mutation, a variation linked to breast cancer.

Wolf and his wife, Frances, credit early detection and the PSA test for the ability to treat Wolf’s cancer easier.

“We are very thankful that Tom’s doctors caught this cancer quickly and have worked to plan a treatment schedule that will address his medical issues and allow him to serve the people of Pennsylvania,” the first lady said in a Monday blog post.

“Prostate cancer is the most common cancer in men. Early detection is important, and promising research shows accurate screening tests and preventive measures should help reduce the risk of death from prostate cancer.”

Many are sending their well wishes to the governor and his family, including the Pennsylvania Medical Society and the York County commissioners.

“My thoughts and prayers are with him and his family,” said Susan Byrnes, York County president commissioner. “I’m sure that his treatment will be successful.”

– Reach Katherine Ranzenberger at kranzenberger@yorkdispatch.com.