• High Risk

    Azure: The designation “High-Risk,” refers to the risk of PSA relapse after surgery or radiation, not to a high risk of cancer mortality. Men in the Azure category most commonly receive Testosterone Inactivating Pharmaceuticals (TIP) aka hormone blockade, in combination with radiation.

    The optimal duration of TIP is controversial but should probably continue for at least a year. Some experts recommend two or three years.

    Combination radiation with IMRT and a seed implant boost is often recommended to augment the dose of radiation in the prostate gland. IMRT directed at the pelvic lymph nodes is also being used more frequently as physicians are realizing that improved targeting makes node radiation feasible. Previous generation radiation technology was so inaccurate there was a high risk for collateral damage to the intestines.

    Surgery for Azure is less popular due to the increased risk of cancer left behind after the operation, an occurrence termed positive surgical margins. Since positive margins require radiation, men choosing surgery often end up the undesirable outcome of having both an operation plus radiation.

    High Risk (Azure)

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