PROSTAID CalgaryCalgary's Prostate Cancer Support Group
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Prostate Cancer Treatments Available in Provinces

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In October 2018 Jessica Yuck, a practicum student at University of Western Ontario, researched the prostate cancer treatments available across Canada where information was available. The main goal is to provide men and their families with an understanding of the various treatment options available to help improve their health outcomes. The information was obtained from web sites, and email and telephone requests.

PROSTAID Calgary is please to provide a summary of her findings. It is beyond the scope of this report to describe each of the treatments. These can be easily found on various web sites list at http://pccncalgary.org/n_links.php.

In her conclusion it is worth noting that treatment information is not easily found:

“ The fact that I had such a difficult time gathering such small amounts of data over the course of several weeks throughout my practicum, indicates how inaccessible this information is to the public. It is essential that we advocate for a change in the way health information is displayed to the public online. I strongly believe that all regional healthcare administrations should be required to provide a minimum level of healthcare information to the public. In addition, all information should be formatted in a similar manner in order to increase clarity for those seeking pertinent answers to their healthcare concerns.”

PROSTAID Calgary agrees that healthcare information and treatments for prostate cancer should be easily and readily available.

Table 1
Table 1 lists all prostate cancer treatments found on the Canadian Cancer Society’s website. This information provided a reference for treatments when conducting the systematic web search.

Table 1. Prostate cancer treatments listed on the Canadian Cancer Society website*

Prostate Cancer Treatments Subcategories

Active Surveillance

None

Surgery

  • Radical prostatectomy
  • Retropubic radical prostatectomy
  • Perineal radical prostatectomy
  • Laparoscopic radical prostatectomy
  • Robotic radical prostatectomy
  • Nerve-sparing radical prostatectomy
  • Transurethral resection of the prostate (TURP)
  • Cryosurgery
  • Pelvic lymph node dissection (PLND)

Radiation therapy

  • External beam radiation therapy
  • 3-dimensional conformal radiation therapy (3-D CRT)
  • Intensity-modulated radiation therapy (IMRT)
  • Stereotactic
  • Gamma Knife
  • CyberKnife
  • Tomotherapy
  • Brachytherapy (internal radiation therapy)
  • Low-dose-rate (LDR) brachytherapy
  • High-dose-rate (HDR) brachytherapy
  • Proton beam radiation therapy
  • Systemic radiation therapy

Hormonal therapy

  • Medications
  • Luteinizing hormone-releasing hormone (LHRH) antagonists
  • Androgen deprivation therapy (ADT)
  • Estrogens
  • Orchiectomy (surgical castration)

Chemotherapy

  • Drugs available:
  • Docetaxel (Taxotere)
  • Mitoxantrone
  • Cabazitaxel (Jevtana)
  • Estramustine (Emcyt)
  • Paclitaxel (Taxol)
  • Doxorubicin (Adrimycin)
  • Epirubicin (Pharmorubicin)
  • Vinorelbine (Navelbine)

High-intensity focused ultrasound (HIFU)

None

Corticosteroids

  • Prednisone
  • Dexamethasone

*Information retrieved from Canadian Cancer Society (no date)


Table 2             
Table 2 lists the 7 provinces that replied to the email correspondence regarding treatment options by province. Answers vary significantly

Table 2. Responses by healthcare workers and prostate cancer support groups via email correspondence or phone calls

Province/Territory Response

Alberta1

  • Provided the following list of treatment options:
  • External beam radiation
  • Brachytherapy
  • Cryoablation surgery
  • Radical open prostatectomy
  • Robotic prostatectomy
  • Also provided a PowerPoint with explanations of each option

Manitoba2

  • Stated that the only treatment option not available is “robotic prostatectomy”

New Brunswick3

  • Provided lists of the three major types of treatments undergone by those belonging to the PCCN Fredericton support group:
  • Radical prostatectomy
  • Radiation therapy
  • Brachytherapy
  • Indicated that robotic-assisted laparoscopy is not offered in New Brunswick but covered if patients were to go out-of-province
  • Noted that hormone therapy and drug treatments are available but not covered by Medicare unless administered in a hospital

Saskatchewan4

  • Provided a phone number to call and listed the following:
  • Surgery (no robotic-assisted radical prostatectomy)
  • HDR brachytherapy
  • Hormone deprivation therapy

Newfoundland and Labrador5

  • Provided the following list of treatment options:
  • Surgery
  • Radical prostatectomy (but no robotic-assisted)
  • Brachytherapy
  • HDR (LDR brachytherapy must be conducted in Moncton, New Brunswick)
  • Androgen deprivation therapy
  • Although not covered by provincial drug plan (only private insurance)
  • Chemotherapy
  • Although unsure of which pills are covered
  • Indicated that HIFU, Cryotherapy and Thermal ablation are not offered

Northwest Territories6

  • Noted that they offer the same treatments as Alberta as they use our oncologists and urologists

Ontario7

  • Indicated that standard treatments such as radiation and surgery are offered
  • HIFU and Proton therapy were listed as treatments not offered

Data table references:

  1. Prymack, A (2018)
  2. Sprott, B (2018)
  3. Patterson, S 2018)
  4. Ward, L (2018)
  5. Hammond, L (2018)
  6. Cancer Care Coordinator Stanton Territorial Hospital (2018)
  7. Canadian Cancer Society, Hamilton (2018)

Table 3a) lists the provinces that offer certain types of radiation therapies.

Data table references:

  1. Provincial Health Services Authority. (n.d.). Prostate. Retrieved from http://www.bccancer.bc.ca/health-info/types-of-cancer/mens-cancer/prostate#Treatment
  2. Vancouver Prostate Centre. (2017). Radiation treatment. In Vancouver Prostate Centre. Retrieved December 5, 2018, from https://www.prostatecentre.com/patient-information/diseases-prostate/prostate-cancer/treatments/radiation-treatment
  3. Vancouver Prostate Centre. (2017). Brachytherapy. In Vancouver Prostate Centre. Retrieved December 5, 2018, from https://www.prostatecentre.com/patient-information/diseases-prostate/prostate-cancer/treatments/brachyotherapy
  4. Healthwise. (n.d.). Radiation therapy for prostate cancer. Retrieved December 05, 2018, from https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=hw76948
  5. Government of Saskatchewan. (n.d.). Prostate cancer treatment Options. Retrieved December 05, 2018, from http://www.sasksurgery.ca/patient/treatment.html
  6. Cancer Care Manitoba (2018). Clinical fellowship in radiation oncology. Retrieved December 05, 2018, from http://www.caro-acro.ca/wp-content/uploads/2018/08/UofM-Radiation-Oncology-2019-2020.pdf
  7. CancerCare Manitoba. (2010, May). Radiation . In CancerCare Manitoba. Retrieved from https://www.cancercare.mb.ca/export/sites/default/Treatments/.galleries/files/radiation-therapy-files/radiation-therapy-translations-files/Radiation_Facts-English.pdf
  8. Yong, J. H. E., McGowan, T., Redmond-Misner, R., Beca, J., Warde, P., Gutierrez, E., & Hoch, J. S. (2016). Estimating the costs of intensity-modulated and 3-dimensional conformal radiotherapy in Ontario. Current Oncology (Toronto, Ont.), 23(3), e228-38. https://doi.org/10.3747/co.23.2998
  9. Cancer Care Ontario, & Action Cancer Ontario. (2017, May 02). ASCO and cancer care ontario update guideline on radiation therapy for prostate cancer. Retrieved December 05, 2018, from https://archive.cancercare.on.ca/..._therapy_for_prostate_cancer/
  10. Procure. (n.d.). Radiation therapy. Retrieved December 05, 2018, from http://www.procure.ca/en/prostate-cancer/treatment-options/radiation-therapy/
  11. Horizon Health Network. (n.d.). Saint John Regional Hospital (SJRH) Site. Retrieved December 05, 2018, from http://en.horizonnb.ca/home/facilities-and-services/services/clinical-services/oncology/oncology-services-at-the-saint-john-regional-hospital/saint-john-regional-hospital-(sjrh)-site.aspx
  12. Keyes, M., Crook, J., Morton, G., Vigneault, E., Usmani, N., & Morris, W. J. (2013). Treatment options for localized prostate cancer. Canadian family physician Medecin de famille canadien59(12), 1269-74.
  13. Lawlor, A. (2016, June 16). A less invasive treatment. Retrieved December 05, 2018, from http://www.qe2times.ca/a-less-invasive-treatment-141
  14. Eastern Health. (n.d.). Radiation Therapy. Retrieved December 05, 2018, from http://cancercare.easternhealth.ca/cancer-care-services/radiation-therapy/

Table 3b) Types of radical prostatectomy surgeries offered by province

Data table references:
Canadian Institute for Health Information. (2014, August). Prostate Cancer Surgery in Canada - Canadian Institute for Health Information Retrieved from https://www.cihi.ca/sites/default/files/prostate_surgery_pubsummary_en.pdf

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