Prostate Cancer Treatment
If you or someone you care about has recently been diagnosed with prostate cancer, you probably have many questions and concerns about the disease and treatment. There are a lot of things to consider at this point, especially in regards to the various treatment options.
Make sure you give yourself time to absorb all the information you have been given and that you fully understand your options before choosing a treatment plan. As most cases of prostate cancer are not in need of immediate treatment, you should not feel as if you need to rush into making a quick decision.
Although it is impossible to guarantee an outcome, prostate cancer treatments are generally successful in treating the disease, especially when caught in the earlier stages. Treatments can all have significant side effects and varying degrees of effectiveness, however, so the choice you make regarding treatment can affect your quality of life for quite some time.
Choosing a Treatment Plan
As there is not one set way to treat every case of prostate cancer, it will be up to you and your doctor to determine which approach is best for your situation. Your treatment plan will depend on many factors including: the diagnosis; the medical recommendations of the doctors involved in the process; and each mans personal feelings and concerns about the disease and treatment.
An appropriate treatment plan for prostate cancer should consider the following factors:
- age and life expectancy
- overall health condition
- stage and grade of prostate cancer
- doctor's opinion about the need and/or method to treat the cancer
- your feelings about the need and/or method to treat the cancer
- the side effects of each treatment
- the effectiveness of each treatment
One of the primary factors your doctor considers when recommending specific treatments for prostate cancer is the stage and grade of the disease. In men with localized prostate cancer, common treatments include active surveillance, radiation therapy, and surgery. Treatments for advanced prostate cancer often include external beam radiation therapy, hormone (androgen-deprivation) therapy, and chemotherapy.
Common Treatment Options
The most common treatment options for prostate cancer are:
- surgery
- radiation therapy
- hormone therapy
Some cases of prostate cancer are not treated, but put under watchful waiting.
Prostate Surgery
Prostate surgery, called radical prostatectomy, may be recommended if the cancer is confined to the prostate and has not spread to surrounding tissues or traveled to other parts of the body. The operation is performed in order to remove the affected portion of the prostate gland and the cancer before it spreads to other parts of the body. If cancer has spread beyond the prostate, surgery alone will not treat it, but may be used in conjunction with other therapies.
There are three major types of prostate surgery: open/traditional surgery (either with an incision in your abdomen or with an incision between your anus and scrotum); minimally invasive laparoscopic (keyhole) surgery; or the newest option of robotic-assisted surgery.
While it is natural to want to undergo surgery in order to get rid of the cancer, it is a decision that should be made very carefully due to the possible side effects. The operation may cause damage to the nerves and muscles in the area, leading to erection problems and/or bladder problems that may continue even if the disease is successfully treated. Sometimes sexual function and/or bladder control returns or gets better with time, but sometimes it does not.
Radiation Therapy
Radiation therapy may be used as the only method of treatment or in conjunction with surgery or medications. Radiation treatments are most effective in treating prostate cancer that has not spread outside of the prostate. Following prostate surgery, it may be used to treat any cancer cells that may still remain or to help relieve pain from cancer that has spread outside of the prostate.
Radiation therapy can be given either internally (brachytherapy) or externally (external beam radiation therapy). With external beam radiation therapy (EBRT), a machine targets the cancer with high energy x-ray beams. This type of radiation is effective at killing cancer cells, but it can also damage surrounding healthy tissue. With brachytherapy (also known as radioactive seed implant therapy), radioactive material that is sealed in needles and seeds are placed directly in the body into the cancerous area. Common side effects of radiation therapy are urinary incontinence, inflammation of the bladder (cystitis) or colon (colitis), and impotence. These side effects may be temporary problems for some men, but they may linger over time for other men.
Hormone Therapy
Because male sex hormones can stimulate the growth of cancer cells, hormone therapy uses drugs to try and stop the body from producing male sex hormones and slow the growth of prostate cancer cells. Hormone therapy is sometimes uses in combination with either surgery or radiation to make sure all the cancer cells are destroyed.
Watchful Waiting
Watchful waiting (also called active surveillance) is an option for men who are diagnosed at a very early stage of prostate cancer. Watchful waiting may also be appropriate for a man who is older or in poor health, or both. With watchful waiting, there are no medical treatments provided. Watchful waiting may be an option if the prostate cancer isn't causing any symptoms, appears to be very slow growing, and is confined to a small area of the prostate. During this time a man's doctor will measure the progression of the cancer with regular follow-up blood test, rectal exams, and sometimes with biopsies. Watchful waiting, however, may also increase the chance of the cancer growing, spreading and becoming incurable.
Newer Treatments
In addition to these common treatment options for prostate cancer, many new prostate cancer treatments appear promising as well, including: cryosurgery, chemotherapy, biologic therapy, high-intensity focused ultrasound, and proton beam radiation therapy.
Getting a Second Opinion
Prostate cancer treatment is not an exact science, making it a good idea to get more than one medical opinion about your diagnosis and treatment. Doctors may differ in their opinion regarding the best treatment choices for your situation, especially if they specialize in different types of therapies or provide some of the newer types of treatment. Talking to more than one doctor about your diagnosis may give you a better perspective on your treatment options.
There are three types of prostate cancer specialists - urologist, radiation oncologist, and medical oncologist. Urologists are surgical specialists and tend to favor surgery; a radiation oncologist specializes in using radiation to treat cancer; a medical oncologist specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, biological therapy, and targeted therapy.
One of the best bits of advice you can get regarding treatment is to get a second opinion and consult with all three types of prostate cancer specialists. This will provide you with the most comprehensive assessment of the treatments available for prostate cancer, including information on both standard and new treatment options, the possible side effects and expected outcomes.