Prostate Cancer Treatments
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What should you do if you are given a diagnosis of prostate cancer? The most important thing is to realise that there is no one recommended course of action. There are various treatments available, each suited to a particular manifestation of the disease.
The best advice is to learn all you can about your options. Then, in partnership with your doctors, you’ll be able to make an informed decision about the course of action for you.
It is absolutely vital that you consider your decision carefully. Men diagnosed with localised prostate cancer today are likely to live long lives so any decision taken now will have ramifications in the future.
Take time to consult the professionals. There are three types of prostate cancer specialists – urologists, radiation oncologists and medical oncologists. Each of these will have unique perspectives on the disease and their opinions are to be valued. Taken together, they will offer you the most complete overview of the treatments available and all expected outcomes.
In recent years, active surveillance has become a viable option for many men. If you, for one reason or another, have decided not to undergo surgery or radiation treatment, it may be for you.
The idea behind it is that the cancer is carefully monitored for signs of progression. This usually involves a PSA blood test and DRE on a six-monthly basis along with a yearly biopsy of the prostate.
If symptoms develop or the cancer grows, treatment may be necessary. But if the cancer is slow growing or if you have another serious medical condition, active surveillance will continue.
Surgery is another option. This can be used to remove all or part of the prostate. Usually, men with early-stage cancer will undergo radical prostatectomy – removal of the entire prostate gland plus some of the surrounding tissue – while men with advanced or recurrent cancer may opt for slightly more complicated procedures.
Radiation – the killing of cancer cells and surrounding tissues with directed radioactive exposure – is a third option. The most common type of radiation therapy is external beam radiotherapy. The tumor cells are mapped out using CT scans and MRIs and x-rays are targeted at these specific areas.
There have been huge improvements in radiation over the years. It is now far more precise and as a result, higher and more effective doses can be administered with less chance of damaging surrounding tissue.
Other types of radiation include photon therapy and brachytherapy. Photon therapy is a precise treatment, targeting cells directly. The benefit of brachytherapy is that daily visits to hospital are not necessary. Instead, tiny metal pellets containing radioactive iodine or palladium are inserted into the prostate. Over time, these give off radiation to the immediate area, killing cancer cells.
Hormone therapy is a fourth option. Because testosterone drives the growth of prostate cancer cells, it can be used as part of the treatment. Hormone therapy is designed to stop testosterone from being released or to prevent the hormone from acting on the cells.
The majority of cells respond to this. However, some don’t and they cannot be allowed to grow unchecked. For this reason, hormone therapy is often used in tandem with another treatment.
Chemotherapy is another alternative worth considering. It uses chemicals to kill or halt the growth of cancer cells and can be very effective in the treatment of patients with advanced prostate cancer.
There are other options too. Cryotherapy – the process whereby the prostate is frozen, killing cells and tumors – has proved effective for some patients. High-intensity focussed ultrasound – which heats the cells in order to kill them – has helped others.
New treatments are emerging all of the time, thanks to ongoing research all over the world. Discuss all of your options with your physicians. Weigh up the possible outcomes and side effects. Armed with all of this information, you’ll be able to make the best decision for you.
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