How is Prostate Cancer Treated?
The ideal treatment for prostate cancer stops the disease in its tracks and eradicates it without disturbing the patient's quality of life. The information provided on this site is not intended as a substitute for professional medical care. It is up to you and your physician to choose the best combination of treatments to best address your situation. The most common treatments are profiled here.
Watchful Waiting
Involves regular observation of the cancer to evaluate any changes that may have occurred. Typically used for slow-growing tumors or for very elderly patients. The advantage of watching and waiting is that the patient is not subjected to any treatment. The disadvantage is uncertainty about the progression of the disease.
Surgery
Prostate surgery is called radical prostatectomy, and removes the entire prostate gland and often some surrounding tissue. Surgery is a one-time procedure that may remove all of the cancer if it is detected early enough, but the procedure typically requires hospitalization of 5 to 7 days, results in a lengthy recovery period, and may not be well-tolerated by older men. Prostatectomy can also produce side effects that have a significant impact on the patient's quality of life, the most common being impotence (inability to maintain an erection) and incontinence (loss of bladder and/or bowel control).
External Beam Radiation
Utilizes radiation to stop the growth of cancer cells. A beam of radiation is delivered from outside the body through normal tissue to the site of the cancer. Since it is not a surgical procedure, external radiation tends to be well tolerated. It has shown a fairly high cure rate when the cancer is detected early, and the incidence of impotence and incontinence is lower than with radical prostatectomy. The disadvantages of external radiation include almost daily visits to the hospital for about two months, the risk of radiation damage to healthy tissue, plus fatigue, nausea and rectal irritation or bleeding. When the cancer is not particularly well defined, external beam radiation is sometimes used in combination with other forms of treatment.
Hormone Therapy
A form of therapy, but not a cure for the disease. The goal of hormone therapy is to lower the level of the male hormones (androgens), which promotes the shrinking of the prostate gland and a slowdown in growth of the tumor. Hormone therapy is often used before or combined with other forms of treatment and is usually the preferred option for a patient with advanced prostate cancer. Advantages include relief from symptoms of disease, a slow-down in growth of the tumor, and a prostate gland that becomes more receptive to other treatment. Disadvantages include impotence, infertility, cardiovascular problems, nausea and a decrease in libido.
Cryotheraphy
The controlled freezing of the gland in order to destroy the cancerous and the native prostatic cells. Studies show that cryosurgery results in a long-term survival rate equal to that of radical prostatectomy. Precise monitoring during the freezing process has greatly improved with the advent of advanced transrectal ultrasound, advanced cryo technology and improved interventional radiology skills. Advantages to Cryosurgery include no blood loss, no surgical incisions and outpatient surgery. Disadvantages include the fact that no long-term randomized multi-center studies have been conducted. Also, some insurance companies do not cover cryosurgery, usually because they list the therapy as investigational. The American Urologic Association has approved the procedure, however, meaning it no longer has investigational status with them. If you point this out to your insurance company, you may get coverage. Lastly, the procedure is highly operator dependent.
Brachytherapy
The permanent implantation through hollow needles of radioactive seeds into the prostate gland, guided by ultrasound imaging. Brachytherapy is often used as a sole treatment approach but may also be used in combination with other therapies, such as external beam radiation or hormone therapy. Advantages of brachytherapy include: the precise targeting of the radiation, which spares healthy tissue, a procedure that lasts about an hour-and-a-half and is performed on an outpatient basis, a lower risk of impotence and incontinence than either surgery or external beam treatment, and little to no impact on the patient's quality of life. Disadvantages include some incidence of impotence and incontinence, frequent urination and, occasionally, blood in the urine.
For more information about the benefits and risks involved with various prostate cancer treatment options, download the brochure provided below.
Prostate Cancer Treatment Information and Answers (PDF)
