Prostate cancer may be fairly harmless or slowing growing with few, if any, symptoms. Or it can be quite aggressive, spreading rapidly to other parts of the body. The type of treatment your doctor recommends will depend on the stage of the disease or the grade of tumor.
If the tumor is low grade, slow growing and confined to the prostate, doctors may recommend no treatment. This is sometimes called watchful waiting. It's usually for elderly men who face a greater risk from treatment side effects. It's also for those who are likely to die from other causes before the cancer becomes lethal. During this time, the patient carefully monitors his condition, watching for signs that the cancer is progressing. Far from being a "hand-off" approach, watchful waiting calls on you to decide whether you will undergo aggressive treatment at a later time, what the treatment will be and when it will start.
Your doctor may recommend surgical removal of the prostate, or a radical prostatectomy, if the cancer is confined to the prostate. A transurethral resection of the prostate (TURP) is another procedure that removes the tissue surrounding the urethra and is often used to treat benign prostate hyperplasia (BPH). You may have either general anesthesia or an epidural block, which numbs the lower part of the body. Usually a one or two night stay in the hospital is required. As with any surgery there are risks. In this case, you may become impotent and/or incontinent. But advances in surgery have reduced these risks considerably.
Radiation kills cells that divide quickly. It may be an option if the cancer is confined to the prostate and the surrounding tissue. There are two types of radiation therapy:
- External beam: radioactive beams are directed at the prostate area
- Brachytherapy: radioactive "seeds" are permanently planted in the prostate with a needle
In some cases, cutting off the supply of testosterone can slow the growth of prostate cancer. If the cancer has not responded to surgery or radiation, your doctor may recommend removing the testicles, the main source of testosterone. This is called an orchiectomy. Another type of hormone therapy involves monthly injections of a drug that blocks testosterone production. Hormone therapy is not a cure. It can cause hot flashes, impotence and loss of sexual desire
This therapy uses toxic drugs to slow or reverse the spread of cancer in its later stages. The drugs are injected into the bloodstream to poison rapidly growing cancer cells. Side effects include damage to healthy cells and organs. In addition, there are the better known side effects of nausea, hair loss and anemia.
Clinical trials, also called cancer treatments or research studies, test new treatments in people with cancer. The goal of this research is to find better ways to treat cancer and help cancer patients. Clinical trials test new drugs, new combinations of drugs, or new anticancer treatment strategies to determine whether these promising treatments are safe and effective.
