Prostate Cancer Treatment

Available prostate cancer treatments include the following:

Watchful Waiting: This is also called active surveillance. In men who are older or whose prostate cancer is spreading slowly, the doctor can recommend this method, where the patient's condition is monitored (often via measuring the PSA values) periodically, and unless conditions worsen, no other treatment is given. The underlying theory is that, since prostate cancer often spreads slowly, there is a high probability that the patient will get another type of life-threatening disease before prostate cancer becomes so serious that it must be treated. This also saves the patient from the physically- and mentally-draining treatment procedures.

Surgery: There are two types of surgery, radical prostatectomy or laparscopic surgery. The goal of the surgery is to remove the cancer cells from the body. The advantage of this treatment type is that it is basically the only treatment that may eliminate the cancer completely. The disadvantages are 1) as this is a major surgery, the patient must be strong enough to endure the process and the subsequent healing period. Since many people who has prostate cancer are at an advanced age, they may not have the stamina to withstand a major surgery, 2) as with all surgeries, there are possible side effects. The most obvious side effect is difficulty in urination for weeks or months after the surgery.

Radiation treatment: Radiation treatments use high-energy rays to kill cancer cells. Because it is very difficult to pinpoint the radiation only to the cancer cells, usually the surrounding healthy cells will be affected as well. So, radiation treatment is often given in small amounts over several sessions. Radiation treatment comes in two types: external and internal. In external radiation treatment, a laser is used, usually with the assistance of computer, to point to the cancer cells. In internal radiation treatment (called brachytherapy) , tiny seeds containing radioactive material are injected directly into or near the cancer and left there. In time, the material loses its radioactivity and the seeds do not need to be taken out. Radiation treatment itself cannot fully kill the cancer cells, but may severely hinder their growth. Please note that once radiation treatment starts, it will be difficult to have a surgery to remove the prostate should radiation treatment fail.

Research into better radiation treatment for prostate cancer is ongoing. One example is the CyberKnife, which uses robotic technology to deliver high-dose radiation to the tumor, and the treatment can be completed in a matter of days rather than weeks.

Chemotherapy: In chemotherapy, a drug or a combination of drugs that poison cells is given to the patient, most often via intravenous injection. Once inside the body, the drug travels around the body and kills the rapidly-dividing cancer cells. Because the drug also kills other normal rapidly-dividing healthy cells, there can be adverse side effects. Usually chemotherapy is given only to patients with advanced prostate cancer.

Hormone: Prostate cells need male hormone to grow. Hence, prostate cancer cells also need male hormone to grow. The theory behind hormone treatment is that if we lower the amount of male hormone such as testosterone, the cancer cells may stop growing and can even shrink because they are not getting the necessary nutrients. Hormone therapy will not eliminate prostate cancer, but it can be effective in controlling prostate cancer.

There are two types of hormone treatments: The first is orchiectomy (surgical castration), where testicles are removed. This will decrease the male hormone level right away, but may not be a desirable option for men. The second is taking medicine that will decrease the production or effect of the male hormone by injection or orally. Both types of treatment will cause side effects because of the lowered level of male hormone in the body. Possible side effects include impotence, reduced sexual desire, growth of breast tissue, and fatigue.