Prostate cancer treatment Options: Prostate cancer is a complex disease with different treatment options. Patients should understand and weigh the benefits of each treatment against its side effects, and risks.
- Active Surveillance:
As the prostate cancer often grows very slowly, some men (especially those who are older or have other serious health problems) may never need treatment for their prostate cancer. Active surveillance involves close monitoring of the cancer. This approach is less likely to be a good option in young, healthy, and/or fast-growing cancer (for example, a high Gleason score).
Radical prostatectomy is a surgery that attempts to cure prostate cancer. It is used most often if the cancer is not thought to have spread outside of the gland. Entire prostate gland plus some of the tissue around it, including the seminal vesicles are removed. The different approaches are open, laparoscpic and robotic.
Side-effects: depend on the pre-procedure condition and also the extent of the disease. The possible side-effects of radical prostatectomy are
- urinary incontinence (being unable to control urine) and impotence (being unable to have erections). It should be noted that these side-effects are also possible with other forms of the therapy.
- Sterility: Radical prostatectomy cuts the connection between the testicles (where sperm are produced) and the urethra. This means that a man can no longer be father a child by natural means. Often, this is not an issue, as men with prostate cancer tend to be older. But if it is a concern sperm “banking” can be considered before the operation.
- Radiation therapy:
Radiation therapy uses high-energy rays or particles to kill cancer cells. Radiation is used as the initial treatment for cancer that is still confined within the prostate gland or that has only spread nearby.
Side Effects: The risks of the newer treatment methods are lower.
- Bowel problems: diarrhea, sometimes with blood in the stool, rectal leakage, and an irritated large intestine. Most of these problems go away over time.
- Bladder problems: urinate more often, a burning sensation while urinating, and blood in your urine.
- Urinary incontinence: less common than after surgery.
- Impotence: After several years, the impotence rate after radiation is about the same as that of surgery. It usually does not occur right after radiation therapy but slowly develops over a year or more.
- Feeling tired
- Hormone (androgen deprivation) therapy
The goal is to reduce levels of the male hormones, called androgens, in the body. The main androgens are testosterone and Dihydrotestosterone (DHT). Androgens, produced mainly in the testicles, stimulate prostate cancer cells to grow. Lowering androgen levels often makes prostate cancers shrink or grow more slowly. However, hormone therapy does not cure prostate cancer.
Types of hormone therapy::
Orchiectomy (surgical castration)
Luteinising Hormone-Releasing Hormone (LHRH) analogs
Chemotherapy is sometimes used if prostate cancer has spread outside of the prostate gland and hormone therapy isn’t working.
These side effects may include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Lowered resistance to infection (due to low white blood cell counts)
- Easy bruising or bleeding (due to low blood platelets)
- Fatigue (due to low red blood cells)