When a man gets the diagnosis of prostate cancer, they imagine a future that includes permanent incontinence and erectile dysfunction, and the fear that they will feel less masculine. As many men who have gone through treatment for prostate cancer can attest, these fears are real, but not necessarily well founded.
What you experience as a result of prostate cancer treatment can depend on a number of issues, including:
- How fast your cancer is growing
- How much the cancer has spread
- The patient’s overall health
- Potential benefits and side effects of treatment options
How Many Men Get Prostate Cancer? Here Are Some Statistics
Each year, more than 180,000 men in the United States are diagnosed with prostate cancer. That is about 1 in 7 men who will be diagnosed with prostate cancer during his lifetime. That’s a lot. In fact, other than skin cancer, prostate cancer is the most common cancer among American men. This is why most men are tested regularly for prostate cancer once they are in their 50s, and yet others may be tested earlier given evidence of a higher risk for the disease.
Diagnosed With Prostate Cancer? Discuss All Treatment Options With Your Doctor!
There are many options available for treating prostate cancer. Each treatment has its benefits and side effects, and needs to be considered carefully prior to making a final decision with your doctor.
Early Stage Prostate Cancer
Immediate treatment for early stage, localized prostate cancer may not be necessary. Some men may never need treatment at all.
In many cases, doctors may simply recommend active surveillance of the prostate. This may include:
- Close monitoring of the status of your cancer through regular office visits
- Regular follow-up blood tests, such as PSA tests, to track any changes in the cancer
- Rectal exams
- Biopsies to monitor cancer progression
Active surveillance is usually an option for men whose prostate cancer is not causing symptoms, confined to a small area of the prostate, and is expected to grow very slowly. Active surveillance does carry the risk that the cancer may grow and spread between checkups, making the cancer less likely to be cured.
Surgery: Radical Prostatectomy
Radical Prostatectomy surgery for prostate cancer involves removing the entire prostate gland and surrounding tissue. This procedure is the common choice to try to cure prostate cancer that is not considered to have spread outside the prostate gland. They include:
- Traditional Open Approach to Radical Prostatectomy: The surgeon operates through a long single incision in the skin to remove the prostate and nearby tissue. This procedure is done less often, now, than in the past. There are two ways this procedure can be done.
One way this procedure is performed is by making the incision in your lower abdomen, from your navel down to your pubic bone. You will receive some form of anesthesia for this surgery, along with sedation. This is a better choice if lymph nodes need to be removed or observed for further diagnosis and treatment options.
The second way to perform this type surgery is to cut the skin between the anus and the scrotum. This technique is more likely to lead to erection problems because nearby lymph nodes cannot be removed.
- Laparoscopic Approaches to Radical Prostatectomy or LRP: This approach, more commonly practiced today, uses several small incisions through which the surgeon inserts long instruments and a small camera into the patient’s body, to remove the prostate. The surgeon may directly hold these instruments, or they may direct them robotically via a control panel. The robotic approach is believed to be more precise than the manual approach.
It is important to note that the success and side effects of this approach are dependent greatly upon the skill and experience of the surgeon. The rates of temporary erectile dysfunction and incontinence following surgery are the same for LRP as for the open approach. Depending on the surgical results, these side effects could be permanent, but are more likely to be temporary or intermittent.
Radiation Therapy to Fight Prostate Cancer
Radiation therapy uses high-powered energy to kill cancer cells. This can be accomplished in three ways:
- External beam radiation: This is radiation that is directed at the prostate from outside the body. You lie on a table while a machine moves around your body, directing the radiation beams. Traditionally, these have been X-ray beams, but there is a now newer technology available where a focused ray of proton particles is directed at the prostate to destroy cancerous tissues. Proton radiation treatment is capable of delivering precise, high doses of radiation to accurately targeted cancer cells without causing damage to healthy tissue surrounding the prostate.
- Internal radiation: Brachytherapy involves placing small seeds of radioactive material directly into your prostate tissue using a needle guided by ultrasound imaging. These rice-sized seeds deliver a low dose of radiation over a long period of time. They eventually stop emitting radiation, but do not need to be removed.
This treatment is used to lower the amount of the male hormone testosterone in your body, because prostate cancer cells rely on testosterone to help them grow. Types of hormone therapy include:
- Medications to stop testosterone production: Medications known as luteinizing hormone-releasing hormone (LH-RH) agonists prevent the testicles from receiving messages to produce testosterone.
- Medications to block testosterone from cancer cells: These medications are known as anti-androgens.
- Surgery to remove testicles (Orchiectomy): This surgery reduces testosterone levels in your body by removing the testicles.
Hormone therapy can be used in men with early-stage prostate cancer to make radiation therapy more effective, or in advanced stage prostate cancer to shrink the cancer and slow tumor growth.
Freezing Prostate Tissue
Cryosurgery or cryoablation involves freezing prostate tissue to kill cancer cells. This technique is used mostly in patients who have failed primary radiation therapy.
Chemotherapy uses drugs to kill rapidly growing cancer cells. It can be administered by a pill, or intravenously (IV). This is used to fight prostate cancer that has spread to other areas of the body, or for cancers that do not respond to hormone therapy.
This is also called immunotherapy, because it uses your body’s own immune system to fight the cancer cells. Scientists take some of your own immune cells and genetically engineer them in a laboratory to fight prostate cancer. These cells are then injected back into your body through a vein. This is a new area of treatment, and some men do respond to this therapy, but it is very expensive and requires multiple treatments.
Each of these therapy options for treating prostate cancer carry risks, and need to be discussed at length with your doctor before deciding which is best for you.
If you are in the Mesa, Arizona area and need to consult with a urologist about prostate cancer treatments, call the office of Urologic Surgeons of Arizona at (480) 409-5060 to schedule an appointment, or request an appointment online.