Which Prostate Cancer Treatment Path Should You Take?

​​​​​​​​​Choosing how—or whether—to treat prostate cancer can be a difficult decision. Although prostate cancer cells eventually spread to other parts of the body, they often grow slowly. Experts say that aggressive treatment for a slow-growing cancer means some patients cope with side effects when they could have been symptom-free for years.

Neverth​eless, some prostate cancers are aggressive. If you're faced with deciding how to treat prostate cancer, your healthcare provider is your best source of information and will recommend one or more of the following treatment options:

 

  • Surgery: A prostatectomy is a surgical procedure that removes the entire prostate gland. It can be performed through an incision in the perineum or the abdomen or as a laparoscopic procedure through several small abdominal incisions. Recovery time varies. Side effects may include incontinence and impotence. In some cases, surgeons perform nerve-sparing surgery, which helps avoid impotence.
  • Radiation: Radiation therapy uses high-energy rays to kill cancer cells in a specific area, sparing healthy tissues. You may have radiation in place of surgery or following surgery to target any remaining cancer cells. External radiation uses a large machine to destroy cancer cells. Internal radiation (also called implant radiation or brachytherapy) involves placing radioactive implants inside the body at the cancer's site. Side effects may include fatigue, hair loss, impotence, and bowel and urinary problems.
    • At The Christ Hospital, we also offer the Edge™, a radiosurgery system that delivers sophisticated treatments in just a few minutes per day, while monitoring and compensating for motion. It incorporates the Calypso 4D Localization System™ to deliver extremely tailored radiation directly to the prostate, through the system's "GPS for the Body". 
  • Hormones: Hormone therapy deprives cancer cells of the male hormones they need to grow. Various drugs block the androgens' action or prevent the adrenal glands or the testicles from making testosterone. Surgery to remove the testicles also reduces androgen levels. Hormone therapy often controls prostate cancer that's spread, but eventually most prostate cancers grow with little or no androgens, and therapy becomes ineffective. Side effects include impotence, hot flashes, loss of sexual desire, weaker bones, nausea, diarrhea, breast growth and liver problems.
  • Active Surveillance: Active surveillance means undergoing no treatments while being frequently monitored for changes in symptoms or rising levels of prostate-specific antigens (PSAs). Your doctor may suggest active surveillance if you have an early-stage, slow-growing cancer, low PSA levels, are older, or have other serious health problems. You may choose active surveillance f you decide the treatment's risks and potential side effects outweigh your expected benefits. You can opt to begin treatment at any time.

 

 

 

 

The best course of treatment depends on the cancer's stage, the tumor's grade, and your symptoms, general health and tolerance for side effects.

Learn more about Dr. Mannion.

​​Brian Mannion, MD, PhD, is the Medical Director of The Christ Hospital – Cancer & Blood Disorders program.