Useful Treatment for Prostate Cancer

What Is Prostate Cancer?

Prostate cancer develops in a man's prostate, the walnut-sized gland just below the bladder that produces some of the fluid in semen. It's the most common cancer in men after skin cancer. Prostate cancer often grows very slowly and may not cause significant harm. But some types are more aggressive and can spread quickly without treatment.

Treatment: Watchful Waiting

With low-risk cancer, one option is to watch and wait. This is determined by your biopsy, PSA test, and Gleason scores. Your doctor will order periodic testing. Other treatments – with the risk of sexual or urinary problems – may not be necessary. Some men who are older or have serious health conditions may not need treatment. However, more aggressive treatment is usually recommended for younger men or those with more aggressive disease.

Treatment: Radiation Therapy

External beam radiation to kill cancer cells can be used as a first treatment or after prostate cancer surgery. It can also help relieve bone pain from the spread of cancer. In brachytherapy, tiny radioactive pellets about the size of a grain of rice are inserted into the prostate. Both methods can impair erectile function. Fatigue, urinary problems, and diarrhea are other possible side effects.
Treatment: Surgery

Removing the prostate, or radical prostatectomy, is used to eliminate the cancer when it is confined to the prostate. New techniques use smaller incisions and seek to avoid damaging nearby nerves. If lymph nodes are also cancerous, prostatectomy may not be the best option. Surgery may impair urinary and sexual function, but both can improve over time.

Treatment: Hormone Therapy

Hormone therapy may shrink or slow the growth of your cancer, but unless it is used with another therapy it will not eliminate the cancer. Drugs or hormones block or stop the production of testosterone and other male hormones, called androgens. Side effects can include hot flashes, growth of breast tissue, weight gain, and impotence.

Treatment: Chemotherapy
Chemotherapy kills cancer cells throughout the body, including those outside the prostate, so it is used to treat more advanced cancer and cancer that did not respond to hormone therapy. Treatment is usually intravenous and is given in cycles lasting 3-6 months. Because the chemotherapy kills other fast-growing cells in the body, you may have hair loss and mouth sores. Other side effects include nausea, vomiting, and fatigue.

Treatment: Cryotherapy

Cryotherapy freezes and kills cancerous cells within the prostate (like the highly magnified cells shown here.) It is not as widely used because little is known about its long-term effectiveness. It's less invasive than surgery, with a shorter recovery time. Because the freezing damages nerves, as many as 80% of men become impotent after cryosurgery. There can be temporary pain and burning sensations in the bladder and bowel.

Treatment: Prostate Cancer Vaccine

This vaccine is designed to treat, not prevent, prostate cancer by spurring your body's immune system to attack prostate cancer cells. Immune cells are removed from your blood, activated to fight cancer, and infused back into your blood. Three cycles occur in one month. It's used for advanced prostate cancer that no longer responds to hormone therapy. Mild side-effects can occur such as fatigue, nausea, and fever.
Louise Chang, MD