Prostate cancer is a form of cancer originating in the prostate gland. In men, this is the third leading cause of death. Choosing the best therapies to treat prostate cancer is not always easy to determine. The doctor may choose based on the individual patient’s risk factors and type of cancer. When deciding on a treatment the patient will work with his doctor and determine which has benefits that outweigh the risks, while most likely being most effective for the patient.
Some patients may be a good candidate for surgery, however, before going in it is important that the patient fully understands all possible risks. When the cancer has not spread any further than the prostate gland itself, a surgical procedure to remove it along with some surrounding tissue is a possible option. This is referred to as a radical prostatectomy. For many patients, depending on the hospital and their doctor’s expertise, this surgery can be performed as a robotic surgery. After surgery, there is a chance that the patient will experience problems with erection, bowel movement difficulties and trouble controlling urine.
The main hormone in the male body is testosterone. For a prostate tumor to grow, it must have testosterone. Hormone therapy works to decrease how this hormone affects prostate cancer. Hormone treatments work to prevent the spread and further growth of cancer. This therapy is primarily administered to patients whose cancer has spread.
Luteinizing hormone-releasing hormones agonist drugs are the main type used. The most commonly used include leuprolide, nafarelin, histrelin, degarelix, goserelin, triptorelin and buserelin. These work to block testosterone from being produced and have to be administered every three to six months via injection. Possible side effects include hot flashes, lethargy, reduced sexual desire, weight gain, nausea and vomiting, anemia, osteoporosis, decreased muscle mass and impotence.
Androgen-blocking drugs may also be used along with the above mentioned drugs. Commonly used ones include flutamide, nilutamide and bicalutamide. Possible side effects include liver problems, breast enlargement, erectile dysfunction, diarrhea and loss of sexual desire.
While not commonly done, removing the testicles will also work as hormonal therapy.
When this cancer stops responding to hormonal therapy, immunotherapy and chemotherapy may be used.
Radiation kills cancer cells through the use of radioactive seeds or high-powered X-rays. This may be performed following surgery. External beam radiation is less invasive and involves pointing high-powered X-rays directly at the patient’s prostate gland. It is typically done five days a week for six to eight weeks. Treatment itself is painless, but side effects may include impotence, loss of appetite, skin reactions, diarrhea, blood in urine, incontinence, fatigue, rectal injury or burning and bladder urgency.
Prostate brachytherapy is more invasive and is done by placing radioactive seeds directly into the patient’s prostate gland. This involves using small needles to inject the seeds. Side effects may include scrotal or penile pain, bruising or swelling, impotence, diarrhea, incontinence and red-brown semen or urine.
Proton therapy is another form a radiation that may be used.
PubMed Health. (2010). Prostate Cancer. Retrieved on March 15, 2011 from PubMed Health: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/
Centers for Disease Control and Prevention. (2010). Prostate Cancer. Retrieved on March 15, 2011 from the Centers for Disease Control and Prevention: https://www.cdc.gov/Features/ProstateCancer/