Once you have been diagnosed with prostate cancer, your doctor will evaluate the type and stage of your cancer as well as your general health to develop a treatment plan.
There are four standard prostate cancer treatment options available: Surgery, Radiation Therapy, and Hormonal Therapy, and Watchful waiting. You may have one of these treatments or a combination.
The main goals of surgery are to remove the tumors from the body and minimize damage to any nearby cancer-free tissues and organs in the body. There are two common types of surgery used to treat prostate cancer:
- Radical retropubic prostatectomy: This is the most common type of surgery. In this procedure, the surgeon will make a skin incision in the lower abdomen, from belly button down to pubic bone. From this procedure, lymph nodes near the prostate also can be removed and examined for evidence of cancer.
- Radical perineal prostatectomy: In this procedure, the surgeon makes an incision in the skin between the anus and scrotum. From this procedure, lymph nodes can not be removed, so that the second incision is sometimes necessary in the lower abdomen to remove it.
These surgeries usually take 90 minutes to 4 hours. The perineal operation usually takes less time than the retropublic operation, and may result in less pain afterwards. After surgery you will need to stay in the hospital for about 1-7 days and will probably be able to return to work within three to five weeks depending on your type of work.
Radiation therapy uses high energy x-rays to kills cancer cells or prevents them from growing. This therapy is often used to treat prostate cancer that can not be removed after surgery. If the disease is more advanced, radiation may be used to reduce the size of the tumor and to relief the possible prostate cancer symptoms. Radiation can be delivered to the area of cancer in two primary ways.
- External beam radiation therapy (ERBT): uses external machine to aims the radiation at the prostate gland where the tumors are located.
Brachytherapy (also called seed therapy): uses small radioactive pellets or seeds that are placed directly into the prostate or near the cancer cells. Brachytherapy is generally used only in men with early stage prostate cancer that is relatively grows more slowly.
The goal of hormonal therapy is to reduce the production of male hormones called androgen. Androgens such as testosterone are produced naturally within the body, where prostate cancer can grow in response to these hormones, thereby reducing androgen levels often makes prostate cancer shrink or grow more slowly. However hormonal therapy does not cure prostate cancer. A number of different medications have been developed to achieve the goal. These include:
- Anti-androgens (flutamide, bicalutamide, and nilutamide)
- Luteinizing hormone-relaxing hormone (LHRH) agonists (leuprolide, goserelin, histrelin, and triptorelin)
- Luteinizing hormone-relaxing hormone (LHRH) antagonists (abarelix, degarelix)
Hormonal therapy is sometimes used alone, but it more often used in combination with other treatments such as radiation therapy.
In some cases, your doctor may recommend no treatment at all, but the patient will be kept an eye for signs of change in their disease or the development of new symptoms. If it is determined at any time that the cancer is progressing, active treatment may then be started.
This kind of “wait and see” approach is often suggested for men aged over 70 as the cancer is unlikely to grow fast enough to cause any problem during their lifetime.
Watchful waiting may be a good option if the side effects of treatment would have more impact on your life than the cancer itself.