Prostate Cancer: Understanding Your Treatment Options
Treatments for advanced prostate cancer have come a long way and are getting better every day. That means you can expect fewer side effects and enjoy better results. The therapy your healthcare provider chooses may even put you in remission, which means tumor cells cannot be detected on imaging tests. Best of all, new treatments are being discovered all the time (including vaccines). Be sure to visit cancer.gov to stay on top of the most recent advances.
Many prostate cancers grow slowly, so when the cancer is detected early men can often be monitored for signs of progression—using periodic checkups, PSA tests and ultrasounds—and then treated later, if need be.
It might be right for you if: You have low-risk prostate cancer (small, symptom-free tumors) and a low Gleason score (6 or below).
What you should know: By opting for active surveillance, you may worry you’re missing an opportunity for early treatment. But according to the American Cancer Society, men who opt for surveillance and then take action when their cancer progresses, have as good an outcome as those who start treating low-risk tumors right away.
Beams of radiation are focused on the prostate gland from a machine outside the body. The treatments are painless and take only a few minutes each, but you may need up to five sessions per week over a period of seven to nine weeks to get the best benefit.
It might be right for you if: You are undergoing hormone therapy. Some doctors pair radiation with hormone therapy for better results.
What you should know: Fatigue, rectal burning and tenderness, and a frequent urge to urinate are common side effects, and they can last several months. You may also experience erectile difficulty.
In a radical prostatectomy, the entire prostate (plus some of the surrounding tissue) is removed. There are two basic ways to do this:
Open radical prostatectomy (ORP)
This surgery is done through a five- to eight-inch incision in the lower belly, or through a smaller incision in the perineum (the space between the anus and scrotum). It’s more difficult to collect lymph nodes and save the nerves that control erections with the perineal approach. But according to a study at the Albert Einstein College of Medicine in the Bronx, NY, this surgery tends to be faster, the recovery is speedier and it’s a good option for men with bigger bellies.
It might be right for you if: Your cancer hasn’t spread beyond your prostate—and in 90% of newly diagnosed cases, it hasn’t.
What you should know: You’ll spend a few days in the hospital, and will need to limit your activities for three to five weeks once you get home. The most concerning side effects are loss of bladder control (incontinence) and trouble getting an erection (impotence). Luckily, normal bladder control returns for many men within a few weeks or months—and the ability to get erections may gradually return, as well.