Prostate Cancer: Understanding Your Treatment Options

Health Monitor Staff
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Robotic/laparoscopic radical prostatectomy (LRP)
This surgery is done through tiny incisions and uses narrow tools to remove the prostate (one has a tiny video camera on it). The tools can be held by a surgeon directly or moved using robotic arms that the surgeon controls.
It might be right for you if: Your cancer has not spread past your prostate (generally, men who are good candidates for ORP are also good candidates for LRP).
What you should know:
Side effects may include incontinence and erectile dysfunction, which can last several months to indefinitely. According to a study at the Sidney Kimmel Center for Prostate and Urologic Cancers in New York City, opting for laparoscopic surgery could cut your hospital stay by 3%, since smaller incisions mean less tissue damage and a quicker recovery.

Systemic treatments

Chemotherapy drugs target and destroy cancer cells. Although they are usually injected into a vein, some can be taken in pill form. Once these drugs enter the bloodstream, they spread throughout the body and can destroy prostate cancer cells wherever they find them. Chemo is given in cycles, with each period of treatment followed by a period of rest so your body has time to recover. Each treatment-and-rest cycle typically lasts several weeks.
It might be right for you if
: Your cancer has spread and hormone therapy has stopped working.
What you should know:
In most cases, chemo is administered intravenously in a procedure known as an infusion. Sometimes chemo is taken as a pill, a liquid or by injection. It’s important to stay on the chemo schedule. If you skip a treatment, cancer cells could regrow. Also, strong chemo can reduce the number of infection-fighting white blood cells called neutrophils in your body, making you vulnerable to disease. Not only can infection interfere with your chemo schedule, it can also lead to life-threatening problems. Before you begin chemo, your healthcare provider will evaluate what steps you can take to boost your white blood cells. If necessary, he may prescribe a medication that increases levels of neutrophils.

Hormonal therapy
Testosterone can fuel the growth of prostate cancers, so the goal of hormone therapy, also called androgen-deprivation therapy, is to either shut down your body’s testosterone production or stop your tissues from using this hormone. Some testosterone-suppressing medications are taken as pills or implanted under the skin, but many are injected (anywhere from once monthly to once yearly). According to the American Cancer Society, prostate cancers often become resistant to these treatments if they’re exposed nonstop—so some doctors now recommend intermittent hormone therapy, instead.
It might be right for you if:
Your cancer has metastasized (spread).
What you should know: Hormone therapy has some significant side effects. It can cause hot flashes, loss of libido, loss of muscle mass and other symptoms. Long-term, it can raise your risk of bone thinning and heart disease. Report any symptoms to your doctor.

May 2013