Prostate Cancer Treatment

Prostate cancer acts differently in each man. You have many choices for prostate cancer treatment. Each of the treatments has its own risks and possible complications.

Before Treatment

Before your prostate cancer is treated, it is given a grade and stage by a health care provider called a pathologist. The grade is called a Gleason score. This is a measurement of how abnormal the cancer cells look when compared with normal prostate cells.

Stage is the word providers use to explain the size of a cancerous tumor, and where and how far cancer cells have spread. Knowing the grade and stage of cancer can help guide your treatment decisions.

Types of Treatment

One type of treatment is called watchful waiting. If you have early stage cancer, are older or in poor health, or want to avoid the side effects of other treatments, your health care provider might recommend watchful waiting. Watchful waiting means keeping an eye on your cancer, seeing how it grows, and having regular blood tests, rectal exams, and biopsies. Because many prostate cancers grow very slowly, some men never get major symptoms, and watchful waiting works well for them.

Another type of treatment is radiation therapy. Your health care provider may use radiation therapy along with other therapies for more advanced cancers. Radiation therapy may be done in two ways: brachytherapy and external beam radiation therapy.

Low-dose brachytherapy is the most common treatment. For this treatment, small pellets called seeds are placed permanently in your prostate. The seeds give a low, steady dose of radiation to help stop the cancer from growing.

High-dose brachytherapy uses larger doses of radiation. Small tubes are put into your prostate for a short period of time. These give off a large dose of radiation, and are then removed.

External beam radiation therapy, or E-B-R-T, uses high-energy X-rays or proton beams to treat your cancer. E-B-R-T can cure early stage cancer. It can also relieve symptoms of more advanced cancer.

In some cases, your provider may recommend a radical prostatectomy. This is a surgery used for cancers that haven't moved outside your prostate. During radical prostatectomy, your provider makes an incision in your lower belly, or through your perineum, the area between your scrotum and anus. Your prostate and other nearby tissues are then taken out. Your health care provider may also remove pelvic lymph nodes for testing.

Another type of surgery is called transurethral resection of the prostate, or TURP ["terp"]. TURP is generally used when you can't urinate because of advanced cancer, and radical prostatectomy isn't an option for you.

During this surgery, your provider puts a resectoscope, or electrical loop, into your urethra. There, he or she cuts pieces from your prostate that are bulging into or blocking your urethra.

Another surgery is called an orchiectomy [or-kee-ECK-toe-mee]. This is a surgery to remove one or both of your testicles. This procedure is also a type of hormone therapy.

Your testicles are your body's main source of male sex hormones called androgens. Androgens make prostate cancers grow. Different types of hormone therapy work in different ways.

Hormone therapy can be done with surgery or with medications. Some medications can decrease the amount of androgens your body makes. Others can block the action of the hormones.

If your cancer doesn't respond to other treatments or it comes back, you may need chemotherapy or immunotherapy. Chemotherapy drugs can slow cancer growth or even kill cancer cells. Immunotherapy uses your immune system to fight the cancer.

Things to Remember

Many types of prostate cancer treatment are available.
Your choices depend on your age, your health, and your cancer stage and grade.
Some men choose watchful waiting as their treatment.

What We Have Learned

Radiation therapy can be given with tiny seeds placed in the prostate. True or false? The answer is true. This is called low-dose brachytherapy.

Chemotherapy is the first choice of treatment for most prostate cancers. True or false? The answer is false. Chemotherapy is a choice if the cancer doesn't respond to other treatments or it comes back.