Prostate cancer is the second leading cancer cause of death in men. More than 1 in 8 men will be diagnosed with prostate cancer during their lifetimes. When men are diagnosed with prostate cancer, they will likely have many questions. Every September is Prostate Cancer Awareness Month. Its purpose is to help improve knowledge and understanding about this disease. This month, take time to learn about prostate cancer treatments.
Prostate Cancer Treatment Planning
While a cancer diagnosis is always frightening, many men diagnosed with prostate cancer do not die from it. Most prostate cancers are slow-growing and present in older patients. Patients with this type of prostate tumor are more likely to die of old age or unrelated conditions. Other prostate cancers grow more aggressively and may even present in younger men.
Factors considered during prostate cancer treatment planning, include:
- Age, overall health & life expectancy.
- PSA levels.
- Gleason score.
- Extent of cancer local or distant.
Prostate-specific antigen (PSA) is a protein produced by the prostate gland and found in the blood. PSA testing is a useful tool that provides valuable information in prostate cancer screening and monitoring. However, elevated PSA levels occur in patients with benign enlargement of the prostate, inflammation of the prostate and prostate cancer.
Gleason score is a prostate cancer grading system. This grade is decided by looking at prostate cancer cells under a microscope and comparing them to healthy prostate cells. Gleason scores range from 2 to 10. The higher Gleason score, the more aggressive the cancer.
Watchful Waiting & Active Surveillance
Men with low-risk, slow-growing cancers may be appropriate candidates for active surveillance. Many men with a Gleason score of 2 to 6 can choose to have their cancer monitored rather than treated immediately.
This option allows men to avoid the side effects of radical prostate cancer treatment, which include incontinence and impotence. During active surveillance, men are routinely tested to monitor their cancer. Testing may include digital rectal exam, PSA testing, prostate MRI, ultrasound and biopsy.
Treatment Options for Advanced, Aggressive Cancers
Men assigned a Gleason score of 7 to 10 will likely require prostate cancer treatment. Specific treatment recommendations will vary for each individual patient. Prostate cancer treatment options in these men include hormone therapy, radiation therapy and/or surgery. In advanced cases, chemotherapy will also be required.
The type of surgery used to treat prostate cancer is called prostatectomy. During prostatectomy, the prostate gland and nearby seminal vesicles are removed. Nearby lymph nodes may also be removed. Prostatectomy is often used to treat men with tumors that have not spread beyond the prostate and are healthy enough for surgery.
The goal of prostatectomy is to removal all cancerous tissue from your body. Newer surgical techniques, including robotic surgery and nerve-sparing prostatectomy, allow more men to avoid undesired side effects, such as impotence and incontinence.
Radiation therapy uses radiation in an attempt to eliminate cancer cells. Radiation is most frequently delivered via external beam radiation therapy (EBRT). During EBRT, beams of radiation are aimed at the prostate from a machine outside the body.
Internal radiation therapy, or brachytherapy, may be appropriate in some men with slow-growing cancers. During internal radiation therapy, tiny radioactive pellets are implanted directly into the prostate.
Hormone therapy attempts to reduce androgen levels in a patient’s body. Androgens are type of hormone that stimulates prostate cancer cells to grow. Androgens include testosterone and dihydrotestosterone.
Hormone therapy is used in patients with cancer that cannot be cured by surgery or radiation therapy, along with radiation therapy to prevent recurrence and before surgery to shrink the tumor. Several different drugs can be used to reduce androgen levels. Surgical removal of the testicles, which produces most androgens, is also an option.
Chemotherapy refers to a type of drug used to treat cancer. There are several different types of chemotherapy used in prostate cancer patients, which may be administered intravenously or orally. Chemotherapy is generally used to treat prostate cancer patients with advanced cancers that have spread to distant organs beyond the prostate.