9 Treatment Methods to Speak to Your Doctor About
Prostate cancer remains one of the most common forms of cancer affecting men worldwide. Although a diagnosis can be frightening, advancements in medical science have significantly improved treatment outcomes. This article explores prostate cancer treatment options currently available to patients.
1. Active Surveillance
Active surveillance represents a monitoring approach rather than immediate intervention. This option is particularly suitable for men with low-risk, slow-growing prostate cancer that appears unlikely to spread quickly. Under active surveillance, doctors closely monitor the cancer through regular prostate-specific antigen (PSA) blood tests, digital rectal exams and periodic biopsies. Treatment begins only if tests indicate the cancer is growing or changing in concerning ways.
2. Surgery: Radical Prostatectomy
Radical prostatectomy involves the surgical removal of the entire prostate gland and some surrounding tissues. This procedure aims to remove all cancerous tissue before it can spread beyond the prostate. Several surgical approaches exist, including traditional open surgery, laparoscopic surgery and robot-assisted surgery. The robot-assisted approach has gained popularity due to its precision and potentially fewer side effects.
3. Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells and comes in two primary forms: external beam radiation therapy (EBRT) and brachytherapy. EBRT delivers radiation from outside the body, focusing beams precisely on the prostate to minimize damage to surrounding tissues. Modern techniques like intensity-modulated radiation therapy (IMRT) and proton therapy offer improved precision.
Brachytherapy involves placing small radioactive seeds directly into the prostate tissue. These seeds deliver radiation directly to the cancer while limiting exposure to surrounding healthy tissues. Low-dose-rate brachytherapy uses permanent seed implants that gradually release radiation over months, while high-dose-rate brachytherapy uses temporary higher-intensity radiation sources.
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4. Hormone Therapy
Also known as androgen deprivation therapy (ADT), hormone therapy works by reducing or blocking male hormones (androgens) that fuel prostate cancer growth. This treatment can be administered through medications that reduce testosterone production or block its action, or through surgical removal of the testicles (orchiectomy).
Hormone therapy is commonly used when cancer has spread beyond the prostate or returned after initial treatment. It may also be combined with radiation therapy for higher-risk cancers. While not typically curative on its own, hormone therapy effectively controls prostate cancer growth, sometimes for many years.
5. Chemotherapy
Chemotherapy uses drugs to kill rapidly dividing cancer cells throughout the body. For prostate cancer, chemotherapy is typically reserved for advanced cases where cancer has spread beyond the prostate and is no longer responding adequately to hormone therapy. Common chemotherapy drugs for prostate cancer include docetaxel and cabazitaxel.
Side effects may include fatigue, hair loss, increased infection risk, nausea and vomiting. While chemotherapy cannot cure advanced prostate cancer, it can extend survival and improve quality of life by reducing symptoms and slowing cancer progression.
6. Immunotherapy
Immunotherapy harnesses the body's immune system to fight cancer. For prostate cancer, Sipuleucel-T (Provenge) represents a form of immunotherapy that involves collecting immune cells from the patient, exposing them to a protein that helps them target prostate cancer cells, then reinfusing them into the patient. This treatment is approved for men with advanced prostate cancer that no longer responds to hormone therapy but causes minimal symptoms.
7. Targeted Therapy
Targeted therapies focus on specific abnormalities present within cancer cells. For prostate cancer, PARP inhibitors like olaparib and rucaparib have shown promise for men with certain genetic mutations, particularly in genes involved in DNA repair pathways such as BRCA1 and BRCA2. These medications can be effective against cancers that have stopped responding to other treatments.
8. Cryotherapy and High-Intensity Focused Ultrasound
These less common approaches offer minimally invasive alternatives for treating localized prostate cancer. Cryotherapy freezes cancer cells to destroy them, while high-intensity focused ultrasound (HIFU) uses sound waves to heat and destroy targeted tissue within the prostate. Both techniques aim to eliminate cancer while minimizing damage to surrounding structures.
These treatments may be options for men who cannot undergo surgery or radiation, or for treating cancer that returns after radiation therapy. Research continues to evaluate their long-term effectiveness compared to more established treatments.
9.Watchful Waiting
Though sometimes confused with active surveillance, watchful waiting takes a less intensive monitoring approach. This strategy is often recommended for older men or those with significant health conditions for whom prostate cancer treatment might pose greater risks than benefits. Under watchful waiting, doctors monitor symptoms rather than conducting regular testing, with treatment focusing on managing symptoms if they develop rather than curing the cancer.
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