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This information represents the views of the doctors and nurses serving on the American Cancer Society's Cancer Information Database Editorial Board.
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How is Prostate Cancer treated? This information represents the views of the doctors and nurses serving on the American Cancer Society's Cancer Information Database Editorial Board. These views are based on their interpretation of studies published in medical journals, as well as their own professional experience. The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.
Types of treatments • Once your prostate cancer has been diagnosed and staged, you have a lot to think about before you and your doctor choose a treatment plan. You may feel that you must make a decision quickly, but it is important to give yourself time to absorb the information you have just learned. Ask questions of your cancer care team. • Depending on the situation, the treatment options for men with prostate cancer may include: • Expectant management (watchful waiting) or active surveillance • Surgery • Radiation therapy • Cryosurgery (cryotherapy) • Hormone therapy • Chemotherapy • Vaccine treatment • Bone directed treatment • To speak to a prostate cancer informational specialist, Click Here
Expectant management and activesurveillance for prostate cancer Because prostate cancer often grows very slowly, some men (especially those who are older or have other serious health problems) may never need treatment for their prostate cancer. Instead, their doctors may recommend approaches known as expectant management, watchful waiting, or active surveillance. Active surveillance is often used to mean monitoring the cancer closely with prostate-specific antigen (PSA) blood tests, digital rectal exams (DREs), and ultrasounds at regular intervals to see if the cancer is growing. Prostate biopsies may be done as well to see if the cancer is becoming more aggressive. If there is a change in your test results, your doctor would then talk to you about treatment options. Watchful waiting is sometimes used to describe a less intensive type of follow-up that may mean fewer tests and relying more on changes in a man's symptoms to decide if treatment is needed.
Surgery The main type of surgery for prostate cancer is known as a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles. A radical prostatectomy can be done in different ways. Open approaches to radical prostatectomy In the more traditional approach to doing a prostatectomy, the surgeon operates through a single long incision to remove the prostate and nearby tissues. This is sometimes referred to as an open approach. Radical retropubic prostatectomy For this operation, the surgeon makes a skin incision in your lower abdomen, from the belly button down to the pubic bone. You will be either under general anesthesia (asleep) or be given spinal or epidural anesthesia (numbing the lower half of the body) along with sedation during the surgery.
Radiation therapy • Radiation therapy uses high-energy rays or particles to kill cancer cells. Radiation may be used: • As the initial treatment for low-grade cancer that is still confined within the prostate gland. Cure rates for men with these types of cancers are about the same as those for men getting radical prostatectomy. • As part of the first treatment (along with hormone therapy) for cancers that have grown outside of the prostate gland and into nearby tissues. • If the cancer is not completely removed or comes back (recurs) in the area of the prostate after surgery. • If the cancer is advanced, to reduce the size of the tumor and to provide relief from present and possible future symptoms.
Cryosurgery Cryosurgery (also called cryotherapy or cryoablation) is sometimes used to treat early stage prostate cancer by freezing it. As with brachytherapy, this may not be a good option for men with large prostate glands. In this approach, several hollow probes (needles) are placed through the skin between the anus and scrotum. The doctor guides them into the prostate using transrectal ultrasound (TRUS). This type of procedure requires spinal or epidural anesthesia (where the lower half of your body is numbed) or general anesthesia (where you are asleep). Very cold gases are then passed through the needles, creating ice balls that destroy the prostate gland. To be sure the prostate is destroyed without too much damage to nearby tissues, the doctor carefully watches the ultrasound images during the procedure. Warm saltwater is circulated through a catheter in the urethra during the procedure to keep it from freezing. The catheter is kept in place for about 3 weeks afterward to allow the bladder to empty while you recover.
Hormone therapy • Hormone therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to prevent them from reaching prostate cancer cells. • Hormone therapy may be used: • If you are not able to have surgery or radiation or can't be cured by these treatments because the cancer has already spread beyond the prostate gland • If your cancer remains or comes back after treatment with surgery or radiation therapy • Along with radiation therapy as initial treatment if you are at higher risk of the cancer coming back after treatment (based on a high Gleason score, high PSA level, and/or growth of the cancer outside the prostate) • Before radiation to try to shrink the cancer to make treatment more effective • Several types of hormone therapy can be used to treat prostate cancer. Some lower the levels of testosterone or other androgens (male hormones). Others block the action of those hormones.
Chemotherapy Chemotherapy (chemo) uses anti-cancer drugs injected into a vein or given by mouth. These drugs enter the bloodstream and go throughout the body, making this treatment potentially useful for cancers that have spread (metastasized) to distant organs. Chemotherapy is sometimes used if prostate cancer has spread outside the prostate gland and hormone therapy isn't working. Chemo is not a standard treatment for early prostate cancer, but some studies are looking to see if it could be helpful if given for a short time after surgery. Some of the chemo drugs used to treat prostate cancer include: Docetaxel (Taxotere®) Cabazitaxel (Jevtana®) Mitoxantrone (Novantrone®) Estramustine (Emcyt®) Doxorubicin (Adriamycin®)
Vaccine treatment Sipuleucel-T (Provenge®) is a cancer vaccine. Unlike traditional vaccines, which boost the body's immune system to prevent infectious diseases, this vaccine boosts the immune system to get it to attack prostate cancer cells in the body. The vaccine is used to treat advanced prostate cancer that is no longer responding to initial hormone therapy but that is causing few or no symptoms. Studies are now being done to see if this vaccine can help men with less advanced prostate cancer. Possible side effects of vaccine treatment Side effects from the vaccine tend to be milder than those from hormone therapy or chemotherapy. Common side effects can include fever, chills, fatigue, back and joint pain, nausea, and headache. These most often start during the cell infusions and last no more than a day or 2. A few men may have more severe symptoms, including problems breathing and high blood pressure, which usually improve after treatment.
Bone directed treatment Preventing or slowing the spread of prostate cancer to the bones is a major goal of treatment if the cancer has grown outside of the prostate. If the cancer has already reached the bones, controlling or relieving pain and other complications is also a very important part of treatment. Bisphosphonates are a group of drugs that can help relieve pain and high calcium levels caused by cancer that has spread (metastasized) to the bones. These drugs may also slow the growth of the metastases and help delay or prevent fractures. Bisphosphonates can also help strengthen bones in men who are receiving hormone therapy. Denosumab (Xgeva®, Prolia®) is another drug that can help when prostate cancer spreads to bone. Like the bisphosphonates, denosumab also blocks bone cells called osteoclasts, but it does so in a different way.
Thank you Source: http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-treating-general-info
