Prostate Cancer Treatment: What You Need to Know

Prostate cancer has shown significant progress, with a 5-year survival rate of over 99% for early-stage cases. However, aggressive forms can exist even when confined to the prostate. It remains the second leading cause of cancer death among men in the US, with 94 men succumbing to it daily¹.

Early detection is crucial for better outcomes. Many men with "low-risk" or some intermediate-risk tumors can opt for active surveillance, closely monitoring the cancer without immediate treatment¹. This preserves their chance of long-term survival if treatment becomes necessary due to aggressive progression. 

Understanding Prostate Cancer

The prostate is a small gland located in the pelvic area of men and is part of the male reproductive system. This walnut-sized gland plays an important role in making semen that fertilises an egg during reproduction².

Cancer is a condition where a healthy cell becomes abnormal and grows uncontrollably without the "brakes" to stop its growth. Prostate cancer specifically occurs when a normal prostate cell starts growing out of control³.

How Is Prostate Cancer Treated?

When diagnosed with localized or locally advanced prostate cancer, there are three main treatment options: active surveillance, radiation therapy, and surgery⁴. Doctors weigh on factors like⁵:

• The stage and grade of your cancer

• Your age and life expectancy

• Any other significant health conditions you may have

Prostate cancer treatments are usually used individually, but in certain situations, they may be combined.

Expectant Management

In some cases, doctors may recommend expectant management, which means that treatment will be delayed until the cancer shows signs of growing or causing symptoms. This is usually done in cases where the cancer is not expected to grow quickly.

Expectant management can be done in two ways⁶:

• Active surveillance: This involves closely monitoring prostate cancer by performing regular PSA tests and prostate biopsies, and only treating it if it shows signs of growth or starts to cause symptoms.

• Watchful waiting: With this method, no tests are performed and treatment is only given when symptoms start to develop. It is usually reserved for patients who do not have a long life expectancy (less than 10 years).

Surgery

The main surgical procedure for treating prostate cancer is called a radical prostatectomy, which involves cutting off the entire prostate gland as well as some surrounding tissue. It may also include the removal of nearby lymph nodes, depending on the extent and stage of the cancer⁷.

• Radical Prostatectomy: Removes prostate, seminal vesicles, and sometimes lymph nodes. There is a risk that it will affect sexual function, but nerve-sparing surgery can help.

• Robotic or Laparoscopic Prostatectomy: A less invasive procedure than radical prostatectomy that may shorten recovery time.

• Bilateral Orchiectomy: Involves removing both testicles.

• Transurethral Resection of the Prostate (TURP): This procedure is mainly used to relieve urinary blockage symptoms, not to treat prostate cancer.

Radiation Therapy

High-energy rays are used frequently in radiation therapy to kill cancer cells. External-beam radiation therapy and brachytherapy are two options for administering it⁶.

• External-beam radiation therapy: focuses X-rays on the cancer area from outside the body. 

• Internal radiation therapy (brachytherapy): involves inserting radioactive seeds directly into the prostate. 

Hormone Therapy

Hormone therapy is a treatment that helps to block the growth of prostate cancer cells in the prostate gland by reducing the levels of male hormones in the body⁷.

This treatment approach is frequently used with radiation therapy for patients with intermediate-risk prostate cancer. It can also serve as the primary course of action for those with advanced prostate cancer.

Chemotherapy

Drugs are used in this form of treatment to kill cancer cells. These medications inhibit the cancer cells from multiplying and developing, preventing them from producing additional cells⁷.

Chemotherapy is often used to treat advanced prostate cancer or resistant prostate cancer and is given in cycles over a set amount of time.

Immunotherapy

This approach uses the body's immune system to fight cancer. It helps the immune system attack cancer cells, and can also be used to manage the side effects of other cancer treatments⁷.

All Things Considered

Prostate cancer treatment options have expanded significantly, providing patients with various approaches to tackle the disease. Regular screenings and early detection remain crucial in improving survival rates and providing the best chances of successful treatment outcomes. Always consult with healthcare professionals to determine the most suitable treatment plan for your specific case.