Prostate cancer is the most common type of cancer in men. In 2011, almost 241,000 men will be diagnosed with this disease. Before you make decisions about treatment, it's important to understand your options.
Standard Treatment
When deciding which treatment is best, oncologists consider several factors: your age, the stage of cancer at diagnosis, whether it's causing symptoms, your overall health, and your personal preferences.
Oncologists typically treat prostate cancer patients with surgery, radiation, or hormone therapy (sometimes in combination).
Physicians generally recommend surgery and radiation therapy with prostate cancer that has not spread. Often treatment in the early stages can be curative. Hormone therapy is more often for men whose cancer has spread. It helps slow the growth of the tumor and reduce its size, but does not remove the tumor in its entirety.
Surgical techniques continue to improve. For example, robotic laparoscopic prostatectomy (removing the prostate) is minimally invasive, so you have less pain and shorter recovery times.
There are newer forms of radiation therapy as well. One new technique, TomoTherapy®, combines 3-D imaging with radiation. TomoTherapy® allows radiation oncologists to closely match the contours of a tumor with the radiation, minimizing damage to healthy tissue.
Newer Treatments
Advances in technology, and a better understanding of prostate cancer, is leading to new treatment options for men. Cryosurgery (or cryotherapy), for example, freezes and destroys cancer cells, and biological therapy uses the patient's immune system to fight cancer. There are also newer forms of chemotherapy, radiation therapy, and hormonal treatments. Oncologists sometimes integrate therapies to produce better outcomes for patients.
Watchful Waiting
When prostate cancer is not causing symptoms, you and your physician may decide that active surveillance is the best course of action. Your physician will monitor the cancer and not treat it until-or if-it becomes symptomatic. This may run contrary to common assumptions that you must treat all cancers. However, H. Gilbert Welch, MD, author of Should I be Tested for Cancer, says all cancers do not inevitably cause symptoms.
Watchful waiting is gaining traction as a treatment option. The results of the PIVOT study (Prostate Cancer Intervention Versus Observation Trial) compared outcomes of localized cancers in men who had a radical prostatectomy to those who opted for watchful waiting. The study found that men at low risk for developing advanced cancer over the next 10 to 12 years were not benefiting from the local therapy.
Sources:
University of Maryland. "Prostate cancer." Web. 20 November 2009.
http://www.umgcc.org/gu_program/prostate-treatment.htm
National Cancer Institute. "Prostate Cancer Treatment." Web. 6 June 2011.
http://www.cancer.gov/cancertopics/pdq/treatment/prostate/Patient
City of Hope. "Prostate Cancer Treatment Options." Web.
http://www.cityofhope.org/patient_care/treatments/prostate-cancer/Pages/Prostate-Cancer-Treatment-Options.aspx
Chodak, Gerald, MD. "Getting Through to Prostatectomy Patients." Medscape Medical News. Web. 19 July 2011. http://www.medscape.com/viewarticle/746200
Chodak, Gerald, MD. "PIVOT: More Evidence for Watchful Waiting in Prostate Cancer." Medscape Medical News. Web. 29 June 2011. http://www.medscape.com/viewarticle/745360
Crawford, David E., MD. "The Changing Landscape of Prostate Cancer Treatment." Medscape Medical News. Web. 17 June 2011. http://www.medscape.com/viewarticle/744716
