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Prostate cancer: Treatments offer hope

This year alone, more than 186,000 men in the United States will be diagnosed with prostate cancer, the most common cancer in American men. Thanks to continually improving treatment plans, however, more men with the cancer are surviving than in decades past.

In most cases, prostate cancer grows slowly, so men diagnosed with the disease usually have time to consider treatment options and gather opinions from several specialists, including doctors specializing in urology, oncology and radiotherapy.

Treating early-stage prostate cancer

Treating prostate cancer in its early stages usually involves radiation therapy to kill cancerous cells, surgery to remove the prostate gland or “watchful waiting.” Often, doctors combine treatments, which may also include hormone therapy to stop cancer growth.

A patient’s age and health, the degree to which the cancer has spread and the speed at which it’s growing help determine the most suitable treatment plan. Men considering their treatment options also need to consider each therapy’s benefits and side effects.

Radiation therapy uses X-rays or other radiation to shrink tumors and kill cancer cells. Side effects may include sexual problems, urinary and rectal discomfort, fatigue and appetite loss. Doctors can administer radiation in two ways:

  • External beam radiation: A high-power X-ray machine targets malignant cells with radiation. One type of external radiation treatment, intensity-modulated radiation therapy (IMRT), targets cancer using higher doses of radiation without damaging surrounding healthy tissue.
  • Brachytherapy, or radioactive seed implants: Physicians inject between 80 and 120 cancer-killing radioactive seeds into the prostate gland. The seeds remain in place permanently but stop emitting radiation within a year.

Surgery to remove all or part of the prostate gland, called radical prostatectomy, is another common treatment for early-stage prostate cancer. It usually results in removing all cancer cells but can lead to urinary or fecal incontinence and impotence.

Watchful waiting is often recommended for older men with other serious medical problems and for whom the risks of treatment may outweigh potential benefits. It may also suit men who have slow-growing early-stage prostate cancer. In watchful waiting, also called observation, patients are monitored regularly but receive no medical treatment.

Treating advanced prostate cancer

Surgery and radiation usually aren’t effective in treating prostate cancer when it has spread beyond the prostate gland. Doctors use hormone therapy to lower the level of male hormones that promote tumor growth and may use chemotherapy to extend life when hormonal therapy is no longer effective.

New types of treatment

Scientists continue to develop and test new therapies for prostate cancer, including:

  • cryotherapy to freeze and kill cancerous prostate tissue
  • laparoscopic, or minimally invasive, surgery to remove the prostate
  • new chemotherapy drugs to halt cancer growth
  • biologic therapy and vaccines to boost or restore a patient’s immune system to fight cancer
  • high-intensity focused ultrasound to destroy cancer cells with sound waves

Men with prostate cancer can learn more about clinical trials for new treatments from their doctors. Deciding on a treatment plan may not be easy, but being involved in decision making helps patients feel more in control and less anxious about the journey ahead.