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Conditions: Prostate Cancer

Treating Prostate Cancer

Currently, there are many treatment options for prostate cancer, including surgery, radiation therapy, cryosurgery, hormone therapy, and chemotherapy. You will need to discuss with your doctor (and, if appropriate, with your partner) which option is right for you. The American Urological Association Foundation has a good website with a lot of information on the different treatment modalities at www.urologyhealth.org. Remember: there is no one right treatment for every man. In fact, for some men “watchful waiting” (no treatment) is the most appropriate selection.

Surgical management

Prostate cancer surgery is generally most effective in men with early stage disease—in other words, in men whose prostate cancer is confined to the prostate gland. Candidates for this treatment must be healthy enough to undergo major surgery. There are a few different surgical approaches that your doctor might use. In the radical retropubic prostatectomy, your doctor will make an incision through your lower abdomen. During a laparoscopic prostatectomy, a small telescopic instrument is inserted through a small incision in your belly button. A few other small incisions are made to accommodate other surgical instruments.

You will want to speak with your doctor about which approach is right for you. Outside of the risks inherent in any surgery, 2 concerns men have regarding prostate surgery are urinary incontinence (loss of bladder control), and impotence (erectile dysfunction, or ED)—not being able to
have an erection. In either case, there are treatments or procedures for both of these problems.


Radiation therapy

Radiation therapy, or radiotherapy, describes several types of treatments for prostate cancer. External beam radiation therapy, uses high-powered X-rays to penetrate deep into the body. Another form, called brachytherapy, places radioactive materials (“seeds”) into the body. Each approach has benefits and disadvantages. Your doctors will help determine if—and which form of—radiation therapy is most appropriate for your specific cancer.


Hormonal therapy

Hormonal therapy is generally reserved for men with more advanced disease. The goal of hormonal therapy is to reduce the testosterone feeding the prostate and its tumors. This treatment can reduce the symptoms and cause the tumor to shrink in a majority of cases, but it does not cure the disease. In addition, the benefits of hormonal treatment are short-lived—lasting between 2 to 3 years. There are a variety of hormonal treatments, ranging from medications to surgically removing the testicles.


Chemotherapy

Chemotherapy uses a variety of drugs to destroy the cancer cells. Chemotherapy is typically reserved for patients whose cancer has spread outside of the prostate. It is also used in combination with other therapies in men who do not respond to their original therapies. Chemotherapy is an aggressive treatment that is associated with many side effects, so you should always discuss all of your treatment options with your doctor.

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