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How Is Prostate Cancer Treated?
There are many treatments for prostate cancer. With new knowledge about prostate cancer and new treatment techniques, cure is possible for a large percentage of men with the disease. Treatments include:
- Watchful waiting
- Radiation therapy
- Hormone therapy
- Prostate removal
In some cases, the cancer is growing so slowly that it most likely will not affect the man over the course of his lifetime. Watchful waiting may be preferable to aggressive treatment for men with other health problems or men over age 80.
If symptoms should develop or if the cancer should begin to spread more quickly, other treatments may be considered.
Nice To Know:
Q: Is “watchful waiting” dangerous?
A: Watchful waiting is likely to be a strategy in older men for whom radical surgery would be taxing and for whom radical surgery might not prolong life. It is often said that an older man is likely to die “with” prostate cancer rather than “from” prostate cancer.
Radiation can kill fast-growing cells such as cancer cells.
- External radiation therapy uses a beam sent from outside the body toward the tumor. Radiation therapy is performed at a hospital or treatment center, usually five days a week for several weeks. Radiation therapy is painless but may produce side effects that include tiredness, nausea, hair loss, skin soreness, and loss of appetite.
- Brachytherapy is an internal radiation therapy in which radioactive seeds or pellets are surgically implanted in the prostate using thin needles. An
ultrasoundpicture guides physicians in placing the seeds. Medication can be given to block discomfort from the procedure.
This procedure, also called radioactive seed implant, allows for a higher total dose of radiation to a smaller area than is possible with external treatment. Men may stay in the hospital for a short time for implant radiation. The length of time that the implant is left in place depends on the amount of radioactivity needed for effective treatment. Once the implant is removed, no radioactivity remains in the body.
For further information about radiation therapy, go to Radiation Therapy.
Cryosurgery is an effective way to treat small areas of cancer. Risks of the procedure include injury to the bladder. Men also may experience temporary swelling in the penis and scrotum.
Because prostate cancer feeds on the male hormone
- The female hormone,
estrogen, may be taken as a pill to counteract the effects of testosterone. This may cause breast tenderness and the growth of breast tissue, which will subside when treatment is stopped.
- Luteinizing hormone-releasing hormone agonists (LH-RH agonistss) are drugs that reduce the production of testosterone. LH-RH agonists can stop the production of testosterone without some of the side effects of estrogen. LH-RH is often used with
hormonescalled antiandrogens, which aim at stopping testosterone from interacting with cancer cells.
- The removal of the testicles prevents the production of testosterone, a hormone known to increase the growth rate of prostate cancer. This procedure is known as
If cancer has not spread beyond the prostate, removing the prostate (prostatectomy) offers an excellent chance of cure. However, time may need to pass following surgery to be certain that the microscopic cancerous cells have not metastasized (spread).
- In a suprapubic prostatectomy, the prostate is removed through an incision in the abdomen.
- In a perineal prostatectomy, the prostate is removed through an incision between the scrotum and the anus. Nearby
lymph nodesare sometimes removed through a separate incision in the abdomen.
The two main side effects of prostate removal are:
- The possibility of urinary incontinence because of damage to the muscles that control urine flow
Impotence(the inability to have an erection)
However, techniques for performing a prostatectomy are improving, and more healthy tissue can now be preserved. Nerve-sparing surgical techniques can preserve the nerve endings that control erection and can help avoid impotence.
For further information about prostate removal, go to Prostate Removal.
A procedure called transurethral resection of the prostate (TURP) removes just a portion of the prostate, with an instrument that is inserted through the
This procedure can be helpful for:
- Men who cannot have a prostatectomy because of health factors or other reasons
- Men who just need to have a freer urine flow because an enlarged or cancerous prostate is constricting the urethra