Prostate Cancer: Treatment Choices?
A Therapy Smorgasbord Awaits After A Prostate Cancer Diagnosis
After a prostate cancer diagnosis, one of the “aftershocks” for most men is that they must make the decision on which treatment to pursue.
With every prostate cancer patient, there are many different variables – age, stage of cancer, lifestyle choices and risks – all which needs to be weighed against a smorgasbord of treatment options and differing recommendations from physicians.
It can be very confusing, and frightening for men without medical degrees. Ultimately, every new patient needs to do their homework and consider all their options carefully.
The Big Two: Surgery or Radiation
The main entrees on the menu – surgery vs. radiation. There are flavors of each.
What many men learn quickly is that the medical community cannot tell them which treatment – surgery or radiation – gives them their best shot for survival.
Urologists are biased toward surgery, radiologists want to radiate it; but neither can brag of a superior cure rate.
In terms of survival, it’s a tie game. Catch it early, which many men will do with an annual PSA Test, and there’s a high (and virtually equal) percentage chance of remaining cancer-free – with either treatment.
Because there’s no consensus ‘gold standard’ therapy for prostate cancer, it’s up to the patient to choose.
A Bigger Menu of Options
Here are some of the treatment options that medical science now offers to prostate cancer patients. Again, there are others beyond this list, so do the homework before choosing:
• ‘Nerve-sparing’ open radical prostectomy is where surgeons cut around the sensitive nerve bundles that cling to the sides of the prostate – all part of a guy’s delicate sexual apparatus. A somewhat bloody operation, it requires anesthesia, at least a five-day hospital stay, and maybe two weeks wearing a catheter to pee.
• Da Vinci robotic surgery is where a machine actually performs the surgery while a surgeon remotely operates the machine. The idea is that by making smaller incisions and working with finer tools, the robot can do better than a surgeon in removing the prostate and minimizing the collateral damage. A high level of skill is generally required, and directly relates to successful outcomes.
• Image-Guided Radiation Therapy, or IGRT, is one of the latest technologies for delivering high-dose radiation to the prostate with uncanny accuracy. Beams of radiation precisely conform to the shape of the prostate, minimizing radiation to healthy tissues surrounding the prostate and, therefore, many side effects like incontinence and impotency.
• Brachytherapy is where permanent radioactive “seeds” – the size of a grain of rice – are strategically implanted into the prostate, each radiating a bubble of death to malignant cells. It’s a few days of outpatient procedures, no extended hospital stay. No cutting. No catheters. No drugs to kill the post-procedure pain.
• Androgen deprivation therapy blocks production of testosterone. Generally, ADT is an adjunct therapy for men with advance-staged prostate cancer
• Crytotherapy freezes the prostate and kills malignant clusters.
• Watchful waiting is an option, generally, for older men in which prostate cancer grows very slowly. Since cancer feasts on testosterone, this is generally not an option in younger men in their 40s, 50s and even 60s.
Talk to your physician about these and other choices. Prostate cancer technology is growing in leaps and bounds; there are even vaccines being developed.
Best advice
Do lots of homework and don’t jump at the first option presented, even by a trusted physician. Every man should understand all his options and choose the one best suited for him, based on age, cancer stage, and risk tolerance for potential lifestyle side effects.
Other articles on prostate cancer:
Treating Prostate Cancer with IGRT
Prostate Cancer: Are You At Risk?
