Treatment

If prostate cancer is detected, treatment options depend on the stage of the cancer, the grade of the tumor, the patient’s age, the number of biopsy samples that contain cancer cells, symptoms, and the patient’s overall health. Patients have time for second opinions and to talk through all of their options with their doctors and develop a treatment plan that best fits their needs.

There are several types of treatment, and some patients may receive one or a combination of the following:

Surgery
Surgery is an option for patients with early (stage I or II) prostate cancer, and is sometimes an option for stages III and IV. The surgeon may remove part or all of the prostate. Sometimes before removing the prostate, the surgeon removes the lymph nodes in the pelvis.

If cancer is found in the lymph nodes, the surgeon may suggest other treatment. There are several types of surgery, including:

Open Surgery - The surgeon makes a large incision to remove the tumor either through the abdomen (called a radical retropubic prostatectomy) or though the scrotum and anus (called a radical perineal prostatectomy).

Robotic Laparoscopic Surgery - The surgeon uses a laparoscope and a robot to remove the prostate through small cuts.

Cryosurgery - The surgeon inserts a tool that freezes and kills prostate tissue through a small cut between the scrotum and anus. This type of surgery is currently under study.

TURP (Transurethral Tesection of the Prostate) - This option is to relieve symptoms in men with advanced prostate cancer. The surgeon inserts a scope with a cutting tool at the end through the urethra. The tool removes tissue from the inside of the prostate and can remove tissue that blocks the flow of urine.

Radiation Therapy
There are two types of radiation used to treat prostate cancer:

External Radiation - A large machine directs radiation at the body and uses high-energy rays to kill cancer cells. Often computers are used to closely target the cancer and lessen the damage to healthy tissue near the prostate.

Internal Radiation - This radiation comes from radioactive material implanted in small containers called seeds. Dozens of seeds are placed in the prostate with needles, and they give off radiation for several months. The seeds do not need to be removed after the radiation is gone.

Hormone Therapy
Hormone therapy uses drugs or surgery, and may be used before, during, or after radiation therapy. This type of therapy is also used when prostate cancer returns after treatment.

Male hormones can help prostate cancer grow, and hormone therapy keeps cancer cells from getting those hormones. Another type of hormone therapy is surgery called an orchiectomy, in which the testicles are removed. Hormone therapy is often used in men whose prostate cancer has spread to other parts of the body.

With time, most prostate cancers can grow without male hormones, but hormone therapy can control cancer in some men for several years. Others have a shorter response time.

Chemotherapy 
This type of therapy may be used when prostate cancer has spread and does not respond to hormone therapy. Chemotherapy uses drugs to kill cancer cells. For prostate cancer, these are usually given through a vein.

Active Surveillance 
This may be recommended if the risks and side effects of treatment outweigh the potential benefits. This involves regular checks by your doctor to monitor the Gleason score of your cancer. Doctors may suggest active surveillance in a diagnosis of slow-growing, early stage prostate cancer or in patients who are older or have other serious health problems.

Choosing active surveillance means putting off side effects of other treatments. It does have risks however, including reducing the chance to control cancer before it spreads. Patients who choose active surveillance can always try another approach at any time. 

Recovery after prostate cancer depends on treatment type, spread of disease, and other factors. Follow-up care after treatment for prostate cancer is important. Even when the cancer seems to be gone, it can return if cancer cells remain in the body after treatment. Regular doctor visits are suggested. Doctors check patients with regular digital rectal exams and PSA tests. Tests may also include biopsies, bone scans, CT scans, and MRIs.


Social networking and online support groups are important tools. Reaching out to others who have or have had similar experiences can provide you with valuable insights. Check out Cancer Support Community's The Living Room for more information on clinically facilitated support online. 

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