Doctors and healthcare professionals (including oncology specialists, scientists, physician assistants, and others) often work together to establish a targeted treatment plan for prostate cancer taking a multidisciplinary approach. It is very important to gain adequate knowledge about the various treatments, including their goals and possible side effects, to make the right decision. A successful treatment for men with prostate cancer depends on many factors and can be one or a combination of the following treatment options.
As its name suggests, local treatment means dealing with the cancer at the site of occurrance, i.e, the prostate. It includes radical treatments like surgery and radiation therapy, but also focal therapy. However, local treatment has little or no ability to solve the problem if the disease has metastasized (spread outside the prostate gland) to other parts of the body.
Surgical removal of the tumor and some adjacent tissue is still a standard procedure to eliminate cancer. In case of prostate cancer, this is called a prostatectomy and can be categorized as follows:
- Radical (open) prostatectomy
- Robotic or laparoscopic prostatectomy
Potential side effects of surgical removal are permanent incontinence and erectile dysfunction, amongst others. Rehabilitation is usually necessary.
Radiation therapy is another type of local therapy. It usually consists of various numbers of therapy procedures over weeks or even months. There are various types of radiation therapies, including
- Conventional external beam radiation therapy
- Proton therapy
Potential side effects of radiation therapy for prostate cancer are urinary leakage, difficult or painful urination, abdominal cramping, and diarrhea. Additionally, depending on the treatment plan, it is not possible to repeat the therapy in the case of a recurrent disease.
Minimally-invasive focal therapies are gaining more and more recognition, as they minimize the side-effects of radical therapies while oftentimes having the same oncological outcome. Focal therapy only destroys a portion of the prostate gland, specifically where the cancer grows, without causing harm to the other parts of the prostate or the surrounding tissue. This treatment option uses extreme cold, heat or other methods to treat prostate cancer. Amongst focal therapy methods are
- Irreversible Electroporation (IRE)
- High Intensity Focus Ultrasound (HIFU)
- Radiofrequency Ablation (RFA)
This treatment option may be adviced in cases where the prostate cancer has already spread to the other parts of the body, or in very aggressive types of the disease. It includes chemotherapy, hormone deprivation therapy, and use of novel agents like immunotherapy.
The use of a chemotherapeutic agent may have the ability to destroy tumor cells throughout the body. Most of the drugs applied usually work by preventing the tumor cells from growing and dividing. Which drug or combinations of drugs your treating physician prescribes depends largely on your age and severity of the disease. In combination with other treatments, it may be a powerful tool to erradiate tumor cells throughout the body.
Chemotherapy has a long list of potential side effects. Some of the prominent ones are increased chances of infections, mouth sores, hair loss, nausea and vomiting, loss of appetite and diarrhea.
Androgen deprivation therapy (ADT)
Male sex hormones called androgens play a major role in prostate cancer growth, therefore methods of lowering the circulating levels of androgens in the blood can not only help slow the tumor growth but also notably reduce troublesome symptoms, because it may reduce the actual cancer size. ADT includes the use of drugs that target testosterone (primary male androgen) and thereby limit the growth of the tumor. This process is called “medical castration”.
Potential side effects of ADT are erectile dysfunction, loss of libido, and hot flashes.
What is your ideal treatment plan? Talk to our experts to discuss your options and to find a therapy that works best for you.