What are your Options for Treating Prostate Cancer

Treating prostate cancer depends on several factors, including the stage of the cancer, the aggressiveness of the tumour and the overall health of the individual. Here are some typical treatment options for prostate cancer;

Treating Advanced Prostate Cancer
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Active surveillance

For low-risk local prostate cancer active surveillance may be recommended. This involves regular monitoring with prostate-specific antigen (PSA) blood tests, digital rectal exams, and periodic biopsies. Treatment is deferred unless there are signs of disease progression.

Surgery

Surgical removal of the prostate gland is known as radical prostatectomy. This is a common treatment option for localised prostate cancer. The entire prostate gland is removed along with nearby lymph nodes. The surgery is typically done by open surgery, key-hole surgery or robotic-assisted DaVinci surgery.

Radiotherapy

High-energy x-rays or other forms of radiation can be used to target and kill cancer cells. External beam radiation therapy delivers radiation from outside the body, while brachytherapy involves placing radioactive seeds directly into the prostate gland. Advancements have been made to navigate radiation just to the cancerous cells for example in Focal Therapy.

Hormone therapy

Prostate cancer cells rely on male hormones, such as testosterone to grow. Hormone therapy, also called androgen deprivation therapy (ADT) aims to reduce the levels of these hormones or block their effects. This can initially be achieved through hormone-reducing medication or by surgical removal of the testicles.

Chemotherapy

Chemotherapy drugs may be used in advanced prostate cancer. Chemotherapy works by targeting and killing the rapidly dividing cancer cells. It can be a tough time for the patient as chemotherapy can destroy healthy cells as well.

Targeted medication therapy

Advancements in technology have allowed for the development of drugs designed to specifically target certain genetic or molecular characteristics of cancer cells. The drugs can disrupt the growth and survival of cancer cells and are often used in advanced (metastasis) prostate cancer.

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Immunotherapy

Immunotherapy drugs help stimulate the body’s immune system to recognise and attack cancer cells. Some immunotherapies have been approved for use in certain cases of advanced prostate cancer.

The choice of treatment depends on the individual’s situation in tandem with the urology team. Multiple treatments are often used together depending on the stage of the cancer, your overall health, potential side effects and the patient’s personal preferences. Do seek a second opinion if you want clarification or wish to discuss your options further or from a different perspective.

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What are the alternatives to removing the prostate?

When it comes to prostate cancer treatment, removing the prostate gland (prostatectomy) is a safe option, but it comes with numerous side effects. Where appropriate there are some alternatives to the complete removal of the prostate;

Radiation therapy

External beam radiation therapy (EBRT) and brachytherapy are commonly used alternatives to a prostatectomy. EBRT involves directing high-energy X-rays at the prostate gland from outside the body whilst brachytherapy involves placing small radioactive seeds directly into the prostate.

HIFU

High-intensity focused ultrasound (HIFU) is a non-invasive treatment option that uses ultrasound waves to heat and destroy cancerous prostate tissue. It is typically used for localised prostate cancer and can be performed on an outpatient basis.

Nerve-sparring prostatectomy

As the name suggests its removal of prostate tissue whilst preserving the nerve bundles that control functions such as achieving and maintaining an erection. This technique is becoming more common as surgeons and equipment develop.

Cryotherapy

Cryotherapy involves freezing and destroying cancerous prostate tissue using very cold temperatures. This treatment is an option for localised prostate cancer and can be done using minimally invasive techniques.

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Focal therapy

Focal therapy targets only the specific areas of the prostate where cancer is located, rather than removing the entire gland. This approach aims to preserve prostate function while treating the cancer. Focal therapy techniques include high-intensity focused ultrasound (HIFU), cryotherapy, and laser ablation.

Active surveillance

Usually the first approach for localised, low-risk prostate cancer. It involves monitoring the cancer closely with regular PSA tests, digital rectal exams, and periodic biopsies. Treatment is deferred unless there are signs of disease progression.

It is important to note that the suitability of these alternatives depends on various factors, such as the stage and aggressiveness of the cancer, the patient’s overall health and preferences.

How fast can prostate cancer spread and what to do?

The speed at which prostate cancer spreads can vary from person to person. Some prostate cancers grow and spread slowly over many years, while others may be more aggressive and spread more rapidly. It is important to note that prostate cancer typically has a relatively slow progression compared to some other types of cancer. If you are worried here is what to do;

Seek medical advice from urologists, oncologists, or other specialists experienced in prostate cancer. They can evaluate your specific situation, including the stage and aggressiveness of the cancer and will recommend appropriate treatment options or further diagnostic assessments.

Prostate cancer staging typically uses the Gleason score to determine the stage of the disease and whether it has spread beyond the prostate gland. Staging tests may include imaging studies like MRI, CT scan, or bone scan. Understanding the stage of your cancer can help guide treatment decisions.

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Based on your Gleason score and other factors, your consultant will discuss potential treatment options with you.

Treatment options may include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or immunotherapy. Each treatment has its benefits and potential side effects, so it is important to have a thorough discussion with your healthcare team.

Remember to take an active role in your care. Learn about prostate cancer and the available treatment options. Ask questions, understand the potential risks and benefits of each treatment and actively participate in shared decision-making with your consultant.

As hard as it may be but adopting a healthy lifestyle can support overall well-being and potentially help in managing prostate cancer. This includes maintaining a balanced diet, engaging in regular exercise, avoiding tobacco, limiting alcohol consumption and actively manage stress.

After treatment, it is important to attend regular follow-up appointments as recommended by your Doctor. These appointments allow your team to monitor your progress, check for any signs of recurrence or spread, and address any concerns or side effects that may arise.

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