Your physician may not be in the best position to completely analysis what options are available to you. This is a compilation of known treatments for prostate cancer. Hopefully this will help determine your best course of treatment. I was diagnosed at 53 with prostate cancer and treated with proton beam therapy. I am in the position as a past patient to at least present what options are available to treat prostate cancer.
The appropriate treatment for prostate cancer is not clear. Treatment options vary based on the stage of the tumor. In the early stages, talk to your doctor about several options including surgery, radiation therapy, or, in older patients, monitoring the cancer without active treatment.
Prostate cancer that has spread may be treated with drugs to reduce testosterone levels, surgery to remove the testes, or chemotherapy.
Surgery, radiation therapy, and hormonal therapy can interfere with sexual desire or performance on either a temporary or permanent basis. Discuss your concerns with your health care provider.
Surgery is usually only recommended after a thorough evaluation and discussion of all treatment options. A man considering surgery should be aware of the benefits and risks of the procedure.
Please note this is a compilation of various sources of information and is not considered medical advise. This is only for your review. You can read my personal battle with prostate cancer here.
Radiation therapy is used primarily to treat stage A, B, or C prostate cancers. Whether radiation is as good as prostate removal is unclear. The decision about which treatment to choose can be difficult. In patients whose health makes surgery too risky, radiation therapy is often the preferred alternative. Radiation therapy to the prostate gland is either external or internal:
The CyberKnife is a frameless robotic radiosurgery system. It produces radiation using a small linear particle accelerator and has a robotic arm that allows the energy to be directed at any part of the body from any direction. By increasing the accuracy of the delivery of radiation, there is a potential for dose escalation, resulting in an increase in effectiveness.
The CyberKnife system has been approved by the US Food and Drug Administration to treat any solid tumor, including tumors of the prostate. Studies of the CyberKnife have not shown any general survival benefit over conventional treatment methods. Studies to date have been limited in scope, and more extensive research will be needed to show any effects on survival.
Proton therapy is a type of radiation therapy in which doctors use positively charged radioactive particles to treat prostate cancer. Understanding proton therapy radiation treatment for prostate cancer involves learning the benefits of proton therapy as well as understanding how it differs from traditional radiation therapies.
How It Works
How It Differs From Other Radiation Therapies
Benefits of Proton Therapy
EMERGING PROSTATE CANCER TREATMENTS
HIFU, which stands for High Intensity Focused Ultrasound, was first developed as a treatment of benign prostatic hyperplasia (BPH) and now is also being used as a procedure for the killing of prostate cancer cells. As shown in Figure 1, this procedure utilizes transrectal ultrasound that is highly focused into a small area, creating intense heat of 80-100° C, which is lethal to prostate cancer tissue. Since ultrasound is non-ionizing (as opposed to ionizing in radiation ), tissue in the entry and exit path of the HIFU beam is not injured.
The published clinical experience with HIFU for this application is limited and only extends out to 5 years, and the procedure is not yet approved by the FDA for use in the United States, (HIFU is approved in Europe, China, Japan, Caribbean, Mexico, and Latin America). However, HIFU offers a powerful advantage over radiation treatment: The control and precision of HIFU allow the accomplished surgeon to accurately target the tissue to be destroyed without injuring adjacent tissue. HIFU destroys tissue by heat, rather than by cavitation or mechanical shearing forces.
Risks and Complications
Immediately after surgery, there will be urinary retention, because the gland will swell. Often, there will be necrosis (slough) of some or all of the urethra. Many patients pass this tissue without any problems, and others may require the removal of the tissue through a cystoscope ( TURP ). (Sloughing can also occur with cryosurgery, especially in radiation failure. Radiation necrosis of the urethra has been seen with brachytherapy, but no surgery is performed due to the high risk of problems in radiated tissue and the seeds.) SourcePCRI
Medicines can be used to adjust the levels of testosterone. This is called hormonal manipulation. Because prostate tumors require testosterone to grow, reducing the testosterone level often works very well at preventing further growth and spread of the cancer. Hormone manipulation is mainly used to relieve symptoms in men whose cancer has spread. It may also be done by surgically removing the testes.
The drugs Lupron and Zoladex are also being used to treat advanced prostate cancer. These medicines block the production of testosterone. The procedure is often called chemical castration, because it has the same result as surgical removal of the testes. However, unlike surgery, it is reversible. The drugs must be given by injection, usually every 3 - 6 months. Possible side effects include nausea and vomiting, hot flashes, anemia, lethargy, osteoporosis, reduced sexual desire, and impotence.
Other medications used for hormonal therapy include androgen-blocking drugs (such as flutamide), which prevent testosterone from attaching to prostate cells. Possible side effects include erectile dysfunction, loss of sexual desire, liver problems, diarrhea, and enlarged breasts.
Chemotherapy is often used to treat prostate cancers that are resistant to hormonal treatments. An oncology specialist will usually recommend a single drug or a combination of drugs. Chemotherapy medications that may be used to treat prostate cancer include:
You will be closely watched to make sure the cancer does not spread. This involves routine doctor check-ups. Monitoring may include: