Last modified on May 26th, 2020
Surgical (Radical Prostatectomy)
Radiation Therapy for Prostate CancerRadiation therapy, also sometimes called radiotherapy, is a general term used to describe several types of treatment including the use of high-powered X-rays, placement of radioactive materials into the body or injection of a radioactive substance into the bloodstream. These various types of radiation treatments are used in a wide range of settings. These circumstances include primary treatment of localized prostate cancer, secondary treatment for cancer recurring within the region of the prostate and for relief of pain and other symptoms related to prostate cancer that has spread to other parts of the body.The curative indication of external-beam radiotherapy is similar to that of radical prostatectomy: organ-confined cancer in patients with a life expectancy above 10 years. The treatment generally involves a 7-week course of radiotherapy. Radiotherapy is considered to result in lower rates of incontinence and erectile dysfunction than with radical prostatectomy. The major side-effects of conventional external radiotherapy are urinary irritative symptoms and bowel complications.
Hormonal Therapy for Prostate CancerWhen the prostate cancer is more advanced, and has spread to other parts of the body, treatment includes reducing the testosterone (male hormone) that supports the prostate and its tumours. Hormone therapy reduces symptoms and prevents further growth. Hormone therapy is achieved by either surgery or medication. Testosterone can be reduced by removing the testes; the operation is called a bilateral orchiectomy. The other commonly used option, however, is chemical castration – injecting synthetic LH-RH analogs every three to four months to suppress the natural production of testosterone. In doing so, it deprives the cancer cells of an element needed for growth. Using a number of medications, hormonal therapy attempts to nullify as much as possible all male hormone effect on prostate cancer cells.There is also evidence that prostate cancer patients whose disease has spread to the lymph nodes will encounter prolonged progressive-free survival and a better quality of life with early hormonal therapy. While hormonal manipulation causes prostate cancer to shrink in 85 to 90 percent of a prostate cancer patients, total and durable eradication of the disease is unlikely. The good news is that hormone therapy may control prostate cancer for many years. The current hormonal therapy standard of care is, once initiated, to continue hormone therapy for life.However, while hormonal therapy can put your cancer in check, there are unpleasant side effects such as nausea and vomiting, hot flashes, anaemia, lethargy, osteoporosis, swollen and tender breasts and erectile dysfunction. Evidence indicates that hormonal treatment when combined with radiation increases survival duration.
ChemotherapyChemotherapy refers to drug treatment using single drugs or a cocktail of several medications aimed at destroying cancer cells. The drugs circulate throughout the body in the bloodstream and can kill any rapidly growing cells, including both cancerous and non-cancerous ones. Chemotherapy drugs are carefully controlled in both dosage and frequency so that cancer cells are destroyed while the risk to healthy cells is minimized. Often, it is not the primary therapy for prostate cancer patients, but may be used when prostate cancer has spread outside of the prostate gland. Over the past 10 years chemotherapy treatments have been shown to improve pain control and survival for patients with advanced prostate cancer, who have progressed despite hormonal therapy.Common side effects of chemotherapy depend on the type of drug used, dosage and length of treatment. For prostate cancer patients, the most frequently used chemotherapy regimen is docetaxel and prednisone. The most common side effects of this regimen are fatigue, nausea and vomiting, diarrhoea, hair loss, taste changes and a decrease in blood cell counts that result in an increased risk of infections.
Active SurveillanceActive surveillance is traditionally reserved for men with small-volume and low-to-moderate-grade prostate cancer, who have a low risk of death from prostate cancer. During active surveillance, men are followed closely with serial PSA, DRE, transrectal ultrasounds, and repeat prostate biopsies at regular intervals. It is different from watchful waiting in that men on active surveillance may elect treatment for cure when their disease appears to be changing and becoming more aggressive. The goal of active surveillance is to allow men to maintain their quality of life when the disease is slow growing or inactive but still allow them to be cured of prostate cancer when the disease appears to become more aggressive or is growing.However, regarding the issue of prevention of prostate cancer, there is still a lingering controversy about true prevention. Consequently, most physicians believe that there is no easy substitute for a healthy lifestyle involving eating a healthy diet, avoiding dietary excesses, eating plenty of fruits and vegetables, getting lots of exercise and being physically active, visiting the doctor on a regular basis, and most importantly achieving and maintaining a normal body weight.
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