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Your Prostate Cancer Treatment Options

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Watchful Waiting: Active Surveillance of Prostate Cancer continued...

Active surveillance doesn’t mean doing nothing, Carroll says. Men are regularly monitored with PSA tests, digital rectal exams, imaging, and follow-up biopsies to make sure the cancer hasn’t progressed. The use of ultrasound, CT, bone scans, or MRI might also be used to watch for disease growth and the need for treatment.

In some cases, men who choose active surveillance may eventually need treatment. Others may not.

The risk, of course, is that by waiting you might miss the window of best opportunity for treating the cancer. “Still, by carefully monitoring the cancer and a patient’s condition, we think that risk is very small,” says Carroll, who is directing a large study of men who have opted for active surveillance.

Types of Radiation Treatment for Prostate Cancer

Radiation therapy has been used to treat prostate cancer for many years. Recent advances allow doctors to target prostate cancer cells more precisely and with a higher dose of radiation, lowering the risk of unwanted side effects while at the same time improving effectiveness. 

External beam radiation treatment targets prostate cancer with high-energy X-rays delivered from outside the body. It is one of the main treatment options for prostate cancer confined to a small area. External beam radiation treatment typically consists of treatments five days a week over a period of eight weeks. Each treatment takes about 15 to 25 minutes. Because there is no pain, anesthesia is not required. Side effects can include sexual problems, fatigue, loss of appetite, and urinary or rectal urgency and bleeding.

Radioactive seed implants deliver radiation via tiny radioactive metal pellets or "seeds" that are implanted into the prostate gland, where they release low-doses of radiation over a period of several months. Toward the end of the year the pellets lose their radioactivity .  The procedure, called brachytherapy, is done under general anesthesia and typically takes an hour or two. Between 40 and 150 seeds are usually implanted, each about the size of a grain of rice. Implants pose less risk of damage to surrounding tissues in the rectum than external beam radiation, but they may have a higher risk of impairing urinary function than external beam radiation. Side effects can also include sexual problems.

Proton therapy is a type of external radiation that uses positively-charged particles to treat the cancer. This type of radiation therapy may allow your doctor to reach tissues deeper within the body.

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