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Your Prostate Cancer Treatment Options

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.

Surgery for Prostate Cancer

Many different approaches are used, each with its own risks and benefits. As with any surgery, the outcome depends in large measure on the expertise of the surgeon. It’s crucial to find a surgeon with extensive experience in performing the type of surgery you choose.  

Open radical retropubic prostatectomy involves removing the prostate through a cut made in the lower abdomen. This technique allows surgeons to remove not only the prostate but also any nearby lymph nodes that have become cancerous. Nerve-sparing techniques are now widely used to preserve urinary control and sexual function. The operation typically requires two or three days in the hospital. Most men need a urinary catheter in place for one two weeks after the surgery. For cancers confined to the prostate, radical prostatectomy remains the most effective way to remove cancer.

Radical perineal prostatectomy involves removing the prostate through a cut made in the perineum, the area between the anus and scrotum. This approach typically causes less bleeding, but surgeons are unable to remove nearby lymph nodes, making it useful only when the cancer is confined to the prostate.

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