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Cryosurgery for Prostate Cancer

Cryotherapy kills prostate cancer by freezing prostate tissue. But so far, the technique has not been widely adopted because of a high risk of damage to the rectum or urethra from freezing. Loss of sexual function is also much more likely after cryosurgery than after other treatments. 

In cryotherapy, surgeons pass liquid nitrogen or argon gas through narrow rods inserted into the prostate. Cryosurgery can be performed in two to three hours, and patients are often able to leave the hospital the same day.

Hormone Therapy for Prostate Cancer

Male sex hormones, mostly testosterone, provide the fuel that drives prostate cancer growth.  The goal of hormone therapy is to deprive prostate cancer cells of that fuel. Hormone therapy is used to treat advanced prostate cancer, but it can also be used to shrink larger tumors, making other treatments easier. Hormone therapy does not kill cancer cells but can significantly shrink tumors and slow any further growth. Side effects include loss of sex drive, impotence, nausea, diarrhea, and fatigue. Hormone therapy takes three forms:

ADT or androgen deprivation therapy. These medications are injected into the buttocks either once a month, once every three to four months, or once a year, depending on the specific drug. If these treatments are used instead of surgery, these drugs must be administered regularly for life.

Anti-androgens prevent prostate cancer cells from using testosterone. They are given in pill form.  This type of therapy is not given by itself. It is used in combination with surgery or other hormonal therapies.

Orchiectomy involves the removal of the testicles, which reduces testosterone production by about 90%. (About 10% of testosterone is produced by the adrenal glands.) This approach is sometimes chosen by older men who do not want the inconvenience or expense of taking medications.  Silicone implants are placed within the testicular sac to preserve a natural look.

Combination Therapy for Advanced Prostate Cancer

To treat aggressive cancers that have spread beyond the prostate gland, doctors may recommend various types of therapies.

ADT and anti-androgens are often prescribed together, for example, to block the maximum amount of testosterone from reaching prostate cancer cells. Hormone therapies are also increasingly used in combination with radiation therapy or surgery. Doctors sometimes prescribe hormones to shrink the prostate cancer before delivering radiation.

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