Prostate Cancer: Latest Treatments and Emerging Therapies
If you've been diagnosed recently with prostate cancer, you might find the latest treatment options somewhat confusing. Each has its benefits and risks. And no single treatment is right for every man with prostate cancer. In this article, WebMD examines the various treatment options and their side effects. We'll consider the options in terms of:
The grade and stage (severity) of cancer
Other important factors
Ultimately, you'll need to decide for yourself, with the help and guidance of your doctor, which is best for you.
Prostate cancer is the second leading cause of death among American men, and
will affect one in six in this country. As with any cancer, spotting it early
is key. Dr. David G. McLeod, a professor of surgery at the Center for Prostate
Disease Research at the Water Reed Army Medical Center, talks about what can
raise your risk of the disease, what tests you need to protect yourself, and
why early detection is so important.
Dr. S. Ward Casscells, Assistant Secretary of Defense for Health Affairs
with the Department of Defense, talks candidly about his ordeal with advanced
prostate cancer and what all men should know about the disease.
What are the options for early stage prostate cancer?
Early-stage prostate cancer refers to cancer that is contained entirely within the prostate gland. It has not spread -- metastasized -- either to local tissues or to distant body parts, such as bone. This type of cancer, which doctors often call low-risk disease, is the most curable.
One out of every two men diagnosed with prostate cancer is aged 72 or older. Since prostate cancer often grows very slowly, many of these men may die from other causes before the prostate cancer causes any significant problems. In other words, many men will die with prostate cancer but not from prostate cancer. Another thing to keep in mind is that therapies for prostate cancer can have significant side effects and complications. So trying for a cure -- what doctors call "definitive therapy" -- may not always be the right choice.
There are three basic options for early-stage prostate cancer. The two active treatment options -- surgery and radiation -- can often lead to a cure when used alone. Men with intermediate-risk or high-risk disease usually need a combination of therapies to achieve a high likelihood of cure or disease control.
The three options for early-stage/low-risk prostate cancer are:
Radiation therapy - either external beam radiation or radioactive tumor seeding (brachytherapy)
Active surveillance, also known as expectant management or watchful waiting
The third option is not actually a form of treatment. Instead, it's a form of patient management that involves close observation and testing.
There is a fourth basic treatment option: hormone therapy. It is usually reserved for older men too debilitated for active treatment and for treatment of men with more advanced disease.
Chemotherapy plays only a limited role in prostate cancer treatment. It's reserved primarily for the treatment of men with advanced or recurrent prostate cancer that does not respond to hormone therapy.
Your choice of surgery, radiation, or expectant management may depend on several factors:
Your age and life expectancy
Other serious health problems you may have, such as heart disease
Your personal preference, informed by your doctor's opinion, about whether to begin treatment or to wait
Your concerns about the side effects common with prostate cancer therapies
Side effects may include things that affect your lifestyle. For example, erectile dysfunction and incontinence, or urine leakage, are both possible side effects.