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Understanding Prostate Cancer -- Diagnosis & Treatment

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What Are the Treatments for Prostate Cancer? continued...

Radioactive seeds (brachytherapy) deliver radiation to the prostate with little damage to surrounding tissues. During the procedure, the tiny radioactive seeds, each like a grain of rice, are implanted in the prostate gland using ultrasound guidance. The implants remain in place permanently and become inactive after many months. In some patients, brachytherapy may be used with traditional radiation. In some patients, if the prostate gland is too large for brachytherapy, hormone therapy can shrink the prostate to allow brachytherapy to be done.

Hormone Therapy

Hormone therapy is the recommended treatment for advanced prostate cancer. Since testosterone can make prostate cancer grow, hormone therapy works by tricking the body to stop making testosterone, thus stopping or slowing the cancer's growth. Even advanced cases that cannot be cured may be controlled for many years with hormone therapy. But there is a higher risk of heart disease with this treatment. Fractures are also a risk due to thinning of bone. Medications are given to reduce the risk of osteoporosis and fractures.

Testosterone can also be removed from the bloodstream by surgically removing the testicles (orchiectomy) or by giving female hormones such as estrogen or other drugs that block testosterone production. Estrogen therapy is no longer used routinely. Patients generally prefer the testosterone-blocking drug treatment because it is effective, less invasive, and causes fewer side effects than surgery or female hormone drugs.

Other Treatments

Chemotherapy and vaccines are effective for some men with advanced prostate cancer who didn’t do well on hormone therapy. Provenge is a new prostate cancer vaccine that helps men with advanced prostate cancer live longer. Unlike most vaccines, Provenge is used for treatment, not prevention. Provenge doesn't cure prostate cancer. It stimulates the immune system to fight the cancer. 

The goal of prostate cancer treatment is long-term survival, and that is likelier in men diagnosed with early prostate cancer. All prostate cancer survivors should be examined regularly and have their PSA and testosterone levels monitored closely.

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WebMD Medical Reference

Reviewed by David T. Derrer, MD on March 31, 2014
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