1) Watchful Waiting: Careful Monitoring.
Watchful waiting is generally used for those with a low PSA and low Gleason scores. Age is also a factor in some cases. The very young or very old are sometimes encouraged to opt for the watchful waiting to avoid the possible side effects or more aggressive treatments such as incontinence or impotence.
Watchful waiting does not mean you do nothing but wait and see what happens. Careful monitoring is done during this period to keep track of the cancers progression. Most prostate cancers grow slowly so the longer you can safely avoid the more aggressive treatments, the longer your quality of life is less likely to be disrupted.
A risk for watchful waiting is that the cancer may spread rapidly between appointments.
2) Radical Prostatectomy: Removal of Prostate.
There are 3 types of this prostate surgery.
Retropubic - Incision made in the center of the lower abdomen to remove prostate.
Perineal- Incision made between the scrotum and sphincter to remove prostate.
Lapruropic and Robotic- Uses a tube like instrument to excise the prostate using a series of small incisions rather than just one to remove the prostate.
This type of surgery is used if the cancer is confined to the prostate gland. Because of the risks and side effects, it generally is used on patients who are young and in good health. The recovery period for this type of operation depends on the type of prostatectomy.
The risk factors of impotence and incontinence are very high but the success rate for these procedures is over 90%.
3) Radiation Therapy: External radiation at prostate cancer cells.
This is the most common treatment for prostate cancer. The patient is evaluated to decide the amount of radiation that can be used effectively to treat the cancer. He then goes for treatment once a day, Monday-Friday, for 5 to 9 weeks. During this treatment, the targeted area is irradiated with attention not to damage the surrounding organs to prevent side effects. This time frame is effective as normal prostate cells can repair themselves from small amounts of radiation while the cancerous cells do not possess this ability for repair. Having the week-ends off gives the body a chance to recuperate for the next series of treatments.
Studies, both long and short term, have success rates of around 85% when used with other therapies. Side effects include tiredness, diarrhea, upset stomach and a burning sensation while urinating.
4) Hormone Therapy: Suppresses, blocks or eliminates testosterone.
This therapy is used to slow or stop the growth and spread of prostate cancer. Hormone therapy can also be referred to as androgen deprivation or androgen ablation. Androgen is the hormone that tends to make men men. As stated above, this therapy removes the testosterone from the body or suppresses the body's use of testosterone. Medical and surgical castrations are two forms of androgen ablation.
There are four basic methods to deprive the body of androgen:
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1. Castration - This involves the removal of the testicles.
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2. Estrogen - This treatment is not used very often as it has a potential to cause serious cardiovascular problems. Basically the estrogen fools the system into thinking it is testosterone and stops the system from making more testosterone.
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3. Anti-androgens - Prevents testosterone from interacting with the prostate gland.
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4. Combined androgen-blockade - Uses castration and anti--androgens to interfere with testosterone production.
Hormone cancer is generally used in conjunction with other treatments. Some of the side effects may include impotence, weight gain, hot flashes, fatigue and loss of muscle mass.
5) Chemotherapy: Used in the treatment of advanced prostate cancer.
This therapy is not recommended for use in the early stages of the cancer as it damages the cells so badly that they die and it does not distinguish which cell will be killed. Chemotherapy is used when the cancer has spread to the bones. This therapy seems to relieve some of the pain suffered by the patient and slows the growth of prostate cancer in the advanced stages.
There are new and more effective chemotherapy drugs on the market today, but they have not been in use long enough to say that patients benefit by the earlier use of these drugs.
The side-effects that one may suffer are nausea, vomiting, hair loss and mouth sores.
6) Cryosurgery & Cryotherapy: Uses needles to apply freezing gases to the prostate.
Cryotherapy is not used as primary treatment for prostate cancer as it is relatively new and not enough data has been compiled at this time however, it is used for treating cancer that is unaffected by radiation.
Cryotherapy works by freezing and thawing which kill the cells by dehydration, changing pH levels or preventing the flow of red blood cells. The freezing process also activates an anti-tumor response by the body to produce antibodies the work to eradicate the tumor.
This treatment is effective for the early stages of prostate cancer. The treatment takes about 2 hours and one may need to stay over night. The side-effects may include moderate pelvic pain, blood in urine, scrotal swelling, mild urinary urgency and impotence.
7) Brachytherapy: Implant high or low dose radiation seeds in prostate.
The term,
brachytherapy
, means to administer from a short distance away. The two types of this therapy are:
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1. LDR - Permanent low dose radiation.
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2. HDR - Temporary high dose radiation.
LDR seeds permanently left inside the prostate and continuously emit radiation to the prostate. An improvement has now been made to this product by producing a covering that allow one direct the radiation in the direction you choose instead of being emitted in all directions. This surgery usually last for about ½ hour and regular activities are usually resumed in a couple of days. In some cases an overnight stay may be necessary.
The HDR treatment lasts from 5 to 15 minutes, and then the patient is returned to his room. This process is repeated one or two times meaning the patient will remain in the hospital until the treatment is completed which will take a day or two. When this treatment is completed, unlike the LDR, no radiation seeds will be left in the body.
Data says that that the success rate for these procedures is from 77 - 93% and is most effective with younger patients that are in good health. The side-effects may be bleeding at the insertion site, blood in urine, scrotal burning, incontinence or impotence.