There are generally three approaches to the treatment of prostate cancer. The decision on which option is best for you will involve several variables. Probably the most important factor will be the stage of the cancer and whether it has spread beyond the prostate.
For cancer that is confined to the prostate, there are two primary treatment options and an option that would probably fall into an “other” category. We’ll cover the other option first. Often prostate cancer is a slow growing cancer, and especially with older men the truth is that an approach called “watchful waiting” may in fact be the most prudent option.
With watchful waiting, a patient and doctor do just that. They monitor the PSA (prostate specific antigen) and the prostate, and if nothing changes in the slow growth, the cancer is left alone. Delicately put by many doctors in this situation, they will tell the patient that they may die, but it is highly unlikely that it will be because of prostate cancer. The watchful waiting method always leaves the door open for intervention if something changes.
The other two treatment methods, when the cancer is confined to the prostate, are a radical prostatectomy (removal of the prostate) or radiation therapy. A prostatectomy, if the cancer is confined, simply removes the problem and the source of origin all in one procedure. It is very rare for prostate cancer to come back after the procedure. One of the factors that many men weigh with this procedure is the side effect of sexual dysfunction.
The other option, radiation, can be done two ways. If the cancer is very small and localized, a radioactive beam can be concentrated on the spot and the cancer eradicated that way. If the cancer is in more than one spot, radioactive seeds can be implanted, a procedure called brachytherapy. Both methods are very effective and many times the choice is made based on the amount of time each procedure takes. With radiation beam treatment, it would need to be done usually 5 days a week for 7 or so weeks. With the seed implant, the implant procedure takes a few hours and you’re good to go.
If the cancer has spread outside of the bladder, a high stage cancer, the most common treatment is hormone therapy. The purpose of hormone therapy is to lower or remove the testosterone from your body. In the absence of testosterone, prostate cancer will often shrink and sometimes completely go away. If it doesn’t go away, the hormone treatment will eventually lose its’ effectiveness and the prostate cancer may come back. At that point, chemotherapy is the only option left and it has very mixed results.