Prostate Cancer Treatment
Treatment options for prostate cancer are based on the size and aggressiveness of the cancer. Because of this, different doctors may recommend different approaches that include the following.
- Active surveillance, or watchful waiting.
- CyberKnife® stereotactic body radiation therapy.
- Radiation therapy.
- Hormone therapy.
In order to determine the best treatment option, it is important to become an educated patient ready to seek second and third opinions. The technology used to treat prostate cancer tumors (and other cancerous tumors) is evolving at an unusually rapid pace. That’s good news for prostate cancer sufferers, who now have a wider variety of treatment options than ever before.
CyberKnife for prostate cancer treatment
In most of the treatments for prostate cancer, side effects are often a major consideration and include erectile dysfunction, lower sex drive and urinary incontinence. Many men with prostate cancer avoid treatments because of this. CyberKnife, which generally has less chance of side effects, may be a better option for them.
Anova Cancer Care is a global leader in treating prostate cancer with CyberKnife, a specialized alternative to surgery and traditional radiation therapy. The CyberKnife Robotic Radiosurgery System is the most advanced system for the delivery of radiosurgery, a form of therapy that precisely targets and kills cancerous cells or tumors while greatly reducing the damage done to healthy cells.
Treatment is noninvasive, requires fewer sessions, is comfortable for the patient and is often more effective. Research supports the use of CyberKnife for prostate cancer, and Anova has successfully treated more than 1,500 prostate cancer patients.
The system can treat tumors and other problems in virtually any area of the body. CyberKnife is often the best or only option for patients with hard to reach or inoperable tumors. It is also an excellent option for those who would otherwise have unacceptable side effects or complications when treated by other methods or require treatment after other attempts to treat have failed.
Anova Cancer Care is a member of the Radiosurgical Society (RSS). RSS conducted a 21-center study on the effectiveness of using CyberKnife to treat prostate cancer.
Other prostate cancer treatment options
Which treatment is best for any one patient depends on a number of factors such as how far the disease has progressed, the age of the patient, which treatment has the fewest side effects and which has the least negative impact on lifestyle.
Prostate cancer treatments include the following therapies or a combination of these options.
While not necessarily an active treatment, watching and waiting, or active surveillance, is a common course of action oncologists take for prostate cancer. This is typically used when the cancer is slow-growing, not causing any symptoms or confined to a small area. Active surveillance can also be utilized if the patient is older or has other serious health problems that would be complicated or exacerbated by treating the cancer.
Depending on the severity of the cancer, active surveillance can require the patient to undergo regular blood tests, including prostate-specific antigen blood tests, rectal exams and possibly biopsies. The oncologist may suggest relying on fewer tests and more on monitoring any changes in symptoms.
A common treatment of prostate cancer that has not spread to other parts of the body, is a radical prostatectomy. This procedure involves removing the entire prostate gland, surrounding tissue and seminal vesicles. Prostatectomies can be done laparoscopically with small incisions including through robotic assisted surgery, or through traditional surgery with a larger incision.
Oncologists perform two types of radical prostatectomy procedures: retropubic and perineal. In a retropubic radical prostatectomy, the surgeon removes the prostate through an incision in the abdomen. During a perineal prostatectomy, the surgeon removes the prostate through an incision in the perineum, which is the area between the scrotum and anus.
As with any surgery, radical prostatectomy has the potential for side effects. Urinary incontinence is an expected side effect of the surgery, and typically after several weeks, normal bladder control will return. If the cancer has spread into or very close to the nerves that control erections, it may be necessary to remove them as well, which can result in erectile dysfunction.
Chemotherapy, or chemo, is used when the prostate cancer has spread beyond the prostate. Chemotherapy uses anti-cancer medications, such as docetaxel, mitoxantrone and cabazitaxel, to stop the growth of cancer cells. This is done by either killing the cells or preventing them from dividing (growing). The medication can be taken by injection or mouth.
Chemotherapy can have side effects such as hair loss, nausea, vomiting, fatigue and more. Once the chemo treatment is completed, these side effects will typically end.
Radiation is often the first treatment for cancer that is contained within the prostate gland and uses ionizing radiation to kill cancerous cells. Radiation therapy can be done internally, also known as brachytherapy, or externally.
Internal radiation therapy uses temporary catheters, small radioactive “seeds” or pellets. Each of these pellets is about the size of a grain of rice and they are placed into the prostate. They emit radiation, which kills the cancer cells over a period of time.
External radiation therapy focuses beams of radiation on the prostate gland. This procedure is similar to getting an X-ray but the radiation is much stronger.
With both internal and external radiation, the side effects include erectile dysfunction. Additionally, internal radiation can result in urinary problems and rectal symptoms such as pain when passing stools.
Androgen deprivation, also called androgen suppression, is a type of hormone therapy. The goal of this treatment is to reduce the androgen hormones in the body. Hormones can cause prostate cancer cells to grow, cutting off the supply can cause the cancer cells to die or grow more slowly. Hormone therapy is often used in conjunction with radiation therapy to treat prostate cancer.
A number of medications can prevent the body from producing testosterone, the hormone that causes prostate cancer to grow, or blocking it from reaching the cancer cells.
- Luteinizing hormone-releasing hormone (LH-RH): These types of medications stop the body from producing testosterone, and are in drugs such as leuprolide (Lupron), gosereline (Zoladex) and histrelin (Vantas).
- Anti-androgens: This type of medication prevents testosterone from reaching prostate cancer cells. Nilutamide (Nilandron) and bicalutamide (Casodex) are examples of this type of medication.
This type of treatment is used most often when the cancer has spread extensively, is recurrent or before any radiation in order to shrink the cancer to make radiation therapy more effective. The use of hormone therapy is not agreed upon by all doctors, specifically the best way to administer the therapy or when to start and stop it. Side effects of hormone therapy include reduced sexual desire, erectile dysfunction, hot flashes and breast tenderness, among others.