Understanding the Benefits and Side Effects
There are many options for prostate cancer treatment, and each one works in a different way. For many men, treatment choices depend on the stage of the cancer, overall health and personal preferences. Let's look at ten options you can ask your doctor about.
1. Prostatectomy
A prostatectomy is a surgical procedure to remove the prostate gland. There are different types of prostatectomy, including radical prostatectomy, where the whole gland is taken out. This surgery is often used when the cancer is found only in the prostate. It may be done in several ways, such as through an open operation or with minimally invasive robotic surgery. Recovery can take time, and side effects may include trouble with urination or sexual function.
2. Brachytherapy
Brachytherapy is a form of radiation treatment where radioactive seeds are placed directly into the prostate. These seeds give off radiation that destroys cancer cells from the inside. Because the radiation is focused on one area, there can be fewer side effects compared to some other treatments. Brachytherapy is usually used for early-stage prostate cancer and recovery is often quicker than after surgery.
3. External Beam Radiation Therapy (EBRT)
EBRT uses high-energy rays from outside the body to kill cancer cells. The patient lies on a treatment table while the machine sends radiation to the prostate. This method is non-invasive and usually takes place over several weeks. Side effects might include irritation of the bladder or rectum, but many men experience only mild symptoms during treatment.
4. LHRH Agonists and Antagonists
Luteinizing hormone-releasing hormone (LHRH) therapy works to lower the levels of testosterone in the body, as testosterone can encourage prostate cancer cells to grow. Zoladex (Goserelin) is an LHRH agonist. It sends a signal that eventually lowers testosterone production in the body. Firmagon (Degarelix) is another LHRH antagonist. It works more quickly by blocking the hormone receptor in the pituitary gland that causes testosterone release.
5. Antiandrogens
Antiandrogens block the effect of testosterone on prostate cancer cells. These drugs can be used alone or with LHRH therapy. Casodex (Bicalutamide) and Nilandron (Nilutamide) are common antiandrogens that help stop testosterone from fueling cancer growth. While antiandrogens can be effective, they may cause side effects like nausea, vision changes or problems with the liver, so regular monitoring by a doctor is important.
6. Orchiectomy
Orchiectomy is a surgical procedure where one or both testicles are removed. This procedure reduces the amount of testosterone made by the body. Although it is a quick and effective way to lower testosterone, many men may feel emotional distress due to the loss of the testicles. However, orchiectomy offers a fast reduction in testosterone levels to control cancer growth.
7. Chemotherapy
Chemotherapy uses drugs to kill cancer cells throughout the body. It is usually recommended when the cancer has spread beyond the prostate. Chemotherapy drugs are given by injection or sometimes taken as pills. Side effects often include tiredness, hair loss, nausea and a risk for infection because chemotherapy can lower the number of white blood cells.
8. Ablation Therapy
Ablation therapy destroys cancer cells by heating or freezing them. Two common methods are cryotherapy, which uses extreme cold, and radiofrequency ablation, which uses heat. These methods target the cancer directly in the prostate and can be less invasive than surgery. Ablation may be recommended for men with small tumors or for those who cannot have surgery for other health reasons. Side effects can include swelling or temporary problems with urination.
9. Targeted Therapy
Targeted therapy uses drugs to attack specific parts of cancer cells. One example is Zejula (Niraparib). Unlike chemotherapy, which affects many cells, targeted therapy focuses on specific molecules that help cancer cells grow. Niraparib interferes with the DNA repair process in cancer cells, leading to their death. It is usually given as a pill and may be used when other treatments have not worked. Common side effects might include fatigue, low blood counts and nausea.
10. Immunotherapy
Immunotherapy uses the body’s own immune system to fight cancer. The treatment can boost a patient’s natural defenses or help the immune system spot and attack prostate cancer cells. Immunotherapy is a newer approach and may not be suitable for everyone. Side effects differ from person to person and can include flu-like symptoms or skin reactions.
Treatment for prostate cancer is not a one-size-fits-all approach. Men diagnosed with prostate cancer should discuss the different options for prostate cancer treatment with their doctor to understand the best plan for their unique situation.