What are some of the treatment options for prostate cancer?
The treatment options for prostate cancer depend in part on whether the tumor has spread. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and a surgery called radical prostatectomy are common treatment options. "Watchful waiting" is also a treatment option. In this approach, no treatment is given until the tumor gets bigger. Watchful waiting may be the best choice for an older man who has a higher risk of dying from something other than his prostate cancer.
Generally, tumors that have grown beyond the edge of the prostate can't be cured with either radiation or surgery.
Radical prostatectomy is a surgery to remove the whole prostate gland and the nearby lymph nodes.
What are the risks and benefits of radical prostatectomy?
If you're in good health, the short-term risks of this surgery are low. You shouldn't have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.
The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Surgery does have risks and complications. You could lose a lot of blood during this surgery. If you're under 50 years old when you have this surgery, you're likely to regain sexual function. If you're older than 70, you're more likely to lose sexual function.
What is radiation therapy?
There are 2 types of radiation therapy. In one type, called external beam radiation therapy, radiation is given from a machine like an x-ray machine. In another type, radioactive pellets (called "seeds") are injected into the prostate gland. This is sometimes called seed therapy or brachytherapy (say: "break-ee-ther-uh-pee"). Both types work about the same in curing prostate cancer.
The side effects are milder than the side effects that can come with seed therapy. In seed therapy, higher doses of radiation can be put right on the cancer. Many men feel very tired at the end of the treatment period. About 15% to 30% of men who have radiation therapy have urinary burning, urinary bleeding, frequent urination, rectal bleeding, rectal discomfort or diarrhea during or shortly after the treatment. The cancer could come back many years after radiation treatment.
At 10 years after treatment, cure rates are about the same for radiation therapy and radical prostatectomy. There are no surgical risks for men who have radiation therapy. There's no risk of bleeding. Incontinence is extremely rare afterward.
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Many prostate cancers are small and grow slowly. Because many men with a slow-growing tumor have the same life expectancy as men who don't even have prostate cancer, it may not be necessary to treat very small, very slow-growing prostate tumors. Also, some men feel that the side effects of treatment outweigh the benefits. In watchful waiting, you get no treatment, but you see your doctor often. If there's no sign the cancer is growing, you continue to get no treatment. Hormone therapy can be started if the cancer starts to grow.
Your doctor will get clues about the way your tumor will grow by checking your prostate-specific antigen (PSA) level, examining the biopsy tissue and giving you a rectal exam.
What is the purpose of hormone therapy?
Once the testosterone is out of your body, the prostate cancer usually shrinks. Hormone treatments are most often used in patients with cancer that has already spread beyond the prostate gland.
While prostate cancer usually responds to 1 or 2 years of hormone therapy, after some time most tumors start to grow again. No treatment can cure prostate cancer after hormone therapy stops helping.
Where can I get more information about prostate cancer?
Your family doctor, your oncologist (cancer doctor), the radiotherapist and your urologist can give you information. Your local hospital or cancer center may refer you to a local prostate cancer support group, where you can meet other men who have had this cancer.
Mayo Clinic prostate cancer specialists are experienced in every stage and form of the disease.
Treatment
Mayo Clinic physicians guide each patient through several prostate cancer treatment choices. If you are older than age 70, you may opt for expectant management (also called watchful waiting) if your prostate cancer is growing slowly.
Mayo Clinic has a unique resource to help patients and physicians choose the most appropriate treatment. Since 1966, Mayo Clinic has compiled detailed records regarding patients who have undergone surgery for prostate cancer. It's an invaluable tool for doctors to help determine the most effective treatments to cure cancer, minimize side effects, and reduce the risk of recurrence.
Research
Many Mayo oncologists are part of the
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