Treatment options for prostate cancer

What are the Treatment options for prostate cancer?

Your prostate cancer treatment options depend on several factors, such as the speed of the growth of cancer, whether it has spread, and your overall health.

Surgery 

Radical prostatectomy is a surgical procedure during which a part of your entire prostate gland is removed. If you have prostate cancer that has not spread outside the prostate, your doctor may suggest that you have a radical prostatectomy. 

There are 2 different methods of radical prostatectomies (laparoscopic or open surgery). 

  • Open surgery means you will have a larger incision in your lower abdomen. 
  • Laparoscopic surgery means you will have several smaller incisions in your abdomen.

Hormone therapy

As prostate cancer cells rely on testosterone to help them grow, the Hormone therapy stops your body from producing the male hormone testosterone. Hormone therapy options will include:

  • Medications that will stop your body from producing testosterone.
  • Medications that will block testosterone from reaching cancer cells. 
  • Surgery to remove the testicles (orchiectomy): Removing your testicles reduces testosterone levels in your body quickly and is permanent and irreversible.

Hormone therapy is often used to treat advanced prostate cancer or recurrent prostate cancer and is used before radiation therapy to shrink the tumour. 

Chemotherapy

Chemotherapy is done after surgery to destroy any cancer cells that may remain. It is administered through a vein in your arm, in pill form or both. Chemotherapy may be a treatment option for treating prostate cancer that has spread to other areas of the body and hormone therapy has not helped. 

Radiation therapy

Radiation therapy uses high energy beams from X-rays and protons that kill cancer cells. It is delivered by external beam radiation or brachytherapy. Prostate cancer radiation therapy treatments may involve:

  • External beam radiation delivers radiation from a machine outside the body, which targets a specific area, minimizing the risk to healthy tissue. The two types which are useful for prostate cancer are three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT).  
  • Radiation placed inside your body (brachytherapy): A doctor will implant radioactive seeds into the prostate to deliver targeted radiation treatment.

Radiation is useful to shrink the tumour before surgery and to kill any remaining cancer cells after surgery. In advanced stages, radiation helps to relieve symptoms where cancer has spread.

Biologic Therapy or Immunotherapy

Biologic therapy for prostate cancer involves a vaccine to boost the body’s immune system to fight cancer. The technology uses a man’s white blood cells to produce the vaccine, so the vaccine is unique for each man. This vaccine treats advanced prostate cancer that has spread to other organs and is not responding to hormone therapy. It does not cure but can prolong life. Immunotherapy drugs help the immune system cells to identify and attack the cancer cells and it is an option for treating advanced prostate cancers that do not respond to hormone therapy.

Targeted drug therapy

Targeted drug treatments focus on specific abnormalities present within the cancer cells.

  • Targeted drug treatments will block these abnormalities and destroy cancer cells. 
  • Targeted drugs are used to treat advanced prostate cancer

    or recurrent prostate cancer if hormone therapy isn’t working.

  • Targeted therapies only work in those people whose cancer cells have certain genetic mutations.

Freezing or heating prostate tissue

The following therapies destroy prostate tissue with cold or heat:

  • Freezing prostate tissue: Cryoablation or cryotherapy involves using a very cold gas to freeze the prostate tissue. The tissue is allowed to thaw and the procedure is repeated. The cycles of freezing and thawing destroy the cancer cells and some surrounding healthy tissue. 
  • Heating prostate tissue: High-intensity focused ultrasound (HIFU)is a technique that uses concentrated ultrasound energy to heat the prostate tissue and destroy the cancer cells. This treatment option is used when Prostate Cancer spreads to the surrounding tissues. In HIFU, doctors will insert an ultrasound probe into the patient’s rectum and from that position, the ultrasound can direct beams accurately at the prostate. Results from trials reveal that HIFU can be a successful treatment for prostate cancer. 

These treatments may be considered for treating very small prostate cancers when surgery is not possible. They may also be used to treat advanced prostate cancers if radiation therapy has not helped. Researchers are studying whether cryotherapy or HIFU can be used to treat prostate cancer.

What are the Side Effects of Prostate Cancer Treatment?

The side effects of prostate cancer treatment are usually temporary. However, there are a few side effects that might stay for a longer period of time.

  • After or during the prostate cancer surgery, the patient might face some anaesthetic reaction, bleeding near the surgical area, blood clots in lungs and liver or infection. It will affect the normal sexual functions of the patient. 
  • Radiotherapy side effects include diarrhoea, increase in urinary urge, fatigue, vomiting, burning sensation or pain. While these are temporary, impotency is permanent.
  • Hormone therapy generates side effects like loss of sexual desire, weight gain, depression, impotence, and gynecomastia.
  • The temporary side effects of chemotherapy include fatigue, indigestion, hair loss, vomiting, constipation and blood disorders.
  • Under the Vaccine therapy, patients may experience side effects such as fever, fatigue, joint pain, and headache.

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How can you reduce the risk of prostate cancer?

The diet that should be followed:

  • Certain foods may help reduce your risk of prostate cancer, such as cruciferous vegetables, broccoli, Brussels sprouts, fish, soy, oils that contain omega-3 fatty acids and olive oil.
  • A dietary supplement of zinc is advisable.
  • Tomatoes, grapefruits, and watermelons are rich in lycopene (antioxidants) and prevent damage to DNA, which can help to reduce the risk of prostate cancer.
  • Men who eat plenty of fatty fish, such as salmon, herring, and mackerel, are at less risk of developing prostate cancer compared to men who rarely eat fish.

The diet that needs to be avoided:

  • The evidence also suggests that certain foods may increase your risk of prostate cancer, such as milk and dairy products, saturated fat, which is found in animal products, red meat and grilled meat.
  • Men who have a diet rich in fat and who involve a lot of sitting increase their chances of developing cancer.

How can you prepare yourself for the treatment of prostate cancer?

  • The first and foremost thing that you need to do is keep yourself well informed about your cancer, this improves your quality of life as this can make the disease seem less mysterious and frightening. Information from your doctor and other credible sources can be very helpful in this respect.
  • When a person is diagnosed with cancer it hurts their emotional state, so you need to prepare yourself mentally and emotionally. This can be done by being transparent with your family and friends about how you feel, the problems you have been facing so they can help you in a better way. As a peer or a family member of the patient, you must support them at all times by listening to them patiently as they feel emotionally low.
  • You can avail services of a counsellor or attend group therapies consisting of people sharing their past experiences of cancer.
  • Writing down about your queries, problems, new symptoms, any physical changes, medications, past medical reports and other important things will help you to clearly express yourself to the doctor.

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