Treatment of Prostate Cancer

Treatment options

Some common treatments for prostate cancer are:

Expectant management

If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you don't treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:

• Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) tests and prostate biopsies regularly, and treating the cancer only if it grows or causes symptoms.
• Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are not expected to live for more than 10 more years.

Surgery

A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the seminal vesicles (glands that produce the fluids that will turn into semen).

Radiation therapy

Using high-energy rays (similar to x-rays) to kill the cancer. There are two types of radiation therapy:

• External radiation therapy: A machine outside the body directs radiation at the cancer cells.
• Internal radiation therapy (brachytherapy): Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.

Other therapies

Other therapies may be used, depending on whether the prostate cancer has spread:

• Cryotherapy: Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells. This is a less common treatment.
• Chemotherapy: Using special drugs to shrink or kill the cancer after it has spread to other parts of the body. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
• Biological therapy: Works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
• High-intensity focused ultrasound: This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells. This is a less common treatment.
• Hormone therapy: Blocks cancer cells from getting the hormones they need to grow. This is also called androgen deprivation therapy (ADT).
• Targeted therapy: Using drugs that attack cancer cells while minimizing damage to healthy cells. Targeted therapy is used to treat prostate cancer that has spread to other parts of the body and is no longer responding to hormone therapy.

For more information, visit the National Cancer Institute's Prostate Cancer Treatment Option Overview. This site can also help you find a doctor or treatment facility that works in cancer care. Visit Facing Forward: Life After Cancer Treatment for more information about treatment and links that can help with treatment choices.

Which treatment is right for me?

Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.

Sometimes people get an opinion from more than one cancer doctor. This is called a "second opinion." Getting a second opinion may help you choose the treatment that is right for you.

Clinical trials

Clinical trials use new treatment options to see if they are safe and effective. If you have cancer, you may want to take part. Visit the sites listed below for more information.

• NIH Clinical Research Trials and You (National Institutes of Health)
• Learn About Clinical Trials (National Cancer Institute)
• Search for Clinical Trials (National Cancer Institute)
• ClinicalTrials.gov (National Institutes of Health)

Complementary and alternative medicine

Complementary and alternative medicine are medicines and health practices that are not standard cancer treatments. Complementary medicine is used in addition to standard treatments. Alternative medicine is used instead of standard treatments. Acupuncture and supplements like vitamins and herbs are some examples.

Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.

Resources

Through a virtual conversation, Nathan can help you get ready to talk to your doctor about prostate cancer treatment options.