Treatment options for prostate cancer often depend on the cancer’s stage. The most effective treatments for prostate cancer may vary from person to person; however, the most common treatments for prostate cancer include watchful waiting, surgery, radiation therapy, hormone therapy and chemotherapy. Some patients may receive a combination of these treatments. Each of these treatment options has potential drawbacks: for example, surgery, radiation therapy and hormonal therapy may disrupt sexual desire or performance either temporarily or permanently.
- Watchful waiting: For men whose prostate cancer is detected at an early stage and appears to be growing slowly, as well as for older men with other serious medical problems, doctors may recommend closely monitoring the cancer without yet engaging in any active treatments.
- Surgery: Surgery is performed to remove the cancer, and is a common early-stage prostate cancer treatment. The most common procedure is a radical prostatectomy, in which the surgeon removes all of the prostate, as well as nearby lymph nodes in some cases. (In a few cases, only part of the prostate may be removed.) This surgery can lead to side effects such as lack of sexual function or impotence, as well as problems holding urine or incontinence. However, a newer surgical technique called nerve-sparing surgery may allow some men to maintain sexual function, although for men with large tumors or tumors that are very close to nerves, this may not be a viable option. In fact, Florida Hospital has one of the world’s most experienced robotic prostatectomy surgeons, whose patients’ outcomes exceed those of national standards.
- Radiation therapy: This treatment uses high-energy x-rays to kill cancer cells and shrink tumors. It may be used instead of or after surgery to destroy cancer cells. With advanced-stage prostate cancer, doctors may recommend radiation to relieve pain or other symptoms. This therapy, however, can cause problems with impotence and bowel function.
- Hormonal therapy: This therapy works by depriving cancer cells of the male hormones they need to grow and survive. It is often used for prostate cancer that has metastasized to other parts of the body, as well as to keep cancer from coming back after surgery or radiation therapy. As with the other treatment options, hormonal therapy carries the risk of side effects, including impotence, hot flashes, loss of sexual desire and bon thinning, and some types of hormonal therapy may increase the risk of blood clots.
No matter the type of therapy, patients need to be closely monitored to determine how well the treatment is working. This may include a PSA blood test every three months to one year; a bone scan and/or CT scan to see if the cancer has spread; a complete blood count to look for symptoms of anemia; and looking for signs the disease is progressing, such as fatigue, pain, or decreased bladder or bowel function.