The proper management of the many stages of prostate cancer is controversial. Depending on the grade and stage of the cancer, some options are as follows:
- cryosurgery to freeze cancer cells
- external radiation to the prostate and pelvis
- hormone therapy
- radioactive implants put directly into the prostate, which slowly kill cancer cells
- surgery to remove part or all of the prostate and surrounding tissue
- surgical removal of the testicles to block testosterone production
- watchful waiting and monitoring only
Hormone therapy or chemotherapy is used mostly for men with advanced stage D disease. Hormone therapy includes use of the following:
- antiandrogens, such as flutamide and bicalutamide, that block the action of testosterone
- corticosteroids, such as prednisone
- GnRH agonists, also known as LHRH analogues, such as goserelin and leuprolide, which reduce the body's production of testosterone
- medicines that stop the production of testosterone, such as ketoconazole and aminoglutethimide
Treatment for men with prostate cancer that has spread through the body is usually confined to making them as comfortable as possible. Often the prostate is not removed. A cure for prostate cancer is not available. Researchers continue to search for a cure.
What are the side effects of the treatments?
Following are some common side effects of radiation or surgery for prostate cancer: depression; erectile dysfunction; swelling of the extremities; urinary incontinence.
Occasionally, radiation or surgery may cause the following: bladder inflammation; bone marrow suppression; inflammation of the lining of the small intestine; lowered blood counts; severe swelling in the legs and feet.
Depending on exact treatment, hormone therapy may cause the following conditions: erectile dysfunction; fatigue; a higher risk of blood clots in the leg; nausea; osteoporosis or bone thinning; swelling in the breasts.
Often given intravenously, chemotherapy has certain common side effects, such as: bleeding disorders; higher risk of infections; lowered blood counts; vomiting.
Cryosurgery or radiation implants can be painful and expensive. However, these treatments may preserve sexual function.
What happens after treatment for the disease?
After treatment, men are regularly monitored for side effects and a recurrence of the cancer.
How is the disease monitored?
The following are used to monitor the disease: bone scans; chest X-rays; CT scans of the pelvis; digital rectal exams; PSA tests, which are sensitive and specific for recurrence of cancer; ultrasound of the prostate.
Any new or worsening symptoms should be reported to the healthcare provider.