The Best Procedure for Prostate Cancer

Prostate cancer treatment can depend on several factors. The best treatment will depend on your age, the stage of your tumor, how far it has spread, and the potential benefits and side effects. The stage of your prostate cancer can range from A to D. The higher the grade, the faster the tumor is growing. Consult with your doctor before making the decision which is right for you.

Surgery

• Removal of the prostate glade will be recommended to treat stages A and B prostate cancers. There are three types of radical prostatectomy.
  - Retropubic surgery: The surgeon will remove your prostate with an incision in your abdomen.
  - Perineal surgery: The incision is made between your scrotum and anus to remove the prostate.
  - Robot-assisted laparoscopic radical prostatectomy (RALRP): The prostate is removed via a laparoscope. With radical prostatectomy, your prostate and the lymph nodes around it will be removed. Side effects include loss of bladder control and possible erectile dysfunction.

Radiation Therapy

• You may choose one of two types of radiation therapy, if your prostate cancer is in stages A-C.
  - Prostate brachytherapy: During this procedure, your doctor will place radioactive seeds directly into your prostate, using small needles inserted through the skin behind your scrotum. The seeds, which you won't be able to feel, can stay there permanently or temporarily. A benefit to radiation therapy is to reduce damage of tissues located near the prostate. Side effects can include swelling or bruising in your scrotum or penis, pain, impotence, diarrhea, red-brown semen or urine, or incontinence.
  - External beam radiation: This more traditional form of radiation treatment is usually done on an outpatient basis for 6-8 weeks and delivered via a device which looks like an x-ray machine. It is usually painless, however, it can cause fatigue, loss of appetite, inflamed bladder or blood in the urine.

Medication therapy

• Medications, such as Zoladex and Lupron, will block the production of testosterone. Since your prostate tumors require testosterone to grow, this therapy will reduce testosterone levels to prevent further growth. Hormone therapy is also referred to as chemical castration because it's similar to the removal of your testes via surgery. The benefit to hormone therapy is that it can be reversed, unlike the removal of the testes. The drugs are injected typically every 3-6 months. Side effects include osteoporosis, vomiting, nausea, anemia, hot flashes, reduced sexual desire, impotence or lethargy.