Comparison of Prostate Cancer Treatments

Prostate cancer treatment varies depending on the stage of the cancer, how far the cancer has spread, and the patients age and general health. Treatment options can include surgery, radiation, hormone therapy or simply waiting. Each option has risks and benefits inherent, and a different degree of success at treating and controlling types of prostate cancer.

Radical Prostatectomy

• Radical prostatectomy is one option for prostate cancer treatment. This surgical procedure involves the removal of the entire prostate gland along with nearby lymph nodes. Typically, a catheter is installed to allow for urine to be carried out of the body during the first two to three weeks after the surgery. The benefits of this surgery are that it may offer the best long term results--if all the cancer is removed by the surgery, then you are cured. The risks are low, with a short hospital stay. Risks include impotence or loss of bladder control, however the majority of patients are able to urinate normally within 3 weeks after the surgery and the possibility of impotence decreases if the surgeon can avoid cutting penile nerves. Depending on the size of the tumor, the majority of men under 50 do not become impotent from the surgery, while the majority of men over 70 do.

Radiation therapy

• Radiation is another treatment option for prostate cancer. Radiation is administered either as external beam radiation or seed therapy. In external beam radiation, an X-ray-like machine beams high energy rays at the body. In seed therapy, small radioactive pellets are injected directly into the prostate gland. External beam radiation and seed therapy have approximately the same success rates. The therapy is administered for 7 weeks, 5 days each week. The side effects are relatively mild and it is administered on an out-patient basis with no anaesthesia. There is a risk of impotence with radiation as well, and approximately 50 percent of men who have radiation become impotent within 2 years. Urinary discomfort affects between 15 percent to 30 percent of men treated with radiation.

  Radiation therapy may not be as effective at curing cancer than surgery, because the prostate remains so the cancer could return. However, when looking at patients 10 year after treatment, the cure rates are the same for surgery and radiation.

Watchful waiting

• Some prostate tumors are small and progress slowly. Older men may not require treatment with a slow growing tumor. These men, who wish to avoid the side effects of treatment or who have a high chance of dying from an unrelated cause before the cancer spreads, will see their doctor frequently to monitor tumor growth. It may be difficult to tell initially whether a tumor will go slowly or quickly, so regular visits to doctors to check PSA levels (prostate specific antigen) levels are essential. If the tumor begin to grow, hormone therapy or another method of treatment may be recommended.

Hormone Therapy

• Hormone therapy is designed to decrease the amount of male hormones produced by the testicles. These hormones, called androgens, are growth factors for the tumor, so by preventing or reducing the amount of hormones, the growth of the tumor is slowed. Hormone injections can be given, or the testicles can be removed to reduce the amount of hormones produced. Hormone therapy is used most frequently in men whose tumor has spread and can't be removed or treated, and it typically shrinks the tumor initially. However, after approximately 1 to 2 years, the hormone therapy usually stops being effective.

Cryotherapy

• A final treatment option for prostate cancer involves freezing the prostate gland in a procedure called cyrotherapy. This is an alternative to surgery, but it is not a common treatment method because long term survival rates are generally lower with cyrotherapy than with surgery or radiation.