Which are the options for treating prostate cancer
The various treatment options for patients with diagnosed prostate cancer:
It is important that patients are aware on the various treatments and should feel comfortable discussing them with their urologist or oncologist. Whatever treatment the patient undergoes, he should have ongoing observation, which may include a PSA blood test, a finger scan, and a bone scintigraphy, computed tomography, or plain x-ray as long as there is clinical evidence.
- Close observation
- Radical prostatectomy
- Robotic Radical Prostatectomy
- External radiation
- Brachytherapy (radiation)
- Hormone therapy
1. Close observation
2. Radical prostatectomy
4. External Radiation
5. Brachytherapy (radiation)
6. Hormone therapy
When cancer has spread beyond the prostate to the lymph glands or the bones, hormone therapy may be very effective in shrinking the tumor and reducing the complications of the disease. It does not offer a cure, but it may keep cancer under control for some years. Some patients also receive a series of hormone treatments before undergoing radical radiation therapy. This is useful if cancer has spread outside the prostate gland (in the surrounding tissue) but has not as yet reached the lymph glands and the bones. Hormone therapy may continue from 1 to 3 years after the end of radiotherapy in locally advanced cancer. There are many ways of delivering hormone therapy.
(ι) Surgical Operation. The testicles which produce testosterone can be removed surgically through a small operation known as “orchidectomy” that can be done in one day. However, surgery is irreversible and is an option that some men find unacceptable. It is not true that men after such a procedure may show signs of femininity.
(ιι) Treatment by injection. The injection of an agent called «analogue LHRH» has a similar effect as the orchidectomy in the production of testosterone, as the testicles remain in their position. This injection is given every one or three months by the doctor or a nurse. Because there may be an initial increase in testosterone after the first injection, the use of anti-androgens in pill form for two weeks is necessary to stop breastfeeding and impotence are common side effects of such treatments.
(ιιι) Antiandrogens (pills). They are divided into those that prevent testosterone production and those that prevent its action. This treatment involves taking a pill daily. Certain types of these drugs have both effects. Drugs that have this dual effect can be used on their own to treat prostate cancer, but they tend to cause impotence and lack of sexual desire more frequently than the drugs that stop testosterone. The group of drugs with this action is usually used to patients that have undergone orchidectomy or to those who receive regular LHRH injection. The antiandrogens pills often cause nausea and diarrhea or rarely reversible liver damage.