Prostate Cancer: Treatment Options for Early-Stage Cancer
The treatment choices for prostate cancer depend on several things. These include your age and overall health, and the size and location of the cancer. They also include lab test results and the stage of the cancer. When prostate cancer is only in the prostate or has only spread to nearby areas, it is called early-stage prostate cancer. It’s also called localized or local prostate cancer.
Learning about your treatment options
You may have questions and concerns about your treatment options. For example, you may want to know if treatment will affect your urinary or sexual function. You may also want to know if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, giving you a choice. This can be a hard decision to make. Each type of treatment has different benefits and risks. You may want to learn all you can about your disease and treatment choices so that you can make decisions about your care.
Talk with your healthcare provider to get answers to your questions. It’s important to take the time to make the best decision for you.
Types of treatment for early-stage prostate cancer
The goal of active surveillance is to watch a cancer that is growing very slowly and will not likely do any harm for a long time, if ever. Active surveillance is done because the treatments for prostate cancer can cause more harm than living with the disease. This may be a strategy for you if your cancer is only in the prostate, does not cause symptoms, and is not likely to shorten your life. If the cancer starts growing faster or begins to cause symptoms, treatment such as surgery or radiation therapy may be done at that point.
The main goal of surgery is to cure you of prostate cancer by removing the cancer cells. The surgery removes the prostate. Nearby tissues and lymph nodes may also be removed. This surgery is known as a prostatectomy. If the cancer can’t be removed with this type of surgery, your healthcare provider may advise other surgery to ease symptoms. One example is a transurethral resection of the prostate, or TURP.
Radiation therapy uses radioactive beams to kill or shrink cancer cells. There are 2 ways to have radiation therapy. One way sends radiation to the cancer from a source outside your body. For this, a machine sends a beam of radiation to your prostate. This is called external beam radiation therapy (EBRT). The other type of radiation therapy sends radiation to the cancer from a source inside your body. For this, tiny radioactive metal seeds are placed into your prostate using thin, hollow needles. Internal radiation is also called brachytherapy. Early-stage prostate cancer treatment may include EBRT alone, brachytherapy alone, or the 2 of them together. If your cancer is high-risk and may have spread to areas near the prostate, you may also have hormone therapy along with the radiation.
This treatment is also called cryosurgery. The goal of cryotherapy is to freeze the cancer cells before they have a chance to spread. The healthcare provider freezes them by making a tiny incision and inserting a thin metal probe into the prostate. The probe sends liquid nitrogen into the prostate to freeze the cancer cells. This is not a common first treatment for prostate cancer.
Hormone therapy (androgen deprivation therapy)
The goal of hormone treatment is to lower or block male hormones, such as testosterone, which can cause the cancer to grow. They can be blocked in a few ways. One way is through hormone shots. These are done once a month or every few months. Another way is to have surgery to remove the testicles. The testicles make testosterone. Hormone therapy is not a common treatment for early-stage cancer. But hormone therapy is often used along with radiation therapy in cases where:
The cancer has grown outside the prostate but has not spread to other parts of the body (known as locally advanced prostate cancer)
The cancer has a higher risk of coming back after treatment
Talking with your healthcare providers
At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.
May 26, 2017
Alteri, Rick, MD,Gersten, Todd, MD