What treatments work for prostate cancer?
What treatments work for prostate cancer?
BMJ Group, Monday 13 October 2008
The good news is that most prostate cancers grow slowly, so you have a good chance of surviving your cancer whether you have treatment or not. Even if your cancer has spread to tissue nearby, your chances of survival are still good, and certain treatments can make your odds even better.
But the problem is that doctors still don't know enough about whether the treatments available for prostate cancer will help you live longer. And all the treatments for this cancer can have serious side effects.
There are two types of treatments for prostate cancer: local treatments (these only treat the prostate and the nearby lymph nodes and organs) and systemic treatments (these treat the whole body).
What treatments you are offered will depend on:
The size of your prostate cancer and how slow- or fast-growing it is
Whether the cancer has spread to other areas and, if so, where it has spread
Your age and general health.
On this page we look at treatments for cancer that has not spread outside your prostate (clinically localised cancer). In the future, we will cover treatments for cancer that has spread outside your prostate.
Key points for men whose cancer has not spread
You have four options: surgery, radiotherapy, hormone treatment or 'watchful waiting'. Watchful waiting is where doctors regularly check your cancer rather than treat it immediately.
Doctors don't know enough about whether any of these treatments make a difference to your chances of survival, or which treatment works best.
If you choose watchful waiting, you have a good chance of surviving your cancer and you can avoid the side effects of treatment. But you have to live with an untreated cancer.
If you have surgery, there is a small chance that you will live longer than if you choose watchful waiting.
Surgery, radiotherapy and hormone therapy can all have serious side effects. The main ones are erection problems and incontinence (you can't control when you urinate).
A new type of radiotherapy called brachytherapy (where radioactive seeds are put into your prostate) may be more convenient for you than standard radiotherapy (where X-rays are beamed into your prostate). Standard radiotherapy involves treatment for five days a week for six to seven weeks. Brachytherapy involves only one trip to hospital.
Most prostate cancers grow slowly. Most men with early-stage cancer survive for at least 10 years, whether or not they have treatment.
Your decision on treatment may be based on your own personal preference. To help you make this decision, you may need to ask yourself:
Would I be too worried to live with an untreated cancer?
What effect would erection problems and incontinence have on my life?
Am I fit and healthy enough to have surgery?
Does my age make a difference to my decision?
It can be difficult to decide whether you should choose watchful waiting or get early treatment for your cancer. See How do I decide if watchful waiting or early treatment is right for me?
Treatments for cancer that has not spread
This is called clinically localised cancer. All the treatments for this type of cancer fall into two categories.
Treatments that work but whose harms may outweigh benefits
Surgery (radical prostatectomy): This is an operation to remove the prostate and prostate cancer as well as some of the tissue nearby. More...
Watchful waiting: This is where doctors regularly check on your cancer rather than treating it straight away. They may begin treatment if your cancer shows signs of growth and you start having symptoms. More...
Treatments that need further study
Hormone therapy: Some cancer cells need hormones to grow and spread. Hormone therapy can switch off these hormones or block the effects of hormones on your body. Types of hormone therapy include surgery to remove the testicles, tablets called antiandrogens, and injections of drugs called LHRH agonists. Examples of hormone tablets (and their brand names) include flutamide (Drogenil) and bicalutamide (Casodex). Examples of hormone injections include leuprorelin (Prostap SR, Prostap 3), goserelin (Zoladex), buserelin (Suprefact) and triptorelin (De-capeptyl). More...
Internal radiotherapy (brachytherapy): Radioactive seeds are placed directly in the prostate to kill the cancer cells. More...
Radiotherapy: A machine beams radiation from outside the body into the tumour to kill the cancer cells. More...
Glossary
lymph nodes
Lymph nodes (also called lymph glands) are small, bean-shaped lumps that you can't usually see or feel easily. You have them in various parts of your body, such as your neck, armpit and groin. Lymph nodes filter lymph and remove unwanted things from your body, such as bacteria and cancer cells.
© BMJ Publishing Group Limited ("BMJ Group") 2009
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