“It’s cancer.” These are the two words that no family wants to hear. Yet for over 220,000 men a year who are diagnosed with prostate cancer, these words are reality. Prostate cancer is the leading male cancer outside of skin cancer, and millions of men across the United States are living with prostate cancer.
Yet for prostate cancer patients, those words of “It’s cancer” may not be quite as devastating as other types of cancer. If caught early, prostate cancer can be treated and has a high survival rate. However, sometimes prostate cancer treatment can carry significant risk of life-altering side effects, like impotence and incontinence. For that reason, patients and their families need to carefully consider which treatment options are the best for them. Here are some common treatment options often presented to prostate cancer patients.
Watchful waiting, which is also known as active surveillance, is a non-treatment approach to prostate cancer. This works well for patients who have slowly growing tumors, delaying treatment until it is necessary, while carefully monitoring the prostate for signs of cancer growth. For elderly men, this often allows a normal life without the side effects of prostate cancer treatment, because the cancers never begin to grow to the point that treatment is needed.
Because it is not treatment active surveillance has no side effects. However, it always carries the risk that the cancer will begin to grow quickly, putting the patient at risk.
Radical prostatectomy is the surgical removal of the prostate gland. This is an effective way to deal with the cancer, but it is almost certain to cause side effects. Modern robotic-assisted surgical techniques can help reduce this risk, but the location and small size of the prostate gland make it impossible to eliminate risk altogether. Many men will suffer from erectile dysfunction and incontinence after prostate cancer surgery. As with all surgical procedures, blood loss and infection are a risk with this treatment option as well.
Radiation therapy uses high-energy rays to kill the cancer cells. External beam radiation therapy, or EBRT, is a common type of radiation therapy used to treat prostate cancer. This involves sending focused beams of radiation into the prostate gland from outside the body. Unfortunately, this treatment does allow surrounding tissues to be exposed to radiation.
Brachytherapy is another treatment option that uses small radioactive pellets, or seeds, which are inserted into the prostate. Over time those seeds destroy the cancerous tissue around them. This can be more precise than EBRT.
Radiation has several potential side effects. In addition to incontinence and erectile dysfunction, radiation can damage the tissue around the bladder and bowels, leading to problems with passing stool and a bladder condition known as radiation cystitis.
Cryotherapy uses cold gases to create ice balls within the prostate gland to destroy the gland and the cancer it contains. A warming catheter in the urethra helps protect surrounding tissues during cryotherapy. This treatment is considered less invasive than prostate cancer surgery.
Unfortunately, cryotherapy does carry a high risk of side effects, particularly for patients who had radiation therapy performed prior to cryotherapy. Freezing often damages the nerves responsible for erections, making erectile dysfunction quite common after this procedure. In fact, men who undergo cryotherapy actually have a higher risk of erectile dysfunction than those who have surgery for their prostate cancer. Incontinence is rare, however, because of the warming catheter that is used during treatment.
High intensity focused ultrasound is one of the newest treatment options for prostate cancer, and it provides a promising option for those men who wish to treat their cancers but wish to avoid the complications and side effects common with prostate cancer treatment. HIFU uses ultrasound imaging to map out the prostate gland and deliver high intensity ultrasound waves into the gland to ablate the gland and the cancer it contains.
Because ultrasound can pass harmlessly through surrounding tissues, and because the treatment uses real-time images to precisely target the tumors, HIFU has a very low risk of life-altering side effects. Also, because HIFU uses no radiation, it has a short recovery period and can be repeated if needed. This promising new treatment option gives men who wish to deal with cancer aggressively without risk of serious side effects and effective treatment option to consider.
A prostate cancer diagnosis can feel devastating, but effective treatment is available. New treatments, like HIFU, make treatment far more appealing than it once was. If you or someone you love has been diagnosed with prostate cancer, take the time to understand your options, and seek the treatment that will help protect life while preserving it quality.