Prostate Treatment Options

Facts About Prostate Cancer

There are different types of treatment for patients with prostate cancer, says the National Cancer Institute.

Some treatments are standard, and some are being tested in clinical trials. Before starting treatment, patients may want to consider taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.

Four types of standard treatment are used:

  ★ Watchful waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early-stage disease.

  ★ Surgery

Patients in good health who are younger than 70 years old are usually offered surgery as treatment for prostate cancer. There are several types of surgery used.

  ★ Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Impotence and urinary problems may occur in men treated with radiation therapy.

  ★ Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. Hot flashes, impaired sexual function, loss of desire for sex, and weakened bones may occur in men treated with hormone therapy.

New types of treatment are being tested in clinical trials. These include the following:

  • Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells. This type of treatment is also called cryotherapy.

  • Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

  • Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

  • High-intensity focused ultrasound is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells. To treat prostate cancer, an endorectal probe is used to make the sound waves.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

From the American Cancer Society

  ● Prostate cancer is the most common cancer, excluding skin cancers, in American men.

  ● The ACS estimates that during 2006 about 234,460 new cases will be diagnosed in the US.

  ● About 1 man in 6 will be diagnosed with prostate cancer during his lifetime.

  ● Only 1 man in 34 with prostate cancer will die of this disease.

  ● A little over 1.8 million men in the United States are survivors of prostate cancer.

  ● Prostate cancer is a leading cause of cancer death in American men.

  ● The ACS estimates that 27,350 men in the United States will die of prostate cancer during 2006.

  ● Prostate cancer accounts for about 9% of cancer-related deaths in men.

  ● Among men diagnosed with prostate cancer (all stages and grades),
          nearly 100% survive at least 5 years,
          93% survive at least 10 years, and
          77% survive at least 15 years.

  ● Men with localized prostate cancer have nearly the same 5- and 10-year survival as men without prostate cancer.

  ● More than 90% of all prostate cancers are found in the local and regional stages (local means it is still confined to the prostate; regional means it has spread from the prostate to nearby areas, but not to distant sites such as bone). The 5-year relative survival rate for all of these men is nearly 100%.

  ● Of the men whose prostate cancers have already spread to distant parts of the body at the time of diagnosis, about 34% will survive at least 5 years.

  ● Modern methods of detection and treatment now mean that prostate cancers are detected earlier and treated more effectively, which has led to a yearly drop in death rate of about 3.5% in recent years.

  ● The chance of having prostate cancer increases rapidly after age 50.

  ● About two thirds of all prostate cancers are diagnosed in men over the age of 65. It is still unclear why this increase with age occurs.

  ● Prostate cancer occurs about 60% more often in African-American men than in white American men.

  ● Compared with men of other races, African-American men are more likely to be diagnosed at an advanced stage.

  ● African-American men are more than twice as likely to die of prostate cancer as white men.

  ● Prostate cancer occurs less frequently in Asian men than in whites.

  ● Hispanic men develop prostate cancer at similar rates as white men. The reasons for these racial differences are not clear.

  ● Prostate cancer is most common in North America and northwestern Europe. It is less common in Asia, Africa, Central America, and South America. The reason for this is not well understood, but we know that is not simply due to better screening in North America and Europe.

  ● Prostate cancer seems to run in some families, suggesting an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. (The risk is higher for men with an affected brother than for those with an affected father.) The risk is much higher for men with several affected relatives, particularly if their relatives were young at the time of diagnosis.

  ● Men who eat a lot of red meat or who have a lot of high-fat dairy products in their diet appear to have a slightly higher chance of developing prostate cancer.

  ● Some studies have suggested that men who consume a lot of calcium (through diets or supplements) may have a higher risk of developing advanced prostate cancer. Most studies, however, have not found such a link with the levels of calcium commonly consumed in the average diet, and it’s important to note that calcium is known to have other important health benefits.

  ● Several substances, including lycopenes (found in high levels in some fruits and vegetables, such as tomatoes, pink grapefruit, and watermelon), vitamin D, vitamin E, and the mineral selenium may lower prostate cancer risk.

  ● The best advice to lower prostate cancer risk is to eat fewer red meats and high-fat dairy products and to eat 5 or more servings of vegetables and fruits each day. This may also reduce the risk of several other cancers, as well as other health problems such as heart disease.