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Prostate Problem Guide
Prostate Cancer Treatments For Early And Advanced Prostate Cancer
There is a wide range of prostate cancer treatments available today and the treatment that your doctor recommends will depend to a very large extent upon the progression of the disease. Thereafter it is a matter of discussing each treatment option with your doctor and of considering the advantages and disadvantages of each, as well as of course looking carefully at the risks which all prostate cancer treatments carry.
Prostrate cancer treatments fall into two broad categories – those that are recommended for early (Stage I and Stage II) cancer which is confined to the prostate gland and those used to treat advanced (Stage III and Stage IV) cancer which has spread to other areas of the body.
Early stage cancer treatments are designed to remove the prostate or to destroy it and thus to stop the cancer cells before they have a chance to spread to other areas of the body.
The surgical removal of the prostate gland (prostatectomy) will normally be carried out as either traditional open surgery or using a less invasive laparoscopic approach. One recent development is the introduction of robotic surgery (using the da Vinci system) which has the advantage of preserving nerves, muscles and other structures in the area of the prostate. Robotic surgery is extremely effective but should be carried out by a highly skilled surgeon in a centre with considerable experience in using this technique.
Radiation therapy may also be used to kill the cancer cells within the prostate gland. A variety of different radiation therapy techniques may be used and treatment will normally be carried out over a period of several weeks.
A relatively new technique, which is still being evaluated, is known as cryosurgery. During cryosurgery, which is carried out under anesthesia, cooling probes are guided into the prostate using ultrasound and the cancer cells are killed by freezing them.
ANDROGEN DEPRIVATION THERAPY (ADT): a prostate cancer treatment that is based on blocking the amount or availability of androgen to the prostate cancer cell; includes diverse mechanisms such as surgical or medical castration, anti-androgens, 5 AR inhibitors, estrogenic compounds, agents that interfere with adrenal androgen production, agents that decrease sensitivity of the androgen receptor (AR); it also includes monotherapy, CHT with two drugs and triple therapy or beyond.
ESTROGEN: a female hormone or estrogen (e.g. diethylstilbestrol) used in the treatment of prostate cancer.
NILUTAMIDE (NILANDRON®): a non-steroidal anti-androgen.
TETRAPLOID: having four times the amount of DNA or chromosomal material.
The final form of treatment used for early stage cancer is high intensity focused ultrasound (HIFU). This procedure is again carried out under anesthesia (or using a local spinal anesthetic) and a probe is placed into the prostate gland through the rectum. A beam of high intensity focused ultrasound is them used to raise the temperature in the area of focus and thus to kill the cancer cells.
For late stage prostate cancer hormone therapy is used and this is designed not to attack the cancer itself but to target the male hormones (in particular testosterone) which the cancer cells need to grow.
Late stage treatments will include orchiectomy (the removal of the testicles), which is designed to remove the source of the body’s main production of testosterone, or a variety of hormone treatments aimed at either reducing the level of testosterone and other male hormones in the body or of blocking their action.
In cases where hormone therapy proves ineffective, systematic radiation therapy or chemotherapy may be recommended.
Whatever the stage of your cancer it is important to consider all of the options carefully and weigh the advantages, disadvantages and risks of each carefully before choosing the treatment that is best for you.
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