Factors like age, grade, stage of cancer, and how fast it is spreading determine the treatment for prostate cancer.
Prostate cancer is one of the most common cancers affecting Black males. It is a cancer of the prostate gland and occurs when cells in the prostate start dividing abnormally. Prostate cancer also affects older adults more.
There are different treatment options for prostate cancer. But, doctors recommend treatment for each individual based on factors like age, stage of cancer, organs affected, and side effects of the treatment.
Treatments for prostate cancer include:
Prostatectomy is a type of surgery commonly used to treat prostate cancer. It is a surgery used to treat some conditions affecting the prostate. In a prostatectomy, some parts or all of the prostate are removed.
There are different types of prostatectomy, including:
This surgery is done when cancer has not spread to other organs. Radical prostatectomy involves completely removing prostate glands, cancer cells, and sometimes the seminal vesicles. It is done by making an incision on the body to gain access to the prostate. There are various types of radical prostatectomy, differentiated by the type of incision:
In an open prostatectomy, doctors do not remove the whole prostate gland; rather, they remove the affected parts. Aside from treating prostate cancer, this type of surgery is also used to treat an enlarged prostate.
Radiation therapy, also known as radiotherapy, is a type of cancer treatment that uses high doses of radiation to kill cancer cells and shrink cancer tumors. Radiation kills cancer cells, especially at high doses, by destroying the DNA of those cancer cells.
Once a cell's DNA is destroyed or damaged, it stops dividing and dies. Radiation treatment does not kill the cells immediately; it may take weeks or months before they begin to die off. The cells will also keep dying even when the therapy ends.
Radiation therapy is of two types, and the type to be used for treatment depends on so many factors, like the size of the tumor, the type of cancer (in this case, prostate cancer), the closeness of the prostate tumor to nearby organs, the patient's medical history, the general state of their health, and age.
External and internal beam radiation therapy are the two types of radiation therapy.
This type of radiation, also called teletherapy, is done outside the body. It is a local type of treatment, making it more common than internal radiation. It is done with a machine that is situated outside the body.
The machine will send radiation to the cancer cells in your body and only target the part of your body where the cancer is located—in this case, the prostate gland. The machine for this treatment is often big and noisy, although it does not touch patients' bodies.
As the name implies, the treatment (source of radiation) is done inside the body. This radiation therapy can be of two types, solid source (or brachytherapy) and liquid source (systemic therapy).
Brachytherapy is a local treatment that targets the part of your body where the cancer cells have affected. In the treatment with a solid source (brachytherapy), the doctor will place seeds, ribbons, or capsules that have a radiation source inside the patient's body. The seeds, ribbons, or capsules will keep giving off radiation that will kill the cancer cells.
The liquid source, or systemic therapy, is done through swallowing or injection. The treatment will travel in the blood to tissues all over a patient's body, locating and killing cancer cells.
Medications are also used to treat prostate cancer. Medications for treating prostate cancer come in different forms and have different mechanisms of action. For instance, they can be used as part of chemotherapy (e.g., docetaxel), immunotherapy (e.g., sipuleucel-T), or hormonal therapy (e.g., leuprolide and degarelix). No one medication will work for everyone, and for that reason, oncologists prescribe medications that will best target each person's health needs.
Before prescribing any medication, doctors will often consider many things, including your cancer stage, age, overall health status, other medications you are taking, and any underlying medical condition.
Chemotherapy is often used when prostate cancer has spread to nearby organs and tissues in the body. Chemotherapy uses drugs to shrink and kill cancer cells and is especially used for treating prostate cancer in the advanced stage (stage 4). The drugs are administered as pills, through a vein, or sometimes both.
Chemotherapy drugs for treating prostate cancer include:
Cancer cells have ways of hiding to evade the immune system, but a strong immune system is more capable of fighting cancer than a weak one. Immunotherapy is a prostate cancer treatment option that uses medications to help the immune system fight off malignant cells.
Unlike surgery and radiotherapy, which aim to kill cancer cells, immunotherapy trains and prepares the immune system to fight cancer. The approved immunotherapies for treatment are cancer vaccines and checkpoint inhibitors. Sipuleucel-T (Provenge) is an example of an approved vaccine for prostate cancer. Pembrolizumab (Keytruda) and dostarlimab (Jemperli) are both examples of checkpoint inhibitors.
Hormone therapy is aimed at stopping or reducing the production of male sex hormones (androgens), of which the primary one is testosterone. This is because androgens help cancer cells grow. So, using hormone therapy, medical professionals aim at reducing androgen levels or blocking their actions. This type of prostate treatment can inhibit the growth of the cancer cells, causing them to die off or begin to grow slowly.
Hormone therapy is often used when prostate cancer is in the advanced stage. There are different hormone therapy options for treating prostate cancer, such as:
There are different options for treating prostate cancer. But, there are things to consider before deciding on a prostate cancer treatment, such as:
Even though there are key experts involved in every medical treatment, medical practitioners often work as a team to treat medical conditions like prostate cancer. Three main types of healthcare practitioners are involved in the treatment of prostate cancer:
Medical oncologists are medical specialists that treat prostate cancer using therapies like hormone therapy and chemotherapy. They also handle any other issues that may arise with cancer.
Urologists are medical specialists that treat disorders that affect the male reproductive system and also handle problems of the kidneys, ureters, bladder, and urethra (i.e., the urinary tract)
These are medical specialists that use radiation therapy to treat cancer. During treatment, they will deliver the treatment plan, treat any side effects that may arise, and monitor the patients as they go through the treatment.
Receiving a prostate cancer diagnosis can weigh down on a person. It can be a challenging period in a person's life, and one could need as much support as possible. If your loved one has received a prostate cancer diagnosis, reach out to them and offer them support. Show them you care. Be sensitive to their emotional needs and speak to them with empathy.
If you have been diagnosed with prostate cancer, understand that there are different treatment methods that are very helpful and can even lead to complete remission. Also, a diagnosis does not mean a person is on the verge of death. More than 90% of people with prostate cancer live for up to 5 years after diagnosis - many live much longer.
In the meantime, connect with your loved ones and allow them to support you. Make choices to stay healthy. Eat foods that will help boost your immune system, such as fruits and vegetables, and always keep in touch with your medical team. Joining a support program or group such as Road to Recovery may also help you during your treatment and recovery period.
Different treatment options for prostate cancer include medications, surgeries, radiation therapies, and chemotherapies. Treatments will not be the same for everyone, as there are different things to consider before making a treatment decision for prostate cancer.
It is always helpful when patients discuss their care with their medical team and make decisions together. This will help clear patients' doubts, answer their questions, and give them a general overview of what to expect during their treatment.