There is no such prostate cancer treatment that is valid for every patient. Treatment depends on different factors like; how fast your cancer growing, your age, your general health condition, size of tumor, how much cancer has spreaded and your preferences. Prostate cancer staging is done by medical examination findings, PSA results, biopsy results and other screening tests. Your doctors will choose the treatment option according to all these findings and the stage of the cancer. Prostate cancer treatment is done by urologists, oncologists and nuclear medicine physicians. Here you can see the treatment options for prostate cancer;
1- Watchful waiting or active surveillance
This is an option for low risk prostate cancers. Your doctor may decide to wait and follow the tumor according to the results of PSA level, gleason score and prostate biopsy. You will need to have some periodical tests to monitor the progression of cancer. Active surveilllance may be preferred for patients who has an another serious health problem and older age.
2- Radiation therapy
Radiation therapy may be used as a first option in low grade prostate cancers to eliminate the cancer cells or may be done after the surgery. Cancer may not be removed completely with surgery or cancer may be progressed much and radiation therapy may be done to keep cancer under control. There are 2 kinds of radiation therapy as internal and external;
External beam radiation therapy; radiation is applied on the prostate gland from a machine outside the body
Internal radiation therapy ( brachytherapy- seed implantation); small radioactive-rice sized seeds are placed in the prostate tissue.
In early stage prostate cancer, if the cancer is not spreaded to outside of the prostate gland, prostate is removed with surgery. Sometimes a part of surrounding tissue and a few lymph nodes may be removed.
4- Hormone therapy (androgen suppression therapy)
Prostate cancer cells grow by the effect of androgens because androgens stimulates the prostate cancer cells to grow. The purpose of hormone therapy is to reduce the levels of male hormones (androgens) especially testosterone. Medications are used to stop production of testosterone or to block from reaching to the cancer cells or testicles may be removed to stop testosterone production in the body. Hormone therapy does not cure the prostate cancer alone it is used in some conditions;
Prostate cancer may be spreaded to far and can not be treated by surgery or radiation therapy or cancer may be relapsed after surgery or radiation therapy.
Relaps risk may be found higher by PSA, gleason score and biopsy results and hormone therapy may be done to reduce the risk.
Hormone therapy may be used to increase the radiation therapy effect.
Anti cancer drugs are used by injection or can be given by mouth. Chemotherapy is used when the prostate cancer has spread outside the prostate gland and the hormone therapy is not successful. Chemotherapy is not a first option for early stage prostate cancers, it can be used after surgery to support the treatment.
5- Cryotherapy (cryosurgery)
Small needles are inserted by the guidance of ultrasound images and a very cold special gas is used to freeze prostate cancer cells.
6- Vaccine ( biological therapy)
The prostate cancer vaccine is called sipuleucel-T (provence). It is not similar to traditional vaccines that strengthen your immune system. Your own immune system cells ( WBC- white blood cells) are taken and then they are exposed to PAP ( prostatic acid phosphatase a kind of protein) which comes from prostate cancer cells. These cells are given back to your body to help the immune system to attack the prostate cancer cells.
7- HIFU (high intensity focused ultrasound)
High frequency sound waves are used to kill prostate cancer cells. This method has an advantage that it uses sound waves to kill the cancer cells and doesn’t have many side effects as other treatment types.