By identifying the stage and grade of a prostate cancer, the doctor and affected man can determine the most appropriate treatment options. In cases where the cancer is contained within the prostate, causing no or few symptoms, and appears to be slow-growing, they may decide to monitor its progress regularly rather than pursue immediate treatment. This is called "watchful waiting," and it is a strategy that may work well for many years.
For those men with prostate cancer that requires medical intervention, some combination of surgery, radiation, and/or hormone therapy is usually used. Surgery, if elected, may remove the entire tumor or ease urination in more advanced cases. Cryosurgery, a relatively new surgical option, freezes and kills the affected tissue with liquid nitrogen. Radiation may be delivered with targeted rays from outside the body or with tiny radioactive seeds that are inserted into the prostate. Radiation can also be coupled with hormone therapy to provide pain relief in patients with prostate cancer that has spread to the bones.
Hormone therapy is most commonly used to treat prostate cancer that has metastasized to other areas of the body. While it is not a cure at this stage, such therapy can shrink tumors, relieve symptoms, and extend the life of the affected mean. Hormone therapy is also used to treat less advanced stages of prostate cancer, either in conjunction with radiation therapy or to shrink a tumor prior to surgery. Chemotherapy is rarely used for prostate cancer but may be used in advanced cases that are unresponsive to hormone therapy.
The side effects of different prostate cancer treatments can range from nonexistent to fatigue, hair loss, incontinence, and erectile dysfunction. Men with decreased testosterone levels due to treatment for prostate cancer may be at an increased risk for developing osteoporosis.
Prostate cancer detection and treatment options are continually improving and the recommendations of when and how to use these options are constantly evolving. Men should discuss current prostate cancer screening and treatment alternatives with their doctors and make their own informed choices.