Over 40,000 men in the UK are diagnosed with prostate cancer each year. If you are experiencing any of the symptoms of prostate cancer, usually issues around urination, you should visit your GP as soon as possible. Finding out you have any type of cancer can be a worrying time and the first question people ask is often, ‘What are the treatments for prostate cancer?’
There are a range of treatments available and your doctor will decide which will work best for you based on:
- The exact position of your cancer
- The degree of growth or spread of your cancer
- The cancer type
- The level of abnormality in cells inspected under a microscope
- Your fitness and general health levels
- Your age
Active Surveillance and Watchful Waiting
Localised prostate cancer is prostate cancer that has not spread beyond the prostate. This is a very slow-growing type of cancer and your doctor may suggest ‘active surveillance’ (regular hospital checks including prostate biopsy and MRI) or ‘watchful waiting’ (fewer tests, usually at a GP surgery). These might seem like unusual options but during this time your cancer will be monitored and you will not experience the side effects associated with some treatments. It is not uncommon for men with prostate cancer to have no treatment at all during their lifetime. Talk to your healthcare professionals if you are worried about making the decision whether or not to start treatment.
Locally advanced prostate cancer describes cancer that has either spread just beyond the prostate gland or just started to break out of it. Many men with this stage of prostate cancer or localised prostate cancer opt for surgery on the advice of their doctor.
The most common surgery is called a radical prostatectomy and will remove your prostate gland and seminal vesicles (glands connected with the production of semen). This is a radical operation and won’t be considered suitable for men who are overweight, over 75 or have certain health problems. There are three surgical options: keyhole surgery by hand, robotic keyhole surgery and open surgery.
Other surgical treatments might also be considered including:
Surgery to remove the inner parts of your prostate gland (TURP)
This can be done through the penis or using laser surgery and is particularly effective in alleviating the symptoms of prostate cancer.
Surgery to remove your testicles (orchidectomy)
This is not a common operation but it does greatly reduce the levels of testosterone in the blood, this restricts the growth of prostate cancer cells.
Radiotherapy is the direction of high-energy waves towards specific areas of the body in order to destroy cancer cells. There are two types of radiotherapy treatment for prostate cancer:
This is performed on outpatients in the hospital’s radiotherapy department. This painless treatment is usually daily for 4 to 8 weeks and can cause short-term tiredness, sore skin, diarrhoea or bladder inflammation. There are also some long-term effects of external radiotherapy but it is impossible to predict which will affect each individual.
This treatment involves placing small radioactive pellets inside the prostate gland. It is highly targeted and only suitable for men whose cancer is wholly contained within the prostate. The treatment is performed in hospital and involves the insertion of small tubes into the prostate through the perineum, guided by an ultrasound probe in the rectum. Short-term side effects can include: pain and swelling, urinary problems, tiredness, blood in the semen and changes in bowel movements.
Prostate cancer is dependent on the hormone testosterone to grow. Hormone therapy aims to stop the growth of cancer cells by limiting or removing the levels of testosterone in the body. This can be a stand-alone treatment or combined with internal radiotherapy.
There are two other possible treatments for prostate cancer:
Cryotherapy (also called cryosurgery or cryoablation)
This treatment eliminates cancer cells using extreme cold. It is still at the clinical trial stage and involves the insertion of gas through needles inserted into the perineum, guided by a rectal ultrasound probe. The short-term side effects of cryotherapy include pain, bruising, constipation and bleeding.
High Intensity Focal Ultrasound
During this treatment, high frequency sound waves target the cancer cell area. These waves create heat, which in turn damages cancerous cells. Localised areas or the whole prostate can be effectively targeted but it is not suitable if the cancer has spread to other parts of the body. A probe inserted into the rectum will show the doctor where to target the sound waves. This procedure is usually completed under general anaesthetic.
Research into prostate cancer is ongoing and new treatments are being trialed all of the time. Prostate cancer survival in the UK has tripled in the last 40 years and 84% of men are expected to survive for 10 or more years beyond diagnosis. Don’t be afraid to ask your doctor or medical staff questions about your treatment, understanding what is happening to you and being prepared for it will help to ease any stress you may be experiencing over your prostate cancer.