Prostate cancer treatment is a complex topic as there are many options for treatment including radiation therapy, surgery, hormonal therapy, watchful waiting. The prostate is located beneath the bladder and surrounds the urethra, the tube that carries urine out through the penis. Prostate tumors can be benign or cancerous. With benign tumors, the prostate enlarges and squeezes the urethra, interrupting the normal flow of urine. Prostate cancer is a cancerous (malignant) tumor in the prostate gland, a small walnut-sized gland in men that makes seminal fluid, which helps carry sperm out of the body. Prostate cancer — one of the most common kinds of cancer in men — can spread beyond the prostate gland and be life threatening.
However, most cancerous tumors in the prostate tend to grow slowly and either do not spread or cause harm for decades. When caught early, prostate cancer can be treated successfully in more than 90% of cases. Men 50 years old and older should be regularly screened for prostate cancer.
This information is provided by Dr. Navneet Sharda as an educational source. It is not intended as a substitute for a consultation with a qualified healthcare provider.
Sign and Symptoms of Prostate Cancer
Many people with prostate cancer have no symptoms at all, especially in the early stages.
Dr. Sharda discusses symptoms that may indicate prostate cancer:
- Difficult and painful urination
- Frequent urination (especially at night) and a feeling that you need to urinate even when the bladder is empty
- Incomplete emptying of the bladder, which may lead to dribbling of urine
- Decreased force of urine stream
- Blood in the urine
- Hip and back pain
The American Cancer Society recommends men have annual screening tests for prostate cancer starting at age 50. “Two standard tests are used for early detection of prostate cancer”, states Navneet Sharda, MD.
- Digital rectal exam (DRE) — in this test, the doctor inserts a gloved, lubricated finger into the rectum in order to feel the prostate for bumps or other abnormalities. Many malignant tumors begin in the outer part of the prostate and may be detected by this exam.
- PSA test — blood test measuring the level of prostate-specific antigen (PSA). Prostate cancer cells produce elevated quantities of PSA, so measuring PSA levels may help detect cancer while it is still microscopic. However, finding elevated levels of PSA does not necessarily mean that the man has cancer. Benign conditions such as enlarged prostate can also elevate PSA levels.
If either the DRE or PSA test suggests the possible presence of cancer, the following tests will be performed to make a definite diagnosis:
- Transrectal Ultrasound — using a small probe inserted into the rectum, sound waves help get a visual image of the prostate.
- Biopsy of the prostate — a tissue sample is obtained through the rectum and examined for cancerous cells.
If the biopsy shows the presence of cancer, you may need more tests to see if the cancer has spread:
- Imaging tests — computerized tomography (CT) or magnetic resonance imaging (MRI) scans may pinpoint the location of cancer that has spread beyond the prostate.
- Bone scans and x-rays — these tests look for spread of cancer to the bones.
- Lymph node biopsy — a surgical procedure to determine if the cancer has spread to the lymphatic system.
There are several options for treating prostate cancer, depending on how rapidly the cancer is growing, whether it has spread, how old you are, and the benefits and drawbacks to treatment.
If prostate cancer is detected early, treatment usually involves either surgical removal of the prostate or radiation therapy. For more advanced cases of prostate cancer, or if cancer spreads beyond the prostate, hormone medications may be used.
There are two main types of cancer treatment: local therapy (type of treatment that either removes or destroys the cancer cells) and systemic therapy (treatment that involves medication that is administrated in various ways such as orally or intravenously).
Surgery: This is a local type of therapy and is recommended in early stages of cancer that can remove the whole prostate, prostatectomy, or part of the prostate transurethralresection of the prostate (TURP).
There are three types of prostatectomies:
- Radical retropubic prostatectomy is a common medical procedure where the entire prostate and adjacent affected lymph nodes are removed through an abdominal incision. For retropubic prostatectomy, the incision is located between the navel and pubic bone. This surgery can be performed under general anesthesia or local anesthesia (spinal or epidural anesthesia). The advantage of retropubicprostatectomyis that it provides a better chance of sparing the urethra by preserving urinary continence and the neurovascular bundles (responsible for erections).
- Radical perineal prostatectomy is a rare medical procedure where the prostate is removed through a small incision cut between the scrotum and the anus. This type of prostatectomy is less invasive and the patient recovers faster. It is performed in early stages of cancer when the lymph nodes are not affected and for very obese patients.
- Laparoscopic prostatectomy: During this procedure the prostate and affected lymph nodes are removed through a small abdominal incision. This procedure uses a special medical instrument called laparoscope (a thin lighted tube) to remove the prostate. The advantages of this type of surgery are: greater precision and control, less blood loss and pain, faster recovery, and less hospitalization.
In this form of treatment, radiation is used to kill cancer cells. There are two types of radiation therapy:
- External beam radiation therapy (EBRT or ERT) — uses a machine to send a high-energy beam to the tumor.
- Radioactive seed implants (brachytherapy) — implants tiny radioactive seeds in the prostate to deliver radiation over a longer time period. Using irradiated seeds can lower the risk of damage to organs surrounding the prostate from radiation.
The main side effects of radiation therapy are: impotence, urination problems (frequent urination, burning on urination, stronger urge to urinate), bowel problems, and rectum soreness.
Chemotherapy Chemotherapy is not a common treatment option for prostate cancer. However, it is used for advanced forms or recurrent cancer that did not respond to other types of treatment.
Hormone Therapy Hormone therapy is also known as androgen deprivation or suppression therapy and focuses on reducing the level of male hormones in the body. The majority of prostate cancer cases are hormone sensitive because tumors require male hormones to grow. A reduced level of androgen (male hormone) causes the prostate to shrink and have a slower growth process. This type of treatment is effective in treating early cancer stages and high grade tumors. Also, hormone therapy is available as a treatment option:
- for patients that cannot undergo a surgery or radiation therapy,
- for patients that did not respond to surgery or radiation therapy and the cancer spread beyond the prostate,
- the cancer relapses,
- in addition to radiation therapy for a better outcome,
- before surgery or radiation therapy to shrink the tumor and to make them more effective
There are three types of hormone therapy available for prostate cancer treatment:
- Orchiectomy: This is a surgical procedure where the testicles are removed.
- Luteinizing hormone-releasing hormone (LHRH) analogs therapy: LHRH analogs are a family of drugs that reduce the level of testosterone by decreasing the amount of androgen produced by the testicles.
- Anti-androgen treatment: Anti-androgens block the body’s ability to use the androgens and prevent the cancerous cells to interact with testosterone.
Acupuncture may provide relief from side effects of orchiectomy (removal of the testes). Studies also support the use of acupuncture for the pain that often occurs when cancer has spread beyond the prostate (particularly to the bones). A National Institutes of Health statement released in 1997 also supports the use of acupuncture to alleviate nausea associated with chemotherapy.
Evidence suggests acupuncture can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting that often accompanies chemotherapy treatment). Studies have also indicated that acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness and is a technique that patients can learn and then use to treat themselves.
Massage and Physical Therapy
Studies suggest that massage reduces stress and boosts immune function, so it may help relieve anxiety for men undergoing treatment for prostate cancer.
Pelvic floor exercises — the repetitive use of muscles that start and stop the flow of urine — may help decrease incontinence caused by prostatectomy (removal of the prostate).
To schedule a consultation with Dr. Navneet Sharda call 702-547-2273.
Oncologist Navneet Sharda, MD is the medical director of Cancer Care Center. For more than a decade Cancer Care Center has been specializing in treatment of various types of cancers like multiforme, meningioma, tonsil, tongue, laryngeal, parotid, neck, lung, breast, lymphoma, non hodgkins lymphoma, hodgkins disease, hodgkins lymphoma, skin cancer, melanoma, esophageal, gastric, pancreatic, colon, renal, kidney, ovarian, sarcoma, uterine cancer, cervical cancer, vaginal, brain, breast, vulvar cancer, bone metastasis, bone,osteosarcoma, endometrial cancercarcinoma, tumor, malignant and cancerous Cancers. We offer threapy like chemotherapy, radiotherapy, radiation therapy, radiation oncology, oncology, oncologist, immunotherapy, brachy therapy, stereotactic radio surgery, IMRT, intensity modulated radiation therapy, conformal therapy, anaplasticastrocytoma,gioblastoma.