Prostate cancer can be treated by surgery, radiation therapy or hormone therapy. A combination of these treatments may be used.
Surgery is a common treatment for early state prostate cancer. Types of surgeries include:
- Radical retropubic prostatectomy: This procedure removes the entire prostate and nearby lymph nodes through an incision in the abdomen.
- Radical perineal prostatectomy: This procedure removes the entire prostate through an incision between the scrotum and the anus. Nearby lymph nodes may be removed through a separate incision in the abdomen.
- Laparoscopic prostatectomy: This procedure removes the entire prostate and nearby lymph nodes through small incisions, rather than a single long cut in the abdomen. A thin, lighted tube called a laparoscope is used to help remove the prostate.
- Transurethral resection of the prostate (TURP): This procedure removes part of the prostate with a long, thin device that is inserted through the urethra. The cancer is then cut from the prostate. This may not remove all of the cancer, but may remove tissue that blocks the flow of urine.
- Pelvic lymphadenectomy: This is usually done during a prostatectomy. The doctor removes lymph nodes in the pelvis to see if the cancer has spread to them.
The time it takes to heal from surgery varies from person to person and depends on the type of surgery being performed. Patients will more than likely be sore for a few days, and medicine can be prescribed to help control the pain. After surgery, the urethra will need time to heal. A catheter, or tube put through the urethra into the bladder, is used to drain the bladder.
Radiation therapy (also referred to as radiotherapy) uses high-energy rays to kill cancer cells and only affects the treated area. There are two types of radiation therapy to treat prostate cancer:
- 3-D Conformal Beam Radiation Therapy: Uses high energy rays such as x-rays or high energy particles that are too tiny to see to kill the cancer cells. The beam from the radiation machine is focused so that it kills mainly the cancer cells, not the normal cells.
- External radiation: The radiation comes from a large machine outside the body. The treatment can be done either in a clinic or in a hospital. Treatments are usually done five days a week for several weeks.
- Internal radiation (also referred to as implant radiation therapy or brachytherapy): The radiation comes from radioactive material usually contained in small seeds that are put into the tissue. The seeds give off radiation for months, and are harmless and do not need to be removed.
- IMRT (Intensity Modulated Radiation Therapy): A type of external beam radiation therapy. With IMRT your doctor uses a computer to plan the exact dose (or amount) of radiation that is aimed at your prostate cancer. The computer uses information about the size, shape, and location of your prostate cancer to figure out how much radiation is needed to kill your prostate cancer cells. IMRT uses high doses of radiation to kill your prostate cancer cells while protecting the healthy cells that surround your prostate cancer.
Hormone therapy lowers the levels of androgens, or male hormones, such as testosterone. Hormone treatment involves can involve drugs or surgery.
One example of a drug that blocks natural hormones is luteinizing hormone-releasing hormone (LH-RH) agonists. These drugs prevent the testicles from making testosterone.
Another type of drug is antiandrogens - drugs that can block the action of male hormones. Additional other drugs can be used to prevent the adrenal glands from making testosterone.
A surgery called orchiectomy that removes the testicles can also be used.
In this approach, a man´s physician carefully monitors the progress of the prostate cancer. Usually this method of treatment is used only when the prostate cancer is been determined to be very slow-growing. The man's PSA (Prostate-Specific-Antigen) level is checked regularly and if the PSA level starts to rise then other treatment options are explored.