Prostate Cancer Treatment Options
Treatment for prostate cancer has traditionally been surgery, where the prostate is removed in whole or in part, and radiotherapy, where radioactive emissions are used to burn cancerous cells away. For decades these were the only effective procedures that could eliminate prostate cancer.
Newer treatments have arisen in the past decade thanks to research carried out around the world. Most of them involve some surgical procedure to perform even where no removal of tissue is required.
All treatment options involving surgery require an overnight hospital stay at least the night before the procedure. Some surgical options may require a hospital stay of one or several days depending on the procedure and how quickly you can recover from it.
A prostatectomy is a surgical procedure where the entire prostate gland is removed. This is frequently prescribed for patients with prostate-confined cancer. Along with the prostate gland, also removed are the seminal vesicles which carry sperm to the urethra, part of the bladder neck and the lymph nodes.
As a result of having these organs removed, impotence is a common side effect along with mild to severe urinary incontinence. In addition, recovery times can be slow.
A pelvic lymph node dissection is the removal of just the lymph nodes attached to the prostate gland. The lymph nodes wrap around the urethra on either side of the prostate. Muscle tissue in the lymph nodes allows you to regulate the flow of urine through the urethra.
Removing the lymph nodes can result in mild to moderate urinary incontinence in many patients.
A transurethral resection is a less invasive procedure. It is done to remove or relieve blockages in the urethra. A surgical cutting or cauterizing tool is inserted through the penis and sections of an overgrown prostate are cut or burned away.
Side effects from this surgery can lead to mild to moderate urinary incontinence.
All radiotherapy treatments operate on the principle that radioactive emissions burn cancer cells away to remove them and prevent further growth.
External Beam Radiotherapy, or EBRT, uses high energy radioactive particles aimed at the pelvis from a device outside the body. When the particles strike the cancer cells, they are quickly heated and burned away. This procedure is carried out for 5 consecutive days for about 5 to 7 consecutive weeks. No anesthetic is required and it is typically done on an out-patient basis.
Complications that can arise are as follows.
- Marked inflammation of the rectum or bladder or both.
- Impotence beginning up to 12 months after treatment.
- Radiation burns to the sphincter or bowel.
A similar though slightly different therapy is Proton Beam Therapy. While still employing the external source for the beam, the bean is made up of charged ions rather than radioactivity. The principle of burning away cancer cells remains the same as well. Practitioners of proton beam therapy claim a lower risk of side effects than traditional radiation therapy though clinical studies have yet to prove that conclusively.
High Intensity Focused Ultrasound
HIFU – is a newer treatment that is non-surgical and non-invasive. It has been available in Europe for over a decade and was approved by Health Canada in 2003. It is currently not available in the US. With HIFU for prostate cancer, the patient undergoes a 2-3 hour outpatient procedure where focused ultrasound waves are used with pinpoint accuracy to kill cancerous tissue.