Prostate Cancer Health Article

Watchful waiting

Watchful waiting means no immediate treatment is recommended, but doctors keep the patient under careful observation. This option is generally used in older patients when the tumor is not very aggressive and the patients have other, more life-threatening illnesses. Prostate cancer in older men tends to be slow-growing. Therefore, the risk of the patient dying from prostate cancer, rather than from other causes, is relatively small.

Surgery

For early stage prostate cancer, surgery is the best option and the most common one. Radical prostatectomy involves complete removal of the prostate. During the surgery, a sample of the lymph nodes near the prostate is removed to determine whether the cancer has spread beyond the prostate gland. Because the seminal vesicles (the glands where sperm is made) are removed along with the prostate, infertility is a side effect of this type of surgery. In order to minimize the risk of impotence (inability to have an erection) and incontinence (inability to control urine flow), a procedure known as "nervesparing" prostatectomy is used.

In a different surgical method, known as the transurethral resection procedure or TURP, only the cancerous portion of the prostate is removed, by using a small wire loop that is introduced into the prostate through the urethra. This technique is most often used in men who cannot have a radical prostatectomy due to age or other illness, and it is rarely recommended.

RADIATION THERAPY. Radiation therapy involves the use of high-energy x rays to kill cancer cells or to shrink tumors. It can be used instead of surgery for early stages of cancer. The radiation can either be administered from a machine outside the body (external beam radiation), or small radioactive pellets can be implanted in the prostate gland in the area surrounding the tumor.

HORMONE THERAPY. Hormone therapy is commonly used when the cancer is in an advanced stage and has spread to other parts of the body. Prostate cells need the male hormone testosterone to grow. Decreasing the levels of this hormone, or inhibiting its activity, will cause the cancer to shrink. Hormone levels can be decreased in several ways. Orchiectomy is a surgical procedure that involves complete removal of the testicles, leading to a decrease in the levels of testosterone. Alternatively, drugs (such as LHRH agonists or anti-androgens) that bind to the male hormone testosterone and block its activity can be given. Another method "tricks" the body by administering the female hormone estrogen. When this is given, the body senses the presence of a sex hormone and stops producing testosterone. However, there are some unpleasant side effects to hormone therapy. Depending on the doses of estrogen, men may have "hot flashes," enlargement and tenderness of the breasts, impotence or loss of sexual desire, as well as the risks of blood clots, heart attacks, and strokes.

CHEMOTHERAPY. Chemotherapy is the use of drugs to kill cancer cells. The drugs can either be taken as a pill or injected into the body through a needle that is inserted into a blood vessel. This type of treatment is called systemic treatment, because the drug enters the blood stream, travels through the whole body, and kills the cancer cells that are outside the prostate. Chemotherapy is sometimes used to treat prostate cancer that has recurred after other treatment. Further research is ongoing to find more drugs that are effective for the treatment of prostate cancer.

Expected results

According to the American Cancer Society, the survival rate for all stages of prostate cancer combined has increased from 50–87% over the last 30 years. Due to early detection and better screening methods, nearly 60% of the tumors are diagnosed while they are still confined to the prostate gland. The five-year survival rate for early stage cancers is almost 99%. Sixty three percent of the patients survive 10 years, and 51% survive 15 years after initial diagnosis.

Prevention

Because the cause of the cancer is not known, there is no definite way to prevent prostate cancer. However, the American Cancer Society recommends that all men over age 40 have an annual rectal exam and that men have an annual PSA test beginning at age 50. Those who have a higher than average risk, including African American men and men with a family history of prostate cancer, should begin annual PSA testing even earlier, starting at age 45.

A diet low in fat may slow the progression of prostate cancer. Hence, in order to reduce the risk of prostrate cancer, the American Cancer Society recommends a diet rich in fruits, vegetables, and dietary fiber, and low in red meat and saturated fats. Intake of lycopene, which is found in cooked tomatoes or tomato sauce, is also thought to help reduce the risk of prostate cancer.