Prostate cancer Health Article

X rays and imaging techniques

X-ray studies may be ordered to determine whether the cancer has spread to other areas. Imaging techniques (such as computed tomography scans and magnetic resonance imaging), where a computer is used to generate a detailed picture of the prostate and areas nearby, may be done to get a clearer view of the internal organs. A bone scan may be used to check whether the cancer has spread to the bone.

The American Cancer Society and other organizations recommend that PSA blood testing and DRE be offered to men with at least a 10-year life expectancy beginning at age 50. Men at higher risk for prostate cancer, such as those with a family history of the disease or African American men, may wish to consider screening at an earlier age such as 45. A low-fat diet may slow the progression of prostate cancer. Hence, the American Cancer Society recommends a diet rich in fruits, vegetables, and dietary fiber, and low in red meat and saturated fats, in order to reduce the risk of prostate cancer.

Treatment

The doctor and the patient will decide on the treatment after considering many factors. For example, the patient's age, the stage of the tumor, his general health, and the presence of any co-existing illnesses have to be considered. In addition, the patient's personal preferences and the risks and benefits of each treatment method are also taken into account before any decision is made.

Surgery

For early stage prostate cancer, surgery is frequently considered. 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 gland where the 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 "nerve-sparing" 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 stage 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, may cause the cancer to shrink or stop growing. 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 making the male hormone testosterone. However, there are some side effects to hormone therapy. Men may have "hot flashes," enlargement and tenderness of the breasts, or impotence and loss of sexual desire, as well as blood clots, heart attacks, and strokes, depending on the dose of estrogen.

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. Research is ongoing to find more drugs that are effective for the treatment of prostate cancer.

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.