There are a wide variety of prostate cancer treatments, each with its own potential risks and benefits. Prostate cancer patients are ultimately responsible for making the treatment choice decision after consulting with their medical team. MayoClinic.com recommends that patients carefully consider the possible effects of each therapy option before making a decision.
Active Surveillance
Active surveillance is a treatment approach which does not involve initial treatment, but rather close monitoring of the cancer to determine if and when treatment is called for. The monitoring typically involves regular digital rectal exams and blood testing and sometimes also involves regular biopsies and ultrasound testing. Active surveillance is done either when there is reason to believe that the cancer will progress very slowly, or when the patient's life expectancy -- due to age or other factors unrelated to the cancer -- is thought to be less than 10 or 15 years. The effects of active surveillance include potential patient anxiety and the possibility that the cancer will advance to an untreatable level during the surveillance.
External Beam Radiation Therapy
External Beam Radiation Therapy, or EBRT, focuses radiation directly on the prostate and sometimes on the lymph nodes. EBRT may cause problems, which may be temporary, such as diarrhea, incontinence, painful urination, urinary frequency and urgency, and rectal bleeding, inflammation or tenderness. EBRT may also lead to an increased risk of rectal cancer, permanent abnormal bowel function, blood in the urine and other damage to the bladder. In addition, EBRT may result in the long-term problems of erectile and ejaculation problems, or the temporary problems of depressed appetite, fatigue, skin reaction or localized hair loss.
Brachytherapy
Brachytherapy is the implanting of radioactive seeds in the prostate. According to H. Ballentine Carter, M.D., author of The Johns Hopkins White Paper "Prostate Disorders," brachytherapy leads to the same ill effects as EBRT, but with greater frequency.
Radical Prostatectomy
A radical prostatectomy removes the entire prostate. Some lymph nodes and the seminal vesicles may be taken as well. The primary effects of this procedure are incontinence and erectile difficulty. The urethra may also be permanently narrowed, which can result in a decreased urine stream or urinary retention. Eric A. Klein, M.D., author of "The Cleveland Clinic Guide to Prostate Cancer," explains that a nerve-sparing method of removing the prostate has been practiced since the 1980s. As a result of this method, the problems of incontinence and erectile dysfunction are often temporary, and may last only a year. Some men have permanent stress incontinence after the procedure.
Cryosurgery
Cryosurgery, or the freezing of the prostate to kill the tissue, can lead to incontinence, impotence, inflammation of the prostate, injury to the rectum or urethra, urinary retention, urinary frequency or blood in the urine. It can also lead to temporary soreness, difficulty urinating, or a swelling of the penis or scrotum.
Hormone Therapy
Hormone therapy reduces the size of the prostate by denying it testosterone. Men who undergo this treatment may experience nausea, lassitude, diarrhea, weight gain, intellectual decline, loss of muscle mass, impotence, decreased libido, osteoporosis, hot flashes or breast enlargement.
References
- American Cancer Society: Treating Prostate Cancer
- Mayo Clinic: Prostate Cancer Guide
- "The Johns Hopkins White Papers: Prostate Disorders"; H. Ballentine Carter, M.D.; 2006
- "The Cleveland Clinic Guide to Prostate Cancer: Everything you need to know about prostate health, from the experts"; Eric A. Klein, M.D.; 2009
- "100 Questions & Answers About Prostate Cancer, Second Edition"; Pamela Ellsworth, M.D.; 2009
