There’s no one prostate cancer treatment that’s right for every man, but there are plenty of options. Your doctor will consider many things when they recommend one for you, including:
- The size of your tumor and how far it has spread. This is called the stage of your disease.
- How quickly the tumor is likely to grow
- Your age and how healthy you are
- Your personal preferences
Watchful Waiting or Active Surveillance
Your doctor might suggest waiting to see if your tumor will grow or spread before you treat it. Most prostate cancer grows slowly. Some doctors think it’s better not to treat it unless it changes or causes symptoms. In watchful waiting, your doctor will closely track how the disease makes you feel. With active surveillance, you’ll also get regular tests to check on the cancer.
Surgery
It’s an option if you're healthy and your cancer hasn't spread. There are several types. Your doctor may only remove your prostate gland. Or they might take it and the tissue around it. The most common side effects from an operation are problems controlling your urine and trouble getting and keeping an erection. Sometimes they go away on their own after surgery, especially bladder control issues. Talk to your surgeon beforehand to see if they think they'll be able to protect the nerves around your prostate to prevent these side effects.
Radiation
This treatment uses high-energy beams (similar to X-rays) to kill the cancer. It's often a choice when your cancer is low grade or still only in your prostate. You also might have it after surgery to get rid of any cancer cells left behind. It also helps with cancer that has spread to the bone. There are two types of radiation:
- External: A machine outside your body directs rays at the cancer.
- Internal (brachytherapy): A doctor does surgery to place small radioactive "seeds" into or near the cancer.
Sometimes, a mix of both treatments works best.
Proton Beam Radiation
This special kind of radiation therapy uses very small particles to attack and kill cancer cells that haven't spread.
Radiopharmaceuticals
Radiopharmaceuticals, or medicinal radiocompounds, are a group of pharmaceutical drugs containing radioactive isotopes. This form of radiation is used to treat patients diagnosed with castration-resistant metastatic prostate cancer as a method of controlling the disease. The drugs can be taken orally or by injection. In some cases, they may be placed in the prostate itself.
Hormone Therapy
Prostate cancer cells need male sex hormones, like testosterone, to keep growing. This treatment keeps the cancer cells from getting them. Your doctor might call it androgen deprivation therapy. Some hormone treatments lower the levels of testosterone and other male hormones. Other types block the way those hormones work.
Chemotherapy
Drugs that you take by mouth or through an IV travel through your body, attacking and killing cancer cells and shrinking tumors. You might get chemo if the disease has spread outside your prostate and hormone therapy isn’t working for you.
Immunotherapy
This treatment works with your immune system to fight the disease. It’s used to treat advanced prostate cancer.
Bisphosphonate Therapy
If the disease reaches your bones, these drugs can ease pain and prevent fractures.
Cryotherapy or Cryosurgery
If you have early prostate cancer, your doctor might choose to kill cancer cells by freezing them. They’ll put small needles or probes into your prostate to deliver very cold gasses that destroy the cells.
It’s hard to say for sure how well it works. Scientists haven’t done much long-term research that focuses on using it to treat prostate cancer. It's usually not the first treatment a doctor recommends.
High-Intensity Focused Ultrasound
High-intensity focused ultrasound is not a standard in care but is used for patients seeking an option between active surveillance and radical therapy. This device produces sound waves that deliver heat energy to kill cancer cells. It’s unclear how well it works, as it hasn’t yet been compared with other standard prostate cancer treatments.
Prostate Cancer Vaccine
Most work by boosting your body's defenses so it can fight an infection. The prostate cancer vaccine gets your immune system to attack cancer cells. This treatment works best if you’ve tried hormone therapy and it isn't working anymore. The vaccine is custom-made for you. Scientists don’t know if it stops or slows down the cancer’s growth, but it does seem to help men live longer with prostate cancer.
Are There Side Effects?
The treatments for prostate cancer also can affect your body in other ways. Side effects can include:
- Bowel problems
- Lower sex drive
- Erectile dysfunction
- Loss of your ability to get a woman pregnant
- Leaky bladder or loss of bladder control. You might also need to pee a lot more often.
Side effects are another thing to think about when you’re choosing a treatment. If they’re too tough to handle, you might want to change your approach. Talk to your doctor about what you can expect. They can also help you find ways to manage your side effects.
What Else Should You Consider?
Remember, you have options, and it’s important to choose the one that works best for you. When choosing a treatment, think about:
- The risks. Talk to your doctor about the pros and cons of each type of therapy.
- The side effects. Consider whether or not you’re willing to deal with how the treatment might make you feel.
- Whether or not you need it. Not all men with prostate cancer need to be treated right away.
- Your age and overall health. For older men or those with other serious health conditions, treatment may be less appealing than watchful waiting.
