Prostate cancer is the most common form of cancer in men, with one in eight men diagnosed in their lifetime.
Receiving a prostate cancer diagnosis can be an overwhelming and emotional experience. Not only does it bring uncertainty about the future, but it also presents the challenging task of deciding on the best treatment approach.
Prostate cancer is typically diagnosed through a combination of biopsies, blood tests and imaging studies.
For many men, the pressure to make the right choice is compounded by concerns about long-term effects. The complexity of the decision-making process is further intensified by the need to consider personal factors, like age, overall health and the specific characteristics of the cancer.
With so many variables to weigh, it is necessary for men to gather as much information as they can. This should include getting a second opinion, as it can provide clarity and reassurance. It not only confirms the accuracy of the diagnosis but also opens the door to explore alternative treatment options, including the latest advancements that could make a significant difference in outcomes and quality of life.
Traditional treatment options
Not all prostate cancer cases are the same. No patient’s treatment journey is the same, especially if there are various stages or types of cancer involved. Exploring alternative treatment strategies helps you understand which options are most appropriate for your specific condition.
Dr. Scot Ackerman, medical director of Ackerman Cancer Center, said, “When a man is diagnosed with prostate cancer, there are three cornerstones to treatment: surgery, radiation and active surveillance.”
Ackerman said, “The recommendation is based on several factors, including the patient’s life expectancy, the stage of the cancer, the Gleason score and any other medical conditions the patient may have.”
He further noted that active surveillance is generally recommended for patients diagnosed with early-stage, low-grade prostate cancer, where immediate treatment may not be necessary.
The two primary types of radiation therapy for prostate cancer are photon radiation and proton radiation. Photon radiation uses high-energy X-rays that can damage the DNA inside cancer cells.
Proton therapy uses charged particles to deliver highly precise radiation, minimizing exposure to nearby healthy tissue, which is particularly beneficial for tumors located near sensitive organs like the bladder or rectum. This precision reduces the risk of common side effects like incontinence and erectile dysfunction, which leads to better outcomes and fewer complications.
One of the most common treatments for localized prostate cancer is surgery, specifically prostatectomy, which involves the removal of the prostate gland.
“With surgery, patients should expect to be in and out of the hospital within a day or two,” Ackerman said. “However, if some patients are in and out the same day, they would expect a few weeks of recovery. They may need radiation if the surgeon is unable to remove all the cancer, or if prostate-specific antigen is still detectable.”
After surgery, there are a couple of significant side effects patients have that can be long lasting, including:
1. Urinary incontinence, the inability to hold their urine.
“Almost all patients have some urinary incontinence immediately after surgery. For most patients, it clears up in about nine months to a year,” Ackerman said.
For this considerable number of patients, just under half will have long term issues with urinary incontinence.
2. Erectile dysfunction. “With the classic radical prostatectomy, nearly all men completely lose erectile function. However, with more modern procedures, such as robotic surgery and what is called nerve sparing surgery, only about 60% of men have erectile dysfunction, and approximately 40% of men are still able to have an erection.”
Hormone therapy, another option for patients, can be given orally or through an injection.
“For the most part, the drugs suppress testosterone,” Ackerman said. “When men need hormone therapy for prostate cancer, they generally need it for anywhere from four months to three years, depending on how advanced the prostate cancer is.”
The other option doctors might opt for is chemotherapy, which uses drugs to stop cancer cells from growing, either by stopping them from dividing or killing them.
Advancements in prostate cancer treatment
The treatment options for prostate cancer have come a long way in recent years. Newer, innovative treatments are typically more effective, targeted and personalized approaches, compared to traditional treatments.
Ackerman said these include:
- Immunotherapy: Uses checkpoint inhibitors to help the immune system recognize and attack cancer cells.
- Hormone therapy: Reduces or blocks hormones that produce prostate cancer cells.
- Genomic testing: Looks at all a person’s genes to identify specific genetic alterations or mutations within tumor cells.
- Robotic surgery: Minimally invasive procedure to remove the prostate and nearby tissues.
- Chemotherapy: Targets and destroys fast-growing cancer cells, often used in advanced stages of prostate cancer.
- High intensity focused ultrasound (HIFU): Aims to kill cancer cells with high frequency sound waves.
- PSMA targeted radiation therapy: Treats advanced prostate cancer that doesn’t respond to surgery or radiation.
- Proton therapy:
- Delivers radiation therapy directly to the tumor while minimizing radiation exposure to surrounding tissues.
- Fewer side effects and better quality of life and survival for prostate cancer patients.
Ackerman said these advancements reflect a shift toward more precise, less invasive and better-targeted treatments, which provides more hope for improved quality of life.
Making a decision
When diagnosed with prostate cancer, it’s normal to feel uncertain about treatment options. Cancer treatment is deeply personal, and everyone deserves to feel confident in the path they choose.
A second opinion can provide peace of mind and ensure the treatment plan not only aligns with the latest medical research but also with a patient’s preferences and lifestyle. It offers the reassurance that a patient is making the most informed decision possible about their health.
To learn more about cancer care at Ackerman Cancer Center, click or tap here.