Prostate cancer develops in the prostate, a small gland found in the male reproductive system, and it occurs when cells in the prostate mutate and multiply out of control. When doctors diagnose this condition, they evaluate the stage of the disease, the tumor size, and the patient’s overall health to determine the appropriate treatment. Prostate cancer treatment options range from careful observation to surgical removal and advanced therapies. Understanding these options helps you and your healthcare team make informed decisions about your care.
Active Surveillance of Prostate Cancer
For some men, immediate prostate cancer treatment is not recommended. Active surveillance is a management strategy used for slow-growing, early-stage prostate cancers that do not cause symptoms. Instead of intervening right away, your medical team closely observes the condition over time. During active surveillance, doctors schedule regular check-ups, and they monitor prostate-specific antigen (PSA) levels. This approach avoids the potential side effects of surgery or radiation for as long as possible. Your monitoring plan will typically include:
- Regular physical examinations and digital rectal exams (DRE)
- Routine blood tests to track PSA levels
- Periodic imaging tests, such as MRI scans, to view the prostate
- Follow-up biopsies to check for changes in the cancer cells
If test results indicate that the cancer is growing or changing, your physician will transition your care plan to include active treatment options.
Surgical Prostate Cancer Treatment
When the cancer is confined to the prostate gland, surgery is a common intervention. The primary surgical procedure is a radical prostatectomy. This operation involves the complete removal of the prostate gland, the surrounding tissue, and the seminal vesicles; the goal of this procedure is to remove all cancer cells before they can spread to other parts of the body.
Surgeons perform this procedure using traditional open surgery, or they use minimally invasive robotic techniques. Robotic-assisted laparoscopic radical prostatectomy uses small incisions and precise robotic arms controlled by the surgeon. This method often results in a shorter hospital stay and a faster recovery time.
Following surgery, a catheter remains in place for one to two weeks to assist with urination. Patients undergo routine monitoring after the procedure to check for signs of cancer recurrence. Physicians also monitor for expected post-surgical side effects, and these may include changes in urinary control or erectile function.
Systemic Therapies and Radiation
When surgery is not the preferred option or the cancer has spread beyond the prostate, doctors rely on radiation and systemic therapies. Radiation targets the tumor directly, and systemic therapies treat cancer cells throughout the whole body. These approaches are selected based on the specific characteristics of the cancer.
Radiation therapy uses high-energy rays to destroy cancer cells. It comes in two primary forms:
- External beam radiation: A machine directs radiation from outside the body to the prostate.
- Brachytherapy: Doctors implant small radioactive seeds directly into the prostate tissue.
Systemic therapies circulate through the bloodstream to reach cancer cells wherever they are located. The most common systemic treatment for this condition is hormone therapy. Because prostate cancer cells rely on testosterone to grow, hormone therapy lowers testosterone levels to slow the progression of the disease. If the cancer stops responding to hormone therapy, medical oncologists may introduce other systemic options. Chemotherapy uses specific drugs to stop the growth of cancer cells, and immunotherapy stimulates your immune system to recognize and destroy cancer cells.
Talk to a Urologist Today
Every cancer diagnosis requires a specific, tailored approach based on individual health factors and test results. Urologists and oncologists have the specialized training to evaluate your condition and recommend a clear path forward. Reach out to a urologist to discuss your diagnosis and review your test results, and they will help establish a personalized management plan. Establishing open communication with a specialist helps you receive accurate information regarding your specific medical needs.
