Prostate Treatment Options

Treatment options for cancer spread beyond the prostate.

In this situation, the localized therapies just won’t be enough to stop the growth. This is Stage III and radiation therapy will most likely help by keeping the tumor in check. Radiation combined with hormonal therapy will help to slow the growth.

Hormonal therapy

I briefly touched on this subject previously, but now let us explore this therapy.

With hormonal therapy the goal is to cut off all production of male hormones, such as testosterone, resulting in castration. Castration can be surgical or medical but the end result is the same and for good reason.

Prostate cancer cells can actually “feed” on male hormones causing them to grow. Blocking the hormones with an antiandrogen (drugs that block male hormones from circulating in the blood) will slow the growth of the cancer cells. This process is the equivalent of a medical castration.

There are numerous approaches to the use of hormonal therapy. Different drugs have been combined to test the results. An example of one such combination is known as maximum androgen blockade. This is a total hormonal therapy usually combined with either surgical or medical castration. An antiandrogen pill is ingested each day for months or years.

Evidence as to the efficacy of this approach has proven that there is no significant difference in the effectiveness of this process as opposed to standard hormonal therapy. However, surgical and hormonal therapies in combination do seem to relieve symptoms.

When considering surgical castration versus medical castration, it’s important to keep one fact in mind. Medical castration can be reversed simply by ending use of the drug. Oddly enough in some cases ceasing the hormonal treatment has temporarily interrupted the growth of the cancer.

While hormonal therapy in the case of metastatic cancer seems to work, sadly, the reprise is only temporary. Remission will normally last for 2 or three years. At some point, those cancer cells that do not need testosterone to grow will begin the growth cycle again. If this takes place a second array of hormonal drugs (progesterone or hydrocortisone to name two) may be considered.

Clinical Trials

Investigating the possibility of participating in clinical trials is always an option for treatment. Clinical trials are usually new drugs, combination of drugs or mechanical in nature.

Cryosurgery

This process is used to kill prostate cancer cells by freezing them. Similar to the tiny radioactive seeds delivered through thin needles that I discussed previously, rather than seeds liquid nitrogen is passed through thin probes that are passed through needles that have been passed through the perineum directly into the prostate. The liquid nitrogen will form a ball of ice from the cancer cells and as the frozen cells thaw out they break up. This procedure will take a couple of hours under anesthesia which can be either local or a spinal and a 1 or 2 day hospital stay.

There is a downside to this treatment. Even though a “warming catheter” is inserted into the penis to protect the urethra, the overlying nerve bundles usually freeze as well rendering the man impotent.

Chemotherapy

While chemotherapy is an aggressive approach, according to the medical community it is not necessarily effective as a choice to fight the slow growing prostate cancer cells.

This does not mean that it should be ruled out entirely. New anti-cancer drugs are always being studied and released. There are a few currently under study that are being included surgical or radiation therapy in men at Stage III prostate cancer.

Another study includes them in the regimen along with hormonal therapy. This is specifically being used for men with advanced cancer that is not responsive to hormonal therapy by itself.

Early Hormonal Therapy

Just as the name signifies, this is the practice of starting hormonal therapy immediately upon the diagnosis of prostate cancer. The goal is to slow the growth of cancer cells that have grown beyond the prostate and into surrounding tissue and even the lymph nodes. Sometimes early hormonal therapy helps in shrinking the tumor.

Conformal Radiation Therapy

Conformal radiation therapy (3D-CRT) is a three dimensional computer software program. It allows radiation beams to conform and shape to fit the prostate thereby accurately targeting only the prostate gland thereby minimizing damage to the surrounding healthy tissue.

No matter what avenue of treatment you select for managing prostate cancer, do your very best to maintain a positive attitude. Yes, the horizon may look a bit gloomy, but with modern medicine advancements are being made every day.

Your best defense is a strong offense. Get screened as soon as possible for early detection then have regular follow-ups especially if you are in an at risk group.

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