After a prostate cancer diagnosis, it’s important to understand your treatment options. Learning about the fundamentals of prostate cancer, from diagnosis to treatment, will empower you to make informed decisions with your healthcare team.
Understanding Prostate Cancer
Prostate cancer is a type of cancer that begins in the prostate gland, a small walnut-shaped gland located in men below the bladder and in front of the rectum.
Throughout a man’s lifetime, some prostate cells may become cancerous. Early-stage prostate cancer is present only in the prostate and has not grown to other body parts. If left untreated, these cancerous cells can spread beyond the prostate gland to areas such as the lymph nodes and bones. Early detection and treatment are crucial for managing prostate cancer effectively.
Diagnosis of Early-Stage Prostate Cancer
Most prostate cancers in the United States are identified through a prostate-specific antigen (PSA) screeningor digital rectal examination, which are typically done during an annual physical with your primary care doctor or urologist.
PSA is a protein in the blood produced by prostate cells, which can be measured with a simple blood test. Elevated PSA isn’t always caused by prostate cancer; benign conditions like an infection and urinary retention can also alter these protein levels. While the PSA test is not foolproof for prostate cancer detection, it is currently the most commonly used tool for identifying cancer early on.
Other tests used to diagnosis prostate cancer include a PCA3 urine test and 4Kscore blood test, both of which help differentiate prostate cancer from other causes of elevated PSA.
Your urologist may decide to proceed with a biopsy depending on several factors, including the PSA level, nature of the prostate during examination, family history of cancer, age, race and other medical comorbidities. Biopsies should be performed only after discussing the risks and benefits with a urologist.
Treatment Options for Early-Stage Prostate Cancer
If you are diagnosed with prostate cancer, deciding on which therapy to select can be a confusing process. The choice of treatment depends on various factors such as the aggressiveness of the cancer, the patient’s age and overall health, and personal preferences. Each treatment has its risks, benefits and impact on quality of life.
You don’t have to make treatment decisions by yourself. Your urologist and healthcare team will guide you through the options and help you make the best decision for your individualized case.
The most common treatment options for prostate cancer in early stages include:
1. Active Surveillance
Active surveillance is a way to monitor low-risk prostate cancer with a plan of timely intervention should the tumor become larger or grow in size. Patients undergo regular monitoring and testing to track the progression of the cancer without immediate treatment.
2. Radical Prostatectomy
A radical prostatectomy is surgery to remove the entire prostate gland and seminal vesicles. Sometimes, the regional lymph nodes are also removed. A modern, minimally invasive approach to prostatectomy surgery is the use of a robotic-assisted surgical system, which the surgeon operates. This results in less blood loss, shorter hospital stays and a quicker recovery.
3. Radiation Therapy
Radiation can be given as external beam radiation therapy (EBRT) and as brachytherapy. EBRT is external and local radiation treatment that is done with a machine. Brachytherapy radiation is given from inside the body, with radioactive seeds placed permanently in the prostate or with narrow, seed-filled tubes that are placed temporarily for one or two days.
4. Cryotherapy
Cryotherapy is used to treat localized (no cancer beyond the prostate gland) prostate cancer, killing cancer cells in the prostate by freezing them. This procedure is mainly used when radiation therapy has been ineffective.
5. Hormone Therapy
Hormone therapy for prostate cancer aims to reduce levels of male hormones, particularly testosterone, in the body. Hormone therapy may involve medications or surgical procedures to suppress testosterone production or block its effects on cancer cells. It is commonly used in combination with other treatments for prostate cancer, such as surgery or radiation therapy.
Choosing the Best Treatment Option
Choosing the best treatment option for early-stage prostate cancer involves a collaborative effort between the patient and their healthcare team, which may include a urologist, oncologist, radiation oncologist and other specialists.
Common factors to consider include the:
- Stage and grade of the cancer
- Patient’s lifestyle and preferences
- Potential benefits and risks of each treatment option
- Likelihood of the cancer responding to treatment
Ultimately, the best treatment option for a patient’s individual needs should be based on a thorough discussion of these factors.
Stony Brook Cancer Center offers a full spectrum of prostate cancer care, including advanced diagnostics and treatment from a multidisciplinary team of experts. Find out more about prostate cancer treatment here.
Stony Brook’s Urological Oncology team serves the community with new technological advancements that assist in both diagnosis and treatment. Find out more about Stony Brook Urology here.
