Understanding Your Prostate Cancer Treatment Options

If you are diagnosed with prostate cancer, your healthcare team will work with you to determine the best treatment options. These treatment options may include standard treatments as well as clinical trials. Understanding those options can make it easier to create the best treatment plan for you. 

Determining which options are available to you will depend on the stage of the cancer, your general health, and the recommendations of your doctors. 

When it comes to treating prostate cancer, most oncology teams will recommend one or more standard treatment practices. These treatment options are often combined, depending on your type of prostate cancer and its stage of growth. Combining treatments can help improve outcomes¹ and may help reduce drug resistance. 

Active surveillance and watchful waiting

These are the least invasive prostate cancer treatment options, as they require no surgery or immediate medical intervention.

Active surveillance is most commonly used for prostate cancers that are in the very early stages of growth. Your oncology team will regularly monitor the development of the cancer. They will then begin treatment when the prostate cancer begins to grow. 

With a watchful waiting treatment plan, your doctors will monitor your condition along with any other health concerns. They will only treat the cancer when it starts to impact your quality of life. 

Radiation therapy

Radiation therapy uses radiation to kill cancer cells. Radiation for prostate cancer is most commonly done externally with a machine that beams radiation to the site of the cancer cells. 

There are alternative forms of radiation therapy that involve placing radioactive particles inside the body near the tumor site. With both methods, radiation is very effective at killing cancer cells. However, it may damage some healthy tissue in the process, as well. 

Radiation therapy can be quite effective for early-stage prostate cancer². It's also an effective method to slow the spread of cancer outside the prostate area, especially in the later stages.

It does have some serious side effects to consider, though. Radiation therapy can cause issues with the bowel and bladder for up to six weeks after treatment. 

There is also an increased risk of certain types of cancers and urinary and impotence issues. Your doctor may be able to treat these side effects with medication or other treatment options. 

Immunotherapy

Immunotherapy puts your immune system to work, destroying cancer cells. Your doctor will extract immune cells from your blood, treat them, and then inject them back into your body. Those immune cells should then recognize the abnormal cancer cells and work to destroy them.

Side effects of this treatment method include flu-like systems and weight changes. 

Unfortunately, immunotherapy will not stop prostate cancer from growing or spreading. It can, however, prolong life expectancy³ in late-stage prostate cancer patients. 

Chemotherapy

Chemotherapy is a drug that works to stop the spread of cancer cells in the body. You can take chemotherapy (or chemo) via oral medication, an injection, or an infusion. 

The chemotherapy drugs travel through your bloodstream to find cancer cells, killing them or preventing them from dividing. 

Chemotherapy for prostate cancer is often used alongside other treatment options, such as hormone therapy, and it's more commonly used to treat aggressive forms of prostate cancer that may not have responded to other treatments. 

While chemotherapy drugs can be effective at killing cancer cells, they may do unintentional damage to other cells in your body, leading to side effects. These side effects may include: 

• Hair loss 

• Nausea

• Fatigue

• Loss of appetite

You may also be more prone to bruising or infections. Most side effects will disappear a few weeks after the chemotherapy treatment. In the meantime, you might find relief through medication for symptoms such as nausea. 

Chemotherapy can be an effective treatment for prostate cancer, and research shows that newer chemotherapy drugs such as docetaxel can prolong life expectancy⁴ in men with prostate cancer.

Hormone therapy

Male hormones can fuel the growth of prostate cancer cells. Hormone therapy works to suppress those hormones, which should slow the growth of prostate cancer or potentially even shrink the tumor. 

Hormone therapy for prostate cancer won't get rid of cancer on its own, though. However, it can work alongside other treatment options to improve outcomes. 

For example, your doctor may recommend hormone therapy before you go through radiation, as the hormone therapy can shrink the size of the area requiring radiation.

Because this prostate cancer treatment option reduces the male androgen hormones, you may experience male hormone-related side effects such as: 

• Reduced libido

• Weight gain

• Depression

• Anemia

• Erectile dysfunction 

Your medical team may be able to help treat or prevent many of these side effects with medications. They may also recommend increased exercise to manage weight gain or counseling for anxiety and depression. 

Surgery

Surgical treatment for prostate cancer is very common. The goal of the surgery is to remove any cancer while preventing nerve damage that may interfere with your sexual and urinary functions. 

The surgical treatment to remove your prostate is called a prostatectomy. There are two options to achieve this, and which one is right for you will depend on your overall health and which stage of development the cancer is in. 

The two options are:  

Radical or open prostatectomy

This surgery removes the prostate along with the seminal vesicles and some lymph nodes. 

Your surgeon will make an incision in your abdomen and remove your prostate, seminal vesicles, and potentially the lymph nodes in your groin. 

There is a risk of the loss of sexual function with this surgery, but doctors will try to spare the nerves responsible for this to preserve arousal and orgasm. 

Urinary incontinence is another potential side effect, though there are several treatment options to correct this issue.

Laparoscopic or robotic prostatectomy

This surgery is similar to the radical prostatectomy in that it removes the prostate, the seminal vesicles, and potentially the lymph nodes in the groin.

However, your surgeon will make a much smaller incision in your abdomen, then use robotic instruments to complete the operation. 

This often leads to a faster recovery time, but the risk of side effects for sexual dysfunction and urinary incontinence remains the same. 

Prostate cancer surgery recovery will take time. Most men have mild to moderate pain for the first few days, which you can treat with over-the-counter medications. Talk to your doctor about pain management. You'll want to avoid strenuous activity and heavy lifting for at least a month after your surgery, as well. 

The success rate of a prostatectomy is very high⁵. When caught and treated early, most men won't require further treatment.

What to consider when choosing treatment options

Facing a prostate cancer diagnosis can be scary. After your initial diagnosis, you'll need to start thinking about what sort of treatment plan you want to follow. While your oncology team may make recommendations, they will give you all your options. 

When considering those options, think about factors such as: 

• Recovery time

• Potential side effects

• Cost of treatment

• Success rates

• The goal of the treatment

Make sure you thoroughly understand your diagnosis, too. You should also feel free to consult with trusted friends and family members and even get a second opinion from another doctor. 

In the end, you should pick the treatment options you feel the most comfortable with.  Learn more about the costs of prostate cancer care and treatment.