Prostate
Cancer Treatment Options
Treatment
for prostate cancer has traditionally been surgery, where the prostate is
removed in whole or in part, and radiotherapy, where radioactive emissions are
used to burn cancerous cells away. For decades these were the only effective
procedures that could eliminate prostate cancer.
Newer
treatments have arisen in the past decade thanks to research carried out around
the world. Most of them involve some surgical procedure to perform even where
no removal of tissue is required.
Surgical
Options
All
treatment options involving surgery require an overnight hospital stay at least
the night before the procedure. Some surgical options may require a hospital
stay of one or several days depending on the procedure and how quickly you can
recover from it.
A
prostatectomy is a surgical procedure where the entire prostate gland is
removed. This is frequently prescribed for patients with prostate-confined cancer. Along with the prostate gland, also removed are the seminal vesicles
which carry sperm to the urethra, part of the bladder neck and the lymph nodes.
As
a result of having these organs removed, impotence is a common side effect
along with mild to severe urinary incontinence. In addition, recovery times can
be slow.
A
pelvic lymph node dissection is the removal of just the lymph nodes attached to
the prostate gland. The lymph nodes wrap around the urethra on either side of
the prostate. Muscle tissue in the lymph nodes allows you to regulate the flow
of urine through the urethra.
Removing
the lymph nodes can result in mild to moderate urinary incontinence in many
patients.
A
transurethral resection is a less invasive procedure. It is done to remove or
relieve blockages in the urethra. A surgical cutting or cauterizing tool is
inserted through the penis and sections of an overgrown prostate are cut or
burned away.
Side
effects from this surgery can lead to mild to moderate urinary incontinence.
Radiation
Therapy
All
radiotherapy treatments operate on the principle that radioactive emissions
burn cancer cells away to remove them and prevent further growth.
External
Beam Radiotherapy, or EBRT, uses high energy radioactive particles aimed at the
pelvis from a device outside the body. When the particles strike the cancer
cells, they are quickly heated and burned away. This procedure is carried out
for 5 consecutive days for about 5 to 7 consecutive weeks. No anesthetic is
required and it is typically done on an out-patient basis.
Complications
that can arise are as follows.
- Marked inflammation of the rectum or bladder or both.
- Impotence beginning up to 12 months after treatment.
- Radiation burns to the sphincter or bowel.
A
similar though slightly different therapy is Proton Beam Therapy. While still
employing the external source for the beam, the bean is made up of charged ions
rather than radioactivity. The principle of burning away cancer cells remains
the same as well. Practitioners of proton beam therapy claim a lower risk of
side effects than traditional radiation therapy though clinical studies have
yet to prove that conclusively.
High
Intensity Focused Ultrasound
HIFU
- is a newer treatment that is non-surgical and non-invasive. It has been
available in Europe for over a decade and was approved by Health Canada in
2003. It is currently not available in the US. With HIFU for prostate cancer,
the patient undergoes a 2-3 hour outpatient procedure where focused ultrasound
waves are used with pinpoint accuracy to kill cancerous tissue.
The
computer controlled Blather HIFU delivers the ultrasound waves via a computer
controlled probe inserted into the rectum. Clinical results show this alternative treatment to be effective and
safe, with fewer significant side effects.
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