Your Guide to Prostate Cancer Treatment Options With a Urologist

The most common prostate cancer treatments include surgery to remove the prostate and radiation targeted at the prostate. Some treatments have serious side effects like urinary incontinence and erectile dysfunction.

Some people who have early-stage prostate cancer may choose watchful waiting instead of treatment. This involves tracking the cancer through PSA tests and DREs but not routine biopsies.

Hormone Therapy

Most prostate cancers depend on male sex hormones (androgens) to grow. Hormone therapy (also known as androgen deprivation therapy) lowers or blocks these hormones, which can stop the cancer from growing or stopping it from spreading. This is the standard treatment for most patients with localized, early stage prostate cancer.

A urologist may recommend surgery or radiation to destroy the prostate tumor, or they might recommend focal therapies that use heat, freezing, or high-intensity focused ultrasound to kill cancer cells in small areas of the prostate without damaging surrounding tissue. These treatments can be used as an alternative to surgery or radiation and can improve a patient’s quality of life.

If your prostate cancer has spread outside the prostate (metastasized), it is more difficult to cure. However, your doctor might be able to control it with hormone therapy, radiation or other drugs. Urologist in Melbourne can help determine the best course of treatment for advanced prostate cancer and explain what to expect from each option. They can also discuss any clinical trials that might be available for you.

Chemotherapy

Cancer begins when a part of your DNA gets altered and can no longer properly direct your cells. Usually, your doctor will use targeted treatment to destroy the cancerous cells and stop them from multiplying.

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Local treatments get rid of the cancer in a limited area, such as surgery and radiation therapy. These Melbourne prostate cancer treatment will be used to treat early-stage prostate cancer and help keep it from spreading.

Radiation therapy uses X-rays or other types of energy to kill the cancerous cells or keep them from growing and dividing. It is sometimes combined with hormone therapy and/or bisphosphonate drugs to prevent the cancer from returning or spreading.

Focal Therapy, which is a new type of radiation treatment, uses a machine to target only the area with cancerous tissue. This helps reduce side effects such as urinary, bowel, and sexual dysfunction. There are two primary forms of Focal Therapy: TULSA-Pro and HIFU. In the TULSA-Pro, a probe is inserted into your anus while in HIFU, a device delivers heat through the prostate with sound waves.

Radiation Therapy

If the cancer is confined to your prostate and hasn’t spread, a urologist may recommend radiation therapy. It can help shrink tumors, reduce symptoms and lower the risk of recurrence. Modern radiation therapy uses specialized imaging and techniques to focus on your prostate without damaging nearby tissues. Your urologist will work with a radiation oncologist to determine which type of radiation therapy is best for you, including brachytherapy, external beam radiation or high-intensity focused ultrasound (HIFU).

For brachytherapy, doctors place radioactive seeds in the prostate. The seeds emit radiation at the site where they’re implanted. They can be left in the prostate for a short time or longer, depending on your age and other health conditions.

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If the cancer is in other parts of your body, your urologist might recommend hormone therapy or radiation after surgery. These treatments can extend your life and ease urinary and sexual problems that result from the disease. In some cases, you might not need treatment at all. Depending on your age, the grade of your cancer and whether it has spread to other areas of your body, you might choose active surveillance, where the doctor monitors your symptoms with PSA tests and DREs but doesn’t treat the prostate.

Immunotherapy

Prostate cancer is a disease that occurs when healthy prostate cells begin to grow abnormally. Cancer cells differ from normal prostate cells because of an alteration in their DNA — the genetic blueprint that creates new cells. Cancer cells do not die normally and, over time, can grow into tumors and spread to other parts of the body.

Symptoms of prostate cancer may include an increased need or frequency of urination, blood in the urine, painful urination or emptying of the bladder. A doctor can evaluate the severity of these symptoms and how much they interfere with daily life to determine the stage of prostate cancer.

In men with low-grade, slow-growing prostate cancer, doctors may recommend active surveillance. This is a treatment approach in which regular blood tests, rectal exams and prostate biopsies are performed to monitor the progress of the cancer. A man on active surveillance can benefit from medication, radiation and other treatments in the future if his health situation worsens. Medications can reduce the levels of male hormones in the body that stimulate the growth of cancerous prostate tissue.

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Sipuleucel-T (Provenge)

In addition to hormonal therapy, there are other treatments that reduce levels of the male sex hormone androgen, including removing the testicles, known as surgical castration or taking drugs that block the action of androgens in the body, such as enzalutamide and abiraterone acetate. These medications are also called androgen deprivation therapies (ADT). Some patients may choose to have ADT along with watchful waiting, a treatment approach that involves regular PSA tests, DREs, and biopsies but does not involve medical treatment or the use of hormones.

Immunotherapy, which includes drugs that help your immune system cells recognize cancer cells and kill them, is an option for advanced prostate cancer that no longer responds to hormone therapy or causes few symptoms. Sipuleucel-T, an active cellular immunotherapy vaccine, was approved for metastatic castration-resistant prostate cancer in 2010 after randomized trials demonstrated a survival advantage in men with asymptomatic or minimally symptomatic mCRPC. The study used longitudinal, adjudicated claims data from a US national insurer and matched prescription records to a deidentified clinical database (OptumInsight). The cohort analysis compared patients treated with sipuleucel-T to patients receiving one of the other 5 treatments for mCRPC, including abiraterone, enzalutamide, docetaxel, or cabazitaxel, between Jan. 1, 2010, and June 30, 2016 (cohort 1).