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Prostate Cancer Treatment

The risk of prostate cancer increases with age; therefore, it is the most common of the male cancers, and involves mostly men aged over 50 years. This is the second leading cause of cancer death in men after lung cancer. Although treatment of prostate cancer depends somewhat on its stage; however, the most common therapeutic methods of treating prostate cancer include the following:   

Active Surveillance (Watchful Waiting) - monitoring closely without immediate medical treatment is sometimes the best option for certain prostate cancer patients: elderly patients having a non aggressive cancer. Though diagnosed with cancer, these patients are more likely to die with the cancer but not by the cancer. Therefore, possible complications or side effects of treatment will cause more problems than good. 

Treatment of pain - in advanced cases, especially when there is bone metastases, pain may result in impaired quality of life and require special treatment. Some drugs such as bisphosphonates can slow bone lesions associated with the prostate cancer and decrease pain. In case of severe pain and medications do not provide relief, other methods may be used to treat bone pain, mainly internal radiation therapy or/and implantation of radioactive seeds ( brachytherapy) 

Radical Prostatectomy – this surgical procedure is performed to remove the entire prostate gland, the seminal vesicles and deferential bulbs, while preventing damage the nervous system inherent to the prostate so as not to cause urinary incontinence (loss of urine) in case of injury or damage to the sphincters. While useful, radical prostatectomy is likely to cause complications such as hematoma (blood collection), infection, and impotence - due to nerve damage erectors that are damaged or destroyed. In addition, radical prostatectomy can lead to: 

  • inflammation of a vein accompanied by its obstruction (phlebitis) 
  • development of a blood clot in the circulation of the lungs (embolism) 
  • narrowing of the urethral canal (urethra: the tube carrying urine from the bladder to the outside) 
  • lymphorrhea or lymphorrhagia (an escape of lymph from a damaged vessel of the lymphatic system).

Electron Beam Radiation Therapy (EBRT) - this therapy is done by linear accelerators that deliver radiation to the prostate and seminal vesicle; you may receive two or three sessions per week for about a month and a half. This technique causes fewer complications compared to prostatectomy; however, it is less efficient because all prostate cancer cells are not always destroyed. Complications result from external beam radiation are especially cystitis (bladder inflammation), bowel incontinence (inability to hold stool) and impotence (after a year in half in 50% of cases). 

Brachytherapy or Internal Radiation - Prostate brachytherapy involves implanting permanently or temporary radioactive sources (iodine 121 or palladium 103) in the prostate gland to deliver radiation to destroy cancer cells. Unlike surgery (prostatectomy) or external radiation therapy, brachytherapy causes fewer side effects and preserves other surrounding tissues. Prostate brachytherapy is indicated if there is no trouble of urination before treatment. Prostate brachytherapy can cause irritation and sometimes obstruction of the passage of urine.  

Hormone therapy : testosterone (the most well-known of androgenic hormones) is produced by the testes and can be an active agent of proliferation of cancer cells in the prostate gland. Therefore, hormone therapy can be used to reduce the level of male hormones (androgens). Hormone therapy drugs are often used to treat prostate cancers that have spread beyond the prostate gland. In some cases, therapy can also be used to treat cancer localized to the prostate to reduce prostate volume to facilitate surgery or especially radiation therapy.  

Combination of Hormone and Radiation Therapy - The use of radiation therapy in combination with hormone therapy works better in treating prostate cancer. This association is usually used in the treatment of advanced cancer. The use of hormones in prostate cancer seems to give better results than the use of radiotherapy alone. 

Chemotherapy – in this therapy, your oncologist uses strong chemicals to kill or damage cancer cells. Chemotherapy is used to treat aggressive prostate cancer, especially metastatic prostate cancer that has evolved with extraprostatic extension and unresponsive to hormonal treatment. Chemotherapy reduces tumor growth and may reduce pain associated with the cancer