Surgery
A procedure called radical prostectomy may be recommended if the tumour is localised at the prostate. It involves the complete removal of the prostate and often includes the pelvic lymph nodes. This procedure is commonly used to treat early stages of prostate cancer. Some possible side effects of radical prostectomy include incontinence (not being able to control urine) and impotence (not being able to have erections). These side effects can also happen with other forms of treatment for prostate cancer.
Radiation Therapy
Radiation therapy uses high-energy beams to kill the cancer cells. External Beam Radiotherapy (EBRT) focuses radiation from outside the body on the cancer. EBRT techniques involved may include Three-dimensional Conformal Radiation Therapy (3D-CRT) where radiation beams are shaped and aimed at the tumour from several directions. Stereotactic Body Radiation Therapy (SBRT) uses highly focused beams of high-dose radiation given on one day or over several days. Brachytherapy is another form of radiotherapy that involves the surgical placement of permanent or temporary implants to deliver radiation to the prostate.
Hormone Therapy
Hormonal therapy is commonly used to treat prostate cancer when it has spread or in combination with radiotherapy when the cancer is locally advanced or high risk. Hormonal therapy can slow the cancer growth as it interferes with the growth stimulatory effects of male hormones on prostate cancer. There are two forms of hormonal therapy:
- Drugs that prevent the release or counter the action of male hormones
- Surgical removal of the testes which are a major source of male hormones
Chemotherapy
Though uncommon, chemotherapy plays a role in improving symptoms of prostate cancer if hormone therapy is ineffective. It is generally well-tolerated and can alleviate bone pain for most patients. Chemotherapy is usually given in cycles with each cycle lasting for a few weeks. The body is given time to recover during a rest period that follows each cycle of treatment.
Active Surveillance or Watchful Waiting
As some Prostate Cancers grow very slowly and may take many years to cause symptoms or spread, some men with diagnosed Prostate Cancer may not need immediate treatment. Active surveillance refers to a protocol that allows patients with localised Prostate Cancer to be observed safely for a period of time, and then for deferred treatment when necessary. Watchful waiting is also advocated as a reasonable approach for some men with Prostate Cancer (especially asymptomatic men with a limited life expectancy) who are observed and treated only when symptoms or spread occurs.
Energy Ablative Therapy
Energy ablative therapies such as cryotherapy have been offered as minimally invasive therapy options for highly selected men with localised Prostate Cancer. Cryotherapy involves placing cryoneedles into the prostate through the perineal skin, and uses controlled freezing and thawing to destroy Prosate Cancer cells. This form of treatment is sometimes used in men whose prostate cancer has returned following other treatments.