Prostate cancer

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Male reproductive anatomy

Prostatectomy - series

Prostate cancer

Alternative Names:

Cancer - prostate
Treatment:

The appropriate treatment of prostate cancer is often controversial. Treatment options vary based on the stage of the tumor. In the early stages, surgical removal of the prostate (prostatectomy) and radiation therapy may be used to eradicate the tumor. Metastatic cancer of the prostate may be treated by hormonal manipulation (reducing the levels of testosterone by drugs or removal of the testes) or chemotherapy.

text continues below

SURGERY

Surgical treatment is usually only recommended after thorough evaluation and discussion of treatment options. A man considering surgery should be aware of the expected benefit of the procedure, as well as its potential risks.

Removal of prostate gland (radical prostatectomy) is often recommended for treatment of localized stage A and B prostate cancers. This is a lengthy procedure, usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineal area. You may remain in the hospital for 5 to 7 days. Possible complications include impotence and urinary incontinence, although nerve-sparing procedures may reduce the risk of these complications. This surgery should be performed by a urologist with extensive experience doing this specific procedure.

Orchiectomy alters hormone production and may be recommended for metastatic cancer. There may be some bruising and swelling initially after surgery, but this will gradually subside. The loss of testosterone (hormone) production may lead to problems with sexual function, osteoporosis (thinning of the bones), and loss of muscle mass.

RADIATION THERAPY

Radiation therapy is used primarily to treat prostate cancers classified as stages A, B, or C. Whether radiation is as good as prostate removal is a debatable topic, and the decision about which to choose can be difficult. In patients whose health makes the risk of surgery unacceptably high, radiation therapy is often the preferred alternative. Radiation therapy to the prostate gland may be performed in a number of ways:

External beam radiation therapy is performed in a radiation oncology center by specially trained radiation oncologists, usually on an outpatient basis. Prior to treatment, a therapist will mark the location that is to be radiated with a special semi-permanent marking pen. The radiation is delivered to the prostate gland using a device that resembles a normal x-ray machine. The treatment itself is generally painless. However, there are several side effects associated with radiation therapy -- loss of appetite, fatigue, skin reactions such as redness and irritation, rectal burning or injury, diarrhea, cystitis (inflamed bladder), and blood in urine. External beam radiation therapy is usually performed 5 days a week for 6 - 8 weeks.

Another method consists of implanting small pellets of radioactive iodine, gold, or iridium directly into the prostate tissue through a small incision. The advantage of this form of radiation therapy is that the radiation is directed at the prostate with less damage to the surrounding tissues.