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Prostate Cancer

Prevention & Treatment

Monday, Aug. 27, 2007; 7:46 PM

Copyright Harvard Health Publications 2007

Prevention

Table of Contents

There is some evidence that prostate cancer is less common in men who regularly eat a low fat diet that is rich in lycopene (an antioxidant released when tomatoes are cooked).

Prostate cancer can be treated by blocking or lowering the levels of the male hormone testosterone. One large study looked at whether the testosterone-blocking drug finasteride (Proscar) can prevent prostate cancer. While men taking this drug had a lower risk of developing prostate cancer, they also appeared more likely to be diagnosed with an aggressive form of the disease. For this reason, experts are divided as to whether finasteride should be offered to men who have a higher than average risk of prostate cancer.

Treatment

Prostate cancer can be treated several ways. Together, you and your doctor should weigh many important medical and lifestyle issues before deciding on a treatment plan. Ultimately, the best treatment for you will take into account:

  • The extent of your cancer

  • The chances that your cancer will grow and spread rapidly

  • Your age and life expectancy

  • Any health conditions that would increase the risks of surgery or other treatments

  • Your willingness to risk side effects

If your cancer is confined to the prostate gland alone and has not penetrated the prostate capsule, you have at least three treatment options:

  • Watchful waiting - In this approach, you will not be treated immediately. Instead, your doctor will monitor the status of your cancer through regular examinations and PSA tests. This strategy generally is reserved for men whose biopsy shows a low Gleason score (nonaggressive tumor). It also is a good option for elderly men who are too ill to tolerate radiation or surgery, or who have other serious medical conditions that limit their life expectancies.

  • Radiation therapy - Radiation therapy can take two forms. In external-beam radiation, you receive five to seven weeks of treatments from a machine that aims radiation at your prostate. In brachytherapy, radioactive seeds or pellets are implanted directly inside your prostate using a sterile needle guided by either ultrasound or MRI. Side effects of radiation therapy can include impotence, diarrhea, rectal bleeding and incontinence. More men experience side effects from external-beam radiation than from brachytherapy.

  • Surgery - Your doctor may suggest that you have a procedure called radical prostatectomy, which removes your entire prostate gland, seminal vesicles and sometimes the nearby pelvic lymph nodes. Side effects from this procedure can include incontinence and impotence. Both incontinence and impotence are more common after radical prostatectomy than after radiation therapy. However, some experts believe that surgery offers the best chance of curing prostate cancer. A "nerve-sparing" surgical technique can help to preserve sexual potency in many men who undergo radical prostatectomy.

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