Prostate cancer is to men what breast cancer is to women, it is common, it is frightening, and with early detection, treatment or surgery usually takes care of it. Statistics show that “one out of every two diagnosed with prostate cancer is 72 years old, or older.” Often they die of something else or as WebMD stated it, they will die with it rather than of it. The prostate gland is a small walnut sized gland located under the bladder and its function is to produce fluid for semen.
Younger men, beginning at about age 40, are urged to get screened for prostate cancer; it’s more serious and isn’t easily managed when testosterone levels are higher and more active. Removal of the gland—radical prostatectomy—is often advised when men are younger and are not debilitated with other diseases or disabilities where surgery might do more harm than good. Familial incidences of early prostate cancer such as two or three members, father, grandfather, uncles, brothers, demands regular prostate checkups.
Other types of treatment are radiation therapy, external beaming or radioactive tumor seeding—brachytherapy. Radiation has quite extensive side effects, or potential for extensive side effects that patients must know before deciding upon options. Improvements, showing lesser damaging side effects are now coming on the scene and promise to redefine not only prostate surgery but surgery in general. Recent innovations have introduced a technique of surveying the area with a three-dimensional imaging system that shows precisely where the cancer cells are.
The idea is if a powerful beam can hone in on the cancer cells while not interfering with surrounding healthy tissue, muscles and organs, there is less chance of damaging nerves, urethra, or lower bowels. Specifically, intensity-modulated radiation therapy (IMRT) is being done with “lower incidence of side effects in the urinary tract or bowels,” according to WebMd.
Another form of treatment is simply doing nothing but watching the progress of the disease carefully. This of course isn’t a treatment in the usual sense of the word, but with certain low level types of cancer, dependent upon the age of the patent, it is an option. Prostate cancer is spoken of as type 1, 2, 3 or four. Four is the more advanced and I is mild. The cancer cells in the type 1 only slightly varies from normal cells, whereas in type 4, they are abnormal and bear little resemblance to normal cells.
As an example of careful management: An older man, nearing 80 is diagnosed with a type one cancer but his other ailments, high blood pressure, diabetes, and general frailness, are far more serious. Therefore not making him a hopeful candidate for either surgery or radiation therapy, he will be carefully monitored and will be urged to eat a well-balanced diet with less read meat and fatty foods and one that includes lots of green leafy vegetables and fruits
With the newer treatment methods more and more physicians, oncologists in particular, believe the best option is simply to watch and to wait, and give the body time to overcome their illness. Some cancers are slow growing and while never actually healing, progress at such a slow rate, there is little imminent danger.Good medicine is doing no wrong and sometimes the cure or the treatment does more damage than the disease would have had “active surveillance, expectant management, or watchful waiting” been the choice of treatment.
Low risk cancer makes up 50% of all cancers diagnosed, according to WebMD. How is this determined? A prostate-specific antigen (PSA) test lower than 10; aggressiveness scale score of 6 or less on a scale of 2-10; the tumor is not felt when digitally examined rectally and can be determined by biopsy (stage T1c); cancer found in one half lobe (stageT2a). Often this group may fall into the wait and see groups, but as already mentioned, it depends on the circumstance, the agreement of the patient, and the probabilities of the outcome of the study or cautious approach.
The newest treatment is hormone therapy or androgen deprivation. It is seldom advised for younger men and at best it is questionable. How do these work? The drugs used in hormone therapy are LHRH (luteinizing hormone-releasing hormone) agonist. These include several groups of drugs that mimic the actions of the hormones and “trick the body into exhausting its supply of testosterone.” The drugs of choice mostly are Zolodex, Lupron and Trelstar. These long-lasting injections are given monthly or four times a year or can be delivered by way of an under-the-skin implant that is renewed annually. Anti-androgen drugs are oral drugs and are taken daily; their action is to block the effect of dihydrotestosterone on the cancer cells. The ones most often used are Casodex, Fulexin, and Nilandron.
What factors contribute to the decision making as to which type of treatment? Age and general health play a large role. A person with a serious heart disease may find one of the other, surgery or radiation, too risky and would much prefer the wait and see option. Of course age would also be a factor. The most general side effects are incontinence, erectile dysfunction, urine leakage, may also make a prostate cancer victim choose one type of treatment over the other.