The prostate is a walnut-sized gland in men. It surrounds the urethra. The prostate makes a fluid that is part of semen. Prostate cancer is a disease in which cancer cells grow in the prostate gland.
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The sooner prostate cancer is treated, the better the outcome. Call your doctor right away if you think you have this condition.
Once prostate cancer is found, tests are done to find out if the cancer has spread and, if so, to what extent. Treatment depends on how far the cancer has spread. You will work with a team of specialists to develop a treatment plan for you.
Treatment options include:
This involves your doctor monitoring the cancer to see if it is growing. Watchful waiting may be appropriate if you:
- Have early stage prostate cancer that is growing slowly
- Are of an advanced age
- Have serious health problems (risks of treatment outweigh the benefits)
involves the use of radiation to kill cancer cells and shrink tumors. Examples include:
- Conformal radiation therapy—conformal radiation therapy uses three-dimensional radiation beams that are conformed into the shape of the diseased prostate. This treatment spares nearby tissue the damaging effects of radiation.
- Intensity-modulated radiation therapy (IMRT)—IMRT
uses radiation beams of different intensities to deliver higher doses of radiation therapy to the tumor and lower doses to nearby tissues at the same time.
If prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones, called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth. Examples of hormone therapy include:
- Luteinizing hormone-releasing hormone (LHRH) analogs (such as goserelin, histrelin, leuprolide, triptorelin)—these drugs cause testosterone to drop to a very low level.
- Luteinizing hormone-releasing hormone (LHRH) antagonists (such as degarelix)—these also reduce the testosterone level, but do so faster and without the surge of testosterone that happens with the LHRH analogs.
- Anti-androgens (such as bicalutamide, flutamide, nilutamide)—these drugs work by interfering with the body's ability to use androgens.
- Other types of hormone therapy, such as:
- Estrogen therapy—rarely used now unless other treatments are not working
- Ketoconazole—affects the production of androgens
- Abiraterone—may be used in cases where prostate cancer does not respond to other treatments
- Orteronel (experimental drug)—affects the production of androgens
- Enzalutamide—affects the production of androgens
- Abiraterone—may be used in advanced stages of prostate cancer
In some case, a type of surgery called orchiectomy may be needed. This involves removing the testicles, which stops androgens from being produced.
Other Treatment Options
Other options may include:
- Cryosurgery—this involves using an instrument to freeze and destroy prostate cancer cells
Chemotherapy—if prostate cancer has spread and other treatments have not been effective, chemotherapy may be used. There are range of chemotherapy drugs available, such as:
- Docetaxel (this is usually the first chemotherapy drug that is tried)
- Immunotherapy—Immunotherapy is a drug treatment that aims to build your immune system so that you can better fight cancer cells. Sipuleucel-T is a type of immunotherapy that is approved to treat prostate cancer that has spread.
- Targeted therapies—Targeted therapies focus on the cancer cells, rather than attacking both the cancer cells and the healthy cells. Some examples include:
- Selective endothelin A receptor antagonist (SERA)—interferes with the process that cancer cells go through to grow
- Anti-angiogenic drugs—blocks the formation of new blood vessels, which stops the growth of the cancer cells
- Tyrosine kinase inhibitors (such as Imatinib)—blocks the protein that triggers the cancer cells to multiply
- High-intensity focused ultrasound—This treatment involves using an endorectal probe (a probe that is inserted into the rectum) to destroy cancer cells with ultrasound energy.