There are many treatment options available for prostate cancer based on the stage of the disease progression. Work together with your doctor to weigh the risks, advantages, and disadvantages of each option and its side effects to determine what treatment is right for you or your loved one, alternatives to prostate cancer treatment.
Developed by hundreds of medical experts to provide step-by-step strategies that many doctors follow, the NCCN Guidelines are the most comprehensive and most frequently updated clinical practice guidelines available for any area of medicine. Prostate cancer is diagnosed as early-stage when cancer cells have not spread outside of the prostate, alternatives to prostate cancer treatment.
Aggressive treatment options include various types of prostatectomy, radiation therapy, cryosurgery or high intensity focused ultrasound.
The goal of all invasive options is to remove or destroy cancer cells before they can spread to alternatives to prostate cancer treatment tissues in the body. Watchful waiting describes a less invasive follow-up, where the patient forgoes implementing therapy or treatment, with fewer tests, unless symptoms arise or the prostate cancer spreads to other parts of the body. Active surveillance involves closely monitoring prostate alternatives to prostate cancer treatment with routine digital rectal exams DREsprostate specific antigen PSA tests - usually every 6 months, and periodic biopsies - often yearly.
Active treatment, such as surgery or radiation therapy, does not occur unless there is evidence that the cancer is growing. Active surveillance is considered appropriate for some men with very low- or low-risk prostate cancer. The surgical treatment for localized prostate cancer is a radical prostatectomy, an operation that removes the entire prostate along with both seminal vesicles and a portion of both vas deferens.
Outcomes may vary depending on the skill level and experience of the surgeon. An incision is made from just below the navel to the pelvic bone without damaging muscles. This allows the surgeon access to feel the prostate, surrounding tissues, and the pelvic lymph nodes, which can help the surgeon decide if a nerve-sparing radical prostatectomy is the best option based on the extent of the cancer. If all areas feel smooth, the nerves can be saved because they probably are not cancerous. However, if the surgeon feels a lump, hardness, or any other abnormality near the nerve, the safest approach is to remove one or both nerves.
There is no completely accurate way to confirm whether or not cancer is present in a pelvic nerve unless the nerve is removed and analyzed by a pathologist. The incision for this procedure is between the scrotum and the anus, alternatives to prostate cancer treatment. While there is less blood loss with this operation compared to the retropubic procedure outlined above, alternatives to prostate cancer treatment, the surgeon still has the ability to feel along the pelvic nerves to determine whether they can be saved or must be removed.
Recovery is generally faster compared to the RRP and patients have less blood loss. Three or four small incisions are made in the lower abdomen as access for surgical instruments and a telescopic lens that projects images onto a video monitor.
As with the laparoscopic procedure described above, this operation also begins by inserting a needle into the abdomen to inflate it with carbon dioxide thereby separating the abdominal wall from the organs and providing the space american cancer society fight back to perform the surgery. Three or four small incisions are made in the lower abdomen as access for surgical instruments and a telescopic lens that are attached to robotic arms, which are connected through special cables to instruments providing the surgeon with robotic control of the procedure through a three-dimensional view of the inside of the abdomen shown on a video monitor.
External beam radiation is a treatment for prostate cancer that uses a machine to deliver rays of high energy. It works on the DNA, which is contained in all living cells. DNA controls the ability of cells to divide. Cancer cells harm us because they continue to divide without stopping. The energy from radiation machines is so strong that it can damage the DNA in cancer cells, causing them to die or making them unable to divide.
Cancers are treated with alpha, beta, proton and neutron particles; and gamma and x-ray waves. Prostate cancer is most commonly treated using gamma rays. Cryotherapy is procedure that uses very cold temperatures alternatives to prostate cancer treatment kill prostate cancer cells. Although it has been used to treat prostate cancer for over 20 years, it has not been well studied in controlled trials, alternatives to prostate cancer treatment.
Cryotherapy is used to treat early stage, localized prostate cancer stages T1 and T2or cancer that recurs following radiation therapy.
This outpatient procedure is completed in several hours, under anesthesia spinal, epidural, local or generalafter which the patient is usually able to go home. In the procedure, a catheter is inserted alternatives to prostate cancer treatment bring a warming solution into the urethra to prevent freezing during the cryotherapy process. During cryotherapy, ultrasound imagery is used to accurately insert cryoprobe needles through the perineum into the alternatives to prostate cancer treatment between the anus and scrotum.
Cold argon gasses are passed through the needles into the prostate to freeze the cancerous areas. Helium is then passed through the same needles to thaw the frozen areas. The freeze-thaw is performed twice on each patient during the same anesthesia.
The freezing process kills the cancerous cells. The patient must fast no food or drink for at least eight hours prior to procedure. An enema may be used to empty the colon. An antibiotic may be administered to prevent infection, alternatives to prostate cancer treatment. Hormone therapy can sometimes be used prior to cryosurgery to decrease prostate size if the gland is thought to be too large.
This may require months of androgen suppression therapy. A catheter may need to remain in place for one to three weeks after the procedure.
It might be placed into the bladder through the lower abdomen to drain urine after the procedure. An appointment will need to be made with the doctor to remove the catheter. Antibiotics may be prescribed to prevent infection.
Regular checkups, imaging scans, and lab testing will be needed to monitor the response to treatment. Side effects tend to be worse in men who undergo cryotherapy as a second treatment than those who have it as a first treatment:.
If you are interested in cryotherapy, please talk to your doctor. Alternatives to prostate cancer treatment with all medical treatments, if you alternatives to prostate cancer treatment preparing to undergo the procedure, be sure to seek out medical professionals with extensive experience with the procedure. High-Intensity Focused Ultrasound HIFU is a relatively new, minimally invasive treatment that uses high frequency ultrasound waves to produce very high temperatures to destroy targeted cancer cells.
In some cases, it can reduce the need for more aggressive treatments. HIFU uses real-time imagery to reach specific, targeted areas with less impact on surrounding areas. The procedure has been used in Europe for over 10 years, but it has only recently been approved by the FDA in the US for ablation of cancerous tissue.
That being said, it will still be quite a few years until the efficacy of the treatment can be officially gauged. The HIFU procedure is generally performed in a single session on an outpatient basis, requiring no hospital stay.
It typically takes between hours. Treatment is usually performed under general anesthesia but spinal anesthesia is sometimes possible. In the procedure, alternatives to prostate cancer treatment, a probe is inserted through the rectum that will produce a detailed, 3D image of the prostate — showing the prostate and the cancerous areas.
Those specific, targeted areas are then treated with high intensity ultrasonic waves that emit from the same probe. The area destroyed by each wave is very small and precise. By repeating the process and moving the focal point, it is possible to destroy the cancerous tissue in the prostate.
The patient will not alternatives to prostate cancer treatment able to eat or drink six hours prior to the procedure.
After the procedure, the doctor will alternatives to prostate cancer treatment a catheter which might be left in for about a week. At that point, another office visit will be necessary to have the catheter removed. HIFU can potentially reduce side effects related to sexual function or urinary continence. These effects may still be there, alternatives to prostate cancer treatment, but they are usually comparatively mild and temporary.
There is also the possibility of blood in urine or urinary infection. There is usually some discomfort or pain for days after the procedure. HIFU is used to treat a single tumor or part of a large tumor and is not meant for those whose cancer has spread. Other insurance coverage is variable, and interested parties should contact their specific providers for more information. Prostate cancer cells require male hormones such as testosterone to grow.
Hormone therapy decreases production of testosterone by the testicles so that cancer cell growth slows down. The term most commonly used for this treatment is called androgen deprivation therapy or ADT.
Prostate cancer is advanced when cancer cells have spread to other parts of the body—or metastasized. When cancer has spread beyond the prostate, complete removal of the prostate or destruction of cancer tissue by radiation or cryosurgery is uncommon. For stage T3 and T4 prostate cancer, studies show that combining ADT with radiation can improve survival.
The administration of an injectable luteinizing hormone-releasing hormone LHRH agonist or antagonist that causes a drop in testosterone levels in the body. The administration of an injectable gonadotropin-releasing hormone GnRH receptor antagonist provides rapid, profound and sustained, suppression of testosterone, alternatives to prostate cancer treatment.
The administration of a drug called an antiandrogen that blocks the action of male hormones, including testosterone and androgens released by the adrenal glands.
The anti-androgen is continued until the PSA rises. When PSA rises, stopping anti-androgen can result in short-term benefit. Block conversion of testosterone to DHT, a more potent stimulator of prostate cell growth than testosterone.
Administration of estrogen hormones lowers testosterone production and has some direct apoptotic effects on both androgen-dependent and androgen-independent prostate cancer cells. The P enzymes are involved in the synthesis of several hormones, including testosterone, that stimulate prostate cancer cell growth. Inhibitors of these enzymes can decrease the levels of testosterone and adrenal androgens, and have direct cytotoxic effects on prostate cancer cells.
Prostate cancer that is no longer responsive to hormone therapy is referred to as hormone-resistant prostate cancer, hormone refractory prostate cancer HRPCcastrate resistant prostate cancer CRPC or androgen-independent prostate cancer, alternatives to prostate cancer treatment.
Several new therapies alternatives to prostate cancer treatment been approved in the past several years to treat CRPC. More studies are needed to determine the optimal sequencing of these new treatments. Oral agent that has been approved in combination with prednisone for CRPC. It acts by inhibiting an enzyme complex called CYP that is necessary for producing testosterone.
Studies show that this enzyme is present in the adrenal gland and in prostate cancer cells, alternatives to prostate cancer treatment. For more information about Zytiga, visit zytiga. Oral agent that has been approved for men with CRPC after they progress on chemotherapy. The FDA is currently considering an approval for men prior to alternatives to prostate cancer treatment. It works by interfering with androgen receptor signaling in prostate cancer cells.