Prostate Cancer Treatment Introduction

Different types of treatments have different goals. Below is a list of various treatments with their respective goals.

• Watchful waiting. The goal of watchful waiting is to monitor or check cancer that is very slowly growing and will likely not do any harm for a long time, if ever. Sometimes the treatments for prostate cancer may be worse than living with the disease. As long as the cancer does not bother the man and is not likely to shorten his life this is a sound strategy.

• Surgery. The goal of surgery is to remove the tumor, which requires removing the prostate and possibly the surrounding tissue and lymph nodes.

• Radiation therapy. The goal of radiation therapy is to kill cancer cells using X-rays. Radiation may be used instead of surgery, either externally or internally, with the use of seeds (small pellets of radioactive material).

• Hormonal therapy. The goal of hormonal therapy is to lower or block male hormones, such as testosterone. This does not cure the cancer but slows the growth of the prostate cancer. Lowering of the testosterone can be accomplished by removing the testicles (orchiectomy) or by injections. Sometimes a pill may also be given that can block testosterone.

• Chemotherapy. Chemotherapy is usually recommended for men whose cancer has stopped responding to hormone therapy.  Chemotherapy does not cure the cancer but can decrease the pain associated with the prostate cancer, shrink the tumor and decrease the PSA. It may also help men live longer.

• Vaccine therapy. A prostate cancer vaccine may be recommended for some men whose advanced cancer has stopped responding to hormone therapy but is not causing major symptoms. The vaccine does not cure the cancer but may help men live longer.

Doctors are always finding new ways to treat prostate cancer. These new methods are tested in clinical trials. Before beginning treatment, a person should ask their doctor if there are any clinical trials they should consider.

Observation or "Watchful Waiting" for Prostate Cancer

Sometimes it may be in the man's best interest not to treat the prostate cancer. For older men whose prostate cancer is growing slowly and is found at an early stage, treatment may have more side effects than benefits, and therefore may not be recommended. Treatment may also not be recommended for older men with other serious medical problems for these same reasons. In these cases, the doctor may suggest "watchful waiting," which means monitoring the patient closely and only treating him if the cancer begins to grow or if symptoms arise. Researchers are currently studying men with early-stage prostate cancer to find out when such men benefit the most from treatment.

Questions to Ask About Treatment

At first, the information you receive about treatment options may seem overwhelming. It is important that you take the time to gather as much information as possible about your disease and its treatment, and to discuss the issues with your doctors, nurses and loved ones. Your doctor is the best person to answer your questions about treatment.

Many people find it helpful to make a list of their questions before seeing their doctor. To make it easier to remember what the doctor says, you may want to take notes or ask if you can use a tape recorder. It might also help to have a family member or friend with you to take part in discussion, to take notes, or just to listen.