Since prostate cancer advances slowly, some of those afflicted – especially older men – might never require treatment. As an alternative, their doctors may suggest less intrusive approaches, such as:
Active surveillance
A urologist uses active surveillance to monitor cancer closely with digital rectal exams, ultrasounds, and prostate-specific antigen blood tests to check the progression of the disease. Additionally, prostate biopsies may be done to determine whether the cancer is becoming more aggressive.
Watchful waiting
This is a less intensive follow-up technique that mainly includes observation, which means fewer tests. Watchful waiting relies on the change in symptoms and is recommended to people of advanced age. Such patients usually experience a better quality of life when they wait for the cancer to advance than when it is treated early.
Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells. There are two main types of radiation therapy: brachytherapy (internal radiation) and external beam radiation. The latter uses a machine that is outside the body to focus beams of radiation on the prostate gland. It is successful in treating early-stage cancers and relieving symptoms such as bone pain. Brachytherapy, on the other hand, uses radioactive pellets; they are placed directly into the prostate. Generally, this therapy is used to treat the early stages of cancer.
Robotic prostatectomy
In the past, the only surgical option was open prostatectomy which involved large incisions and post-operative side effects. However, Da Vinci robotic surgery – which uses surgical instruments – achieves better results than a surgeon’s hands. During surgery, the Da Vinci robot allows the surgeon to have improved precision, dexterity and visualization. Therefore, this procedure is safer as it reduces the surgeon’s fatigue during an operation. In addition, research has shown that surgery is more effective when treating cancer in younger men.
The selection of treatment options is a complicated process that involves many factors. When prostate cancer spreads to other areas of the body, the available treatment options change significantly. However, if it remains in the prostate, the best approach might be as simple as active surveillance, watchful waiting, brachytherapy, or external beam radiation therapy. Active surveillance is usually in order when treating slow-growing cancer. Watchful waiting may be recommended when the risks of radiation therapy and surgery outweigh the benefits. Surgery is a common treatment for early stage cancer or cancer that does not respond to radiation therapy treatment. St Pete Urology offers all of these forms of treatment to men of all ages.