Prostate Cancer Treatment: What Are Your Options?
Prostate cancer treatment may start with active surveillance or watchful waiting before moving on to surgery, radiation, hormone therapy, and other types of treatments.
Prostate cancer is often slow growing, and for men without symptoms or long-term health issues, immediate treatment isn’t always required. Depending on various factors, such as your age, health, cancer stage, and preferences, your doctor may recommend one or more of the following treatment options.
Because prostate cancer is usually slow growing, taking a “wait and see” approach may be recommended unless there are other health issues to consider.
In active surveillance, your doctor keeps track of the prostate cancer’s growth by regularly performing tests such as:
In watchful waiting, your doctor will be tracking prostate cancer symptoms rather than doing testing. The goal is to observe the prostate cancer until it has metastasized (spread to other parts of the body) or is causing symptoms such as pain or blockage of the urinary tract. Watchful waiting is often recommended for men with compromised health who want to avoid repeated tests and biopsies.
While observation and active surveillance is often the first course of action, treatments may be started if:
You and your doctor will decide which of the following treatments are best for you.
Cancer that has not spread beyond the prostate gland can be treated with a prostatectomy, which means removal of the prostate.
The major possible side effects of all types of prostate cancer surgeries include:
Radiation therapy uses high-energy rays to destroy the cancer. It is one of the most common treatments for prostate cancer and can be delivered by the following methods:
In most cases, radiation therapy for prostate cancer is used when:
Common side effects of radiation therapy are fatigue, hair loss and skin discomfort, erectile dysfunction, and urinary and bowel issues. There is also an increased risk for cancers of the gastrointestinal or urinary tracts.
Hormone therapy works by removing or blocking the male sex hormones (androgens) like testosterone that can cause prostate cancer cells to grow. Hormone therapy may be used:
Hormone therapy treatments include the following:
Drugs used in hormone therapy for prostate cancer (also called medical castration) prevent the pituitary from telling the testicles to produce androgens. Drugs approved for this use in the United States include the following:
Other drugs for hormone therapy include androgen receptor blockers, which reduce the ability of androgens to encourage cancer cell growth. In the United States, these include:
Androgen synthesis inhibitors prevent the production of androgens in all tissues that produce them. Androgen synthesis inhibitor drugs approved in the United States include:
Another type of hormone therapy involves a surgical procedure called an orchiectomy (also called surgical castration) to remove one or both testicles.
Hormone therapy, either through drugs or surgery, has many possible side effects, including:
Various other treatments may be used for prostate cancer, each of which has its own benefits, harms, and side effects.
Chemotherapy is used to shrink or kill the cancer. There are a range of possible chemo agents, and most, including cabazitaxel (Jevtana), docetaxel (Taxotere), and mitoxantrone (Novantrone), are given intravenously. Estramustine (Emcyt) is taken as a pill. Chemo drugs travel through the bloodstream and can have side effects such as hair loss, digestive issues, fatigue, and greater chance of infections.
Immunotherapy uses the body's immune system to kill prostate cancer cells. Sipuleucel-T (Provenge) is a cancer vaccine typically used to treat advanced prostate cancer that hasn’t responded to hormone therapy. A newer type of immunotherapy uses checkpoint inhibitors that tell “checkpoint” proteins on immune cells to attack only cancer cells but not normal cells. The checkpoint inhibitor drug pembrolizumab (Keytruda) has shown promising results and continues to be studied.
Cryotherapy is less invasive than surgery and involves using a very thin needle to insert very cold gasses that freeze and destroy the prostate. Cryotherapy may be used if the cancer has returned after radiation therapy, but it’s typically not the first treatment for prostate cancer.
High-intensity focused ultrasound, also less invasive than surgery, uses a focused beam of energy to destroy any or all of the prostate gland. It may be used for cancers that didn’t respond to radiation treatment or as a complement to drug therapy.
Targeted drug therapy is a newer type of therapy often used when chemo and hormone therapy don’t work. These include PARP (poly[ADP]-ribose polymerase) inhibitors like olaparib (Lynparza), rucaparib (Rubraca), and talazoparib (Talzenna). Like chemo and hormone therapy, these drugs enter the bloodstream to fight cancer that has spread to distant parts of the body.
Bisphosphonate therapy with drugs such as zoledronic acid (Zometa) can slow the growth of cancer in the bones, relieve pain, and strengthen the bones in cases where prostate cancer has spread to the bones. (This is where prostate cancer usually spreads first.) If zoledronic acid isn’t effective, denosumab (Xgeva) can also be used to strengthen bones. Denosumab can also be used for men whose hormone therapy is causing weakened bones.
RELATED: Boost Your Quality of Life During Prostate Cancer Treatment
©2025 sitename.com All rights reserved