The goal of prostate cancer treatment is to keep the disease under control. Not all patients necessarily require intervention. Some patients are kept under follow-up. It is aimed not to affect the daily activities of the patient and not to harm other organs and tissues. Some patients may be diagnosed in the late period for intervention. Treatments that will make the patient’s life easier and relieve their complaints are recommended for these.
Prostate cancer treatment is planned by a team of experts. The age of the patient, whether there is an additional disease, the stage, type and spread of the cancer will affect the treatment plan. The treatment plan is made with the recommendation of the expert team and the approval of the patient.
All treatment options applied in the treatment of prostate cancer have more or less side effects. The follow-up team will also monitor the side effects and support the patient when necessary.
Table of contents
Prostate Cancer Treatment Options:
Follow-up:
Some types of prostate cancer do not grow quickly and spread late to surrounding tissues or organs. Especially in early stage prostate cancers, if the risk is low, the patient can be followed up without any intervention. This option is often applied with the concern that the patient will not be able to tolerate age, additional disease, and treatment-related side effects. During the follow-up phase, the patient’s PSA value is monitored at regular intervals, examinations are performed, and if necessary, the size of the cancer and the risk of spread are evaluated with imaging methods.
Surgical Treatment:
It can be applied as an option in prostate cancers that have not spread to surrounding tissues or organs, or in advanced cancers that narrow the ureter. Prostate tissue is radically removed along with lymph nodes, vessels and surrounding tissue.
It can be open surgery as well as closed laparoscopic surgery and robotic surgery. The patient stays in the hospital for 3-7 days, depending on the type of surgery performed. Complications related to anesthesia may include bleeding, urinary problems, pain. These are complications that can be easily overcome with supportive treatments.
PSA values recover rapidly after surgery. Some patients may have complaints of frequent urination, urinary incontinence, blood in the urine. Erection problems are seen. Due to the risk of infertility, patients may want to keep their sperm samples in order to benefit from the in vitro fertilization method in the future.
There is a risk of recurrence in the following years in patients who have undergone surgical treatment.
Cryotherapy:
It can be used especially in cancers that have not spread to other organs and are limited to the prostate. Prostate tissue is frozen by entering through the rectum. In this way, cancerous cells are killed and their progression is stopped. It can also damage healthy tissues. Erection problems and infertility can be seen. It is not widely used.
Radiotherapy:
It is as effective a method as surgical treatment. It can be applied on the skin or inside the penis. It is usually applied over the skin. Treatment takes about 8 weeks. Radiation is given for about 10 minutes, 5 days a week. In the meantime, it is important to protect their healthy tissues.
It can be used alone for treatment in early stage prostate cancers. It can also be used to assist other treatment options, shrink the tumor tissue, relieve the patient’s complaints in advanced cases, and make life easier.
Hormone therapy can be applied together with, before or after. In this way, it is aimed to both reduce the area where the radiation is applied and to reduce the risk of cancerous cells remaining behind.
Before radiotherapy, computed tomography is applied to the patient. The aim is to determine the boundaries of the tumor area. Since radiation damages normal cells as well as cancer cells, other healthy tissues must be protected.
Possible side effects of radiotherapy:
- Weakness,
- Frequent urination (especially from the 3rd week of treatment),
- blood in the urine,
- Bleeding from the rectum
- There may be susceptibility to infections.
Most of the side effects improve after treatment. However, urinary incontinence may continue in some patients. Erection problems are seen. It could be infertility.
PSA values do not drop immediately. Sometimes there may be some increase with treatment. It may take 2 years for PSA values to recover.
Since there is adhesion in the prostate tissue and surrounding tissues with radiotherapy, the chance of surgical treatment decreases in case of recurrence. Therefore, radiotherapy should be well planned.
Hormone therapy:
The aim is to introduce cancer cells to the body. It is often used in combination with other treatments. Hormone therapy before radiotherapy reduces the area of the prostate to be irradiated. Afterwards, it prevents cancer cells from remaining behind.
Hormone therapy is given to cut off the nutritional supply of testosterone-sensitive prostate cancer cells. It is desired to stop the production of testosterone or to inhibit its functions. For this purpose, orchiectomy can be applied, or oral or intravenous drugs can be given.
Some side effects of hormone therapy such as fatigue, sweating, weight gain, and hot flashes can be seen.
Chemotherapy:
Chemotherapy can be used in patients whose prostate cancer has spread to other organs or tissues. It may not cure the cancer, but it controls its spread and reduces the patient’s complaints. The follow-up team determines whether the patient needs chemotherapy and, if so, what kind of treatment protocol will be applied.
Chemotherapy treatments have some side effects. Susceptibility to infections, hair loss, mouth sores, loss of appetite, weakness, fatigue, nausea, vomiting are some of them. Side effects vary according to the treatment protocol used. The treatment team informs the patient about possible side effects, teaches methods of struggle, and applies supportive treatments if necessary.
Steroids:
Steroids (dexamethasone, etc.) are used to shrink the tumor and stop its progression in cases that are well advanced and do not respond to hormone therapy.