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The treatment choices for prostate cancer depend on several things. These include your age, personal preferences, and overall health, as well as the size and location of the cancer. Options also depend on lab test results and the stage of the cancer. When prostate cancer is only in the prostate or has only spread to nearby areas, it is called early-stage prostate cancer. This means stage I and II, and some stage III prostate cancers. It’s also called localized or local prostate cancer.
You may have questions and concerns about your treatment options. For example, you may want to know if treatment will affect your urinary or sexual function. You may also want to know if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects might be. Your healthcare provider may advise a specific treatment or a specific combination of treatments. Or he or she may offer more than one option, giving you a choice. This can be a hard decision to make. Each type of treatment has different benefits and risks. You may want to learn all you can about your cancer and treatment choices so that you can make decisions about your care.
Talk with your healthcare provider to get answers to your questions. It’s important to take the time to make the best decision for you.
The goal of active surveillance is to watch a cancer that is growing very slowly and will not likely do any harm for a long time, if ever. Active surveillance is done because the treatments for prostate cancer can cause more harm than living with the disease. This may be a strategy for you if your cancer is only in the prostate, does not cause symptoms, and is not likely to shorten your life. Active surveillance usually invovles PSA tests, rectal exams, and biopsies done on a regular schedule. If the cancer starts growing faster or begins to cause symptoms, treatment can be started.
The main goal of surgery is to cure the prostate cancer by removing all the cancer cells. This surgery is called a prostatectomy. The prostate is removed and nearby tissues and lymph nodes may also be removed.
Radiation therapy uses radioactive beams to kill or shrink cancer cells. There are 2 ways to get radiation therapy. One way sends radiation to the cancer from a source outside your body. This is called external beam radiation therapy (EBRT). For this, a machine sends a beam of radiation to your prostate. The other type of radiation therapy, called internal radiation or brachytherapy, sends radiation to the cancer from a source inside your body. For this, tiny radioactive metal seeds are placed into your prostate using thin, hollow needles. Early-stage prostate cancer treatment may include EBRT alone, brachytherapy alone, or a combination of the two.
Cryotherapy or cryosurgery freezes and kills the cancer cells before they have a chance to spread. The healthcare provider makes a tiny incision (cut) and puts a thin metal, needle-like probe into the prostate so the tip is at the tumor. The probe sends liquid nitrogen into the tumor to freeze the cancer cells. This is not a common first treatment for prostate cancer.
The goal of hormone treatment is to lower or block male hormones, such as testosterone, which can cause the cancer to grow. Hormone therapy may involve hormone shots done once a month or every few months. Another way is to have surgery to remove the testicles. (The testicles make most of a man's testosterone.) Hormone therapy is not a common treatment for early-stage cancer. It doesn't cure prostate cancer, but it slows its growth. Still, hormone therapy may be used along with radiation therapy in cases where:
The cancer has grown outside the prostate but has not spread to other parts of the body (known as locally advanced prostate cancer)
The cancer has a high risk of coming back after treatment
At first, thinking about treatment options may seem overwhelming. Talk with your healthcare providers and loved ones. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.
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