What is Prostate Cancer?
Prostate cancer is cancer that begins in tissues of the prostate gland. The prostate is the male sex gland responsible for the production of semen and is located just below the bladder and in front of the rectum. A small, walnut-sized structure, the prostate wraps around the urethra, the tube that carries urine out of the body.
Every year, 1 in 7 men will be diagnosed with prostate cancer. This year alone, about 233,000 men will be newly diagnosed. If caught early, though, prostate cancer is one of the most treatable malignancies.
Most men diagnosed with prostate cancer do not die from it. More than 2.5 million men in the United States have been diagnosed with prostate cancer at some point during their lives and still are alive today.
Learn more about prostate cancer
Treatment and Side Effects
Because prostate cancer is one of the most treatable malignancies when caught early, it is important to consider the side effects of treatment when you and your physician discuss your treatment options.
Men who require treatment typically choose between surgery or radiation therapy. Many men, though, opt for active surveillance as a first step.
Active surveillance: In general, active surveillance could be an option for patients whose prostate cancer is not causing any symptoms, expected to grow slowly, and small and contained within the prostate.
During active surveillance, men are monitored closely for changes in the progression of their cancer and are tested at regular intervals. This treatment approach is reserved for men with slow-growing, localized cancers who are not experiencing symptoms related to their cancer.
Men are not treated with therapies such as chemotherapy, radiation or surgery unless their cancer appears to be growing or getting worse. In some cases, active surveillance may be the entire course of a man's treatment plan, as he and his doctor weigh the risks and benefits of aggressive cancer therapies.
Surgery: Whether a man is a candidate for surgery depends on factors such as the type, size, location, grade and stage of the tumor, as well as general health factors such as age, physical fitness and other medical comorbidities.
Surgery for prostate cancer is called a prostatectomy, which is the partial or total removal of the prostate.
Side effects of traditional surgery include:
- Urinary incontinence, the inability to control your urine
- Erectile dysfunction
- Loss of fertility
- Change in penis length
Because of a higher likelihood of sexual and urinary side effects, a prostatectomy using traditional surgical methods is typically not the preferred method of treatment. Advanced technology can reduce side effects.
At our hospitals, a prostatectomy done using our da Vinci® Surgical System often gives patients a better chance for a return of urinary continence and pre-surgery erectile function.
Radiation therapy: Radiation therapy uses targeted energy to kill cancer cells, shrink tumors and provide relief of certain cancer-related symptoms.
With advanced technology, radiation oncologists are better able to target difficult-to-reach tumors in the prostate. They also can direct higher radiation doses to prostate cancer cells while reducing exposure to nearby healthy tissue.
There are two primary types of radiation therapy for prostate cancer:
- External beam radiation therapy (EBRT): Delivers high doses of radiation to prostate cancer cells from outside the body using a variety of machine-based technologies.
- High-dose rate (HDR) brachytherapy (internal radiation): Delivers high doses of radiation from implants placed close to or inside the tumor(s) in the body.
Survival rates for men with low-grade cancer confined within the prostate gland are about the same as those for men who underwent a radical prostatectomy.
Side effects of radiation therapy include:
- Increased risk of bladder cancer and/or rectal cancer
- Impotence, though it may improve over time
- Urinary incontinence, though it’s less common than after surgery
- Bowel and bladder problems, though they usually improve over time
- Bowel problems, though most go away over time
CTCA has recently introduced an FDA approved treatment option for men with advanced stage prostate cancer, Radium 223 (brand name Xofigo). It is an injectable drug that uses radioactive particles to mimic calcium and targets cancer in the bones. Each dose is personalized based on the patient’s specific criteria. It can provide men a better quality of life, ease pain and show fewer side effects. It has numerous potential benefits including increased survival, decrease in bone pain, and improved quality of life.
The Calypso® 4D Localization System™ helps our doctors deliver focused doses of radiation with greater accuracy to prostate cancer patients receiving external beam radiation therapy.
Chemotherapy: Chemotherapy is typically used for advanced or metastatic prostate cancer. With chemotherapy, men receive anticancer drugs designed to interfere with and stop the growth of rapidly dividing cancer cells.
Prior to delivering chemotherapy, you may have tumor molecular profiling to identify chemotherapy drugs and other targeted therapies that are more likely to work for you. Choosing more effective drugs can avoid unnecessary toxicity to you and can target cancer cells as aggressively as possible from the start.
Side effects of chemotherapy include:
- Hair loss
- Mouth sores
At Cancer Treatment Centers of America®, we offer integrative oncology services such as nutrition therapy and mind-body medicine to help reduce or moderate chemotherapy-related symptoms. Prior to receiving chemotherapy, you may receive pre-medications to help reduce nausea and vomiting.
Immunotherapy: Immunotherapy also is typically reserved for metastatic and more advanced disease. Immunotherpay uses the body's immune system to fight cancer. This treatment option may be used alone or in conjunction with other treatments, such as radiation therapy and hormone therapy.
Side effects of immunotherapy include:
- Flu-like symptoms: fever, chills, nausea and loss of appetite
- Blood pressure changes, usually a decrease
- Decrease in blood pressure
- Bone pain
- Muscle aches
Hormone therapy: Hormone therapy is a form of systemic therapy that works to add, block or remove hormones from the body to slow or stop the growth of cancer cells. Hormone therapy for prostate cancer deprives cancer cells of the male hormones they need to grow.
Hormone therapy is often done in combination with radiation and other therapies for prostate cancer. It may be used to shrink advanced prostate cancer tumors so they can be treated with radiation.
A common regimen for prostate cancer therapy uses a combination of two or more drugs to lower the level of testosterone and other hormones that can fuel the disease. In some cases, hormone therapy may be given intermittently to help reduce treatment-related side effects.
Side effects of hormone therapy include:
- Mood changes
- Low libido
- Erectile dysfunction
- Decreased muscle mass
- Loss of bone density and increased risk of fracture
- Weight gain