Prostate cancer treatment
Treatment for your prostate cancer is chosen after a thorough evaluation. Your health care provider will discuss the benefits and risks of each treatment.
Prostate cancer
Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-shaped structure that makes up part of a man's reproduc...
Read Article Now Book Mark ArticleSometimes your provider may recommend one treatment for you because of your type of cancer and risk factors. Other times, there may be two or more treatments that could be good for you.
Factors you and your provider must think about include:
- Your age and other medical problems you may have
- Side effects that occur with each type of treatment
- Whether the prostate cancer is localized or how much the prostate cancer has spread (described by the stage of the cancer)
Stage of the cancer
Cancer staging is a way to describe how much cancer is in your body and where it is located in your body. Prostate cancer staging helps determine ho...
Read Article Now Book Mark Article - Your Gleason score, which tells how aggressive the cancer is
Gleason score
Prostate cancer is diagnosed after a biopsy. One or more tissue samples are taken from the prostate and examined under the microscope. The Gleason ...
Read Article Now Book Mark Article - Your prostate-specific antigen (PSA) test result
Prostate-specific antigen (PSA) test
Prostate-specific antigen (PSA) is a protein produced by prostate cells. The PSA test is done to help screen for and monitor prostate cancer in men....
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Ask your provider to explain these things following about your treatment choices:
- Which choices offer the best chance of curing your cancer or controlling its spread?
- How likely is it that you will have different side effects, and how they will affect your life?
Radical Prostatectomy (Prostate Removal)
Radical prostatectomy is a surgery to remove the prostate and some of the surrounding tissue. It is an option when the cancer has not spread beyond the prostate gland.
Radical prostatectomy
Radical prostatectomy (prostate removal) is surgery to remove all of the prostate gland and some of the tissue around it. It is done to treat prosta...
Read Article Now Book Mark ArticleHealthy men who will likely live 10 or more years after being diagnosed with prostate cancer often have this procedure.
Be aware that it is not always possible to know for certain, before surgery, if the cancer has spread beyond the prostate gland.
Possible problems after surgery include difficulty controlling urination and erection problems. Also, some men need further treatments after this surgery.
Difficulty controlling urination
You have urinary incontinence. This means you are not able to prevent urine from leaking from your urethra. This is the tube that carries urine out...
Read Article Now Book Mark ArticleErection problems
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
Read Article Now Book Mark ArticleRadiation Therapy
Radiation therapy works best for treating prostate cancer that has not spread beyond the prostate. It may also be used after surgery if there is a risk that cancer cells are still present. Radiation is sometimes used for pain relief when cancer has spread to the bone.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleExternal beam radiation therapy uses high-powered x-rays pointed at the prostate gland:
- Before treatment, the radiation therapist uses a special pen to mark the part of the body that is to be treated.
- Radiation is delivered to the prostate gland using a machine similar to a regular x-ray machine. The treatment itself is usually painless.
- Treatment is done in a radiation oncology center that is usually connected to a hospital.
- Treatment is usually done 5 days a week for 6 to 8 weeks.
Side effects may include:
- Appetite loss
- Diarrhea
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Erection problems
Erection problems
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
Read Article Now Book Mark Article - Fatigue
- Rectal burning or injury
- Skin reactions
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Urinary incontinence, the feeling of needing to urinate urgently, or blood in the urine
Urinary incontinence
Urinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...
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There are reports of secondary cancers arising from the radiation as well.
Proton therapy is another kind of radiation therapy used to treat prostate cancer. Proton beams target the tumor precisely, so there is less damage to the surrounding tissue. This therapy is not widely accepted or used.
Proton therapy
Proton therapy is a kind of radiation used to treat cancer. Like other types of radiation, proton therapy kills cancer cells and stops them from gro...
Read Article Now Book Mark ArticleProstate Brachytherapy
Brachytherapy is often used for small prostate cancers that are found early and are slow-growing. Brachytherapy may be combined with external beam radiation therapy for more advanced cancers.
Brachytherapy
Brachytherapy is a procedure to implant radioactive seeds (pellets) into the prostate gland to kill prostate cancer cells. The seeds may give off hi...
Read Article Now Book Mark ArticleBrachytherapy involves placing radioactive seeds inside the prostate gland.
- A doctor (usually a radiation oncologist) inserts small needles through the skin beneath your scrotum to inject the seeds. The seeds are so small that you do not feel them.
- The seeds are left in place permanently.
Side effects may include:
- Pain, swelling, or bruising in the penis or scrotum
- Red-brown urine or semen
- Impotence
- Incontinence
- Urinary retention
- Diarrhea
Hormonal Therapy
Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer.
Hormonal therapy
Hormone therapy for prostate cancer uses surgery or drugs to lower the levels of male sex hormones in a man's body. This helps slow the growth of pr...
Read Article Now Book Mark ArticleHormone therapy is mainly used for cancer that has spread beyond the prostate, but it can also be used along with surgery and radiation to treat advanced cancers. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer.
The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist. Another class of therapy is called LH-RH antagonists:
- Both types of medicines block the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months.
- Possible side effects include nausea and vomiting, hot flashes, breast growth and/or tenderness, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence.
The other type of hormone medicine is called an androgen-blocking drug:
- It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone.
Adrenal glands
The adrenal glands are two small triangle-shaped glands in the upper abdomen. One gland is located on top of each kidney.
Read Article Now Book Mark Article - Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts.
Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment.
Chemotherapy
Chemotherapy and immunotherapy (medicine that helps the body's immune system fight the cancer) may be used to treat prostate cancer that no longer responds to hormone treatment. Usually a single drug or a combination of drugs is recommended.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark ArticleImmunotherapy
Immunotherapy is a type of cancer treatment that relies on the body's infection-fighting system (immune system). It uses substances made by the body...
Read Article Now Book Mark ArticleCryotherapy
Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue.
Cryotherapy
Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland an...
Read Article Now Book Mark ArticleCryosurgery is generally not used as a first treatment for prostate cancer.
References
National Cancer Institute website. Prostate cancer treatment (PDQ) - health professional version. www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Updated February 13, 2023. Accessed January 18, 2024.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): prostate cancer. Version 4.2023. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Updated September 7, 2023. Accessed January 18, 2024.
Nelson WG, Antonarakis ES, Carter HB, De Marzo AM, DeWeese TL. Prostate cancer. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 81.
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Prostate cancer
Animation
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Male reproductive anatomy - illustration
The male reproductive structures include the penis, the scrotum, the testicles (testes), the epididymis, the seminal vesicles, and the prostate.
Male reproductive anatomy
illustration
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Review Date: 10/15/2023
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.