Medically reviewed by Dr. Paul Song M.D
When men get a diagnosis of prostate cancer, often all they want to do is get rid of the cancer no matter what. This is understandable; it takes time to process the information they have just received and to think about the responsible course of action to take. Soon after, however, it’s time to sit down with a knowledgeable healthcare provider and discuss your treatment options. That introduces a critical question.
How Do I Choose My Treatment Doctors?
Choosing the right doctors should be at the top of your list, because these are the individuals you will be counting on to help guide and instruct you during your journey with prostate cancer. It’s important for you to feel comfortable and confident with the professionals you choose. Many men are limited to the physicians covered by their insurance plan, but be sure to investigate all of your options in that pool of urologists and cancer specialists.
Generally, doctors who treat prostate cancer tend to recommend the procedures they are accustomed to performing. Therefore a surgeon will recommend surgery, a radiation oncologist will suggest radiation, and so on. Keep this in mind when you are considering your treatment options and make sure you explore all the options before making a decision.
Whatever approaches you are considering, you should set aside time with all the members of your treatment team to discuss all the available options as well as all aspects of the treatment both pre and post procedure. This includes preparing for the treatment, other treatment options, the treatment process as well as short- and long-term side effects. It’s a good idea to consult with all three types of specialists—medical oncologist, radiation oncologist, and urologist—so you can get an overall picture of the available treatments.
What Factors Affect My Treatment Choices?
You and your doctors need to discuss each of the treatment options available for you. Choosing a prostate cancer treatment means considering factors that include the stage, grade, extent of disease, and your physical and mental state of health. Learn which treatment options are available in your area, what their success rates are, and/or which ones are covered by your insurance.
Don’t forget to ask for details about the side effects and complications associated with each treatment option. It’s best to discuss post-treatment side effects before you choose a prostate cancer treatment. Prior to treatment, it is also wise to talk to your doctor about a penile rehabilitation program as part of your post-treatment recovery plan. In addition, no matter what treatment option you choose, you need to also consider lifestyle and dietary considerations, since it is critical to maintain optimal immune system health for your recovery and long-term wellness.
What Are My Treatment Options for Prostate Cancer?
Your prostate cancer treatment options range from exerting a minimum amount of effort (active surveillance) to surgery (prostatectomy) and many choices in between. Here’s a rundown of your treatment options, which you should discuss with your doctors.
- Active surveillance (or watchful waiting) means you don’t actively treat your condition, but both you and your doctors monitor your health and symptoms
- Radiation therapy, which can be external or internal (use of radioactive seeds implanted into the prostate)
- Hormone therapy, which includes the use of drugs to block the production and activity of hormones; or surgery to remove the testicles and thus halt hormone production
- Chemotherapy, which is the use of potent drugs to kill prostate cancer cells
- Ultrasound (HIFU), high intensity focused ultrasound, a technique that destroys tissue using rapid heat that is focused on the malignancy in the prostate gland
- Surgeries, which may include removal of the prostate (prostatectomy), cryotherapy (freezing prostate tissue), or TURP (transurethral resection of the prostate)
In addition to the traditional treatment options there are also various alternative treatments that are sometimes used along with changes to diet and lifestyle. Supplements for prostate cancer may also be included as part of a general program to maintain and boost immunity.
Are There Other Resources To Help with Treatment Decisions?
Some of the major prostate cancer medical practices have tools and resources that can help guide your treatment decision, whether it be for initial treatment, additional treatments or salvage treatments after surgery or radiation. (Be sure to discuss these with your doctors.) For example risk assessment tools such as the UCSF-CAPRA Score and the D’Amico classification as well as a number of nomograms can help guide your decision making process. Memorial Sloan-Kettering Cancer Center also developed a series of Nomograms that aid in the prediction of a number of events including:
- For men who have received no primary treatment, the nomogram calculates the statistical probability of a cancer remaining progression-free after receiving one of three options when choosing a prostate cancer treatment: prostatectomy, external beam radiation therapy, and brachytherapy.
- For men who have been treated with a prostatectomy, the tool predicts probability of survival.
- For men who have experienced a recurrence of their prostate cancer after being treated with a prostatectomy, the tool predicts treatment success for salvage radiation therapy (SRT).
- For men who have received either prostatectomy or radiation therapy and who are considering hormone refractory treatment (HRT), the tool predicts one- and two-year survival after HRT.
This tool also can be used to predict the probability and time to the development of metastatic disease as well as prostate volume, which is used to interpret PSA results.