Prostate Cancer Treatments
The standard treatment options for prostate cancer are
- active surveillance
- radical prostatectomy
- radiation therapy
- hormone treatment
One new option recently approved by the FDA is immunotherapy.
Radical prostatectomy and radiation therapy can potentially cure prostate cancer when the disease is detected in its early stages. Radiation therapy can be delivered from an external source (external beam radiation therapy) or by implantation of radioactive seeds (brachytherapy).
Another option is cryotherapy (freezing the prostate). Although long-term data are lacking, early studies suggest that cryotherapy may be comparable to other therapies when used to treat men at low risk for disease progression.
High-intensity focused ultrasound (HIFU) is an investigational treatment that has not been approved by the FDA, but it is being used in Europe. Hormone therapy is not curative and is generally used to slow the progression of the disease once it has spread to other sites.
Though chemotherapy is effective in treating some types of cancer, it has been less successful for prostate cancer. Recently, however, combination chemotherapy using docetaxel (Taxotere) was found to offer a small survival benefit in men with advanced prostate cancer no longer responding to hormone treatment. Men who don't respond to Taxotere have the option of using another chemotherapy agent, cabazitaxel (Jevtana). It was recently approved by the FDA for use in combination with prednisone.
Another option for prostate cancer that has ceased to respond to hormone treatment is the new immunotherapy agent sipuleucel-T (Provenge). It, too, offers a small survival benefit.
Because prostate cancer progresses more slowly than other types of cancer, men can take some time to carefully consider the various treatment options if they have a low-grade cancer. A man should talk with his doctor about the relative risks and benefits of each treatment and consider consulting physicians from different fields (urologists, radiation oncologists, and medical oncologists) to get a broader spectrum of opinions.
Men with early-stage prostate cancer typically have the most difficulty in making a treatment decision because they have more treatment options to choose from, including participation in clinical trials.