Lesson 3: Prostate Cancer Treatment Options
What I did hear during that fateful visit with Dr. Zack was that if we acted quickly my chances for survival would be great – over 90%. There were options I should consider and Dr. Zack wanted to meet with my wife Marlene and me as soon as possible. He wrote on a piece of paper the words "Surgery, Brachytherapy, and Beam Radiation". I thought I understood surgery; the other two terms were new to me. In this lesson, we’ll look at today’s treatment options for Prostate Cancer that is still encapsulated within the prostate. Included will be the three treatments listed above, as well as other treatment options. We’ll also discuss the pros and cons of each treatment, and the inevitable effects, both physical and psychological, of each treatment.
At the end of this lesson, you can expect to better understand Prostate Cancer treatment options, and the effects of each option. If you are a Prostate Cancer patient faced with the decision of which treatment option is right for you, it is my hope that the information in this lesson, while not a substitute for an open and honest discussion with your health care provider, will help you to learn a bit more about the various treatment options available to you.
Introduction
One of the first important decisions you will make is how you want to deal with your cancer. Your doctor should look at your age and medical health to determine what your life expectancy might be, then assess how advanced your tumor is and how aggressive it might be.
The following comments have only to do with the treatment of, and coping with, Prostate Cancer that is still contained within the prostate gland. Others are better able to discuss the treatment of cancer that has spread outside of the prostate, as I have no first hand experience with that. Fortunately for me, my cancer was diagnosed to be within the prostate.
Cancers of the prostate are often multifocal (involving many areas of the prostate at the same time). Therefore, any potentially curable treatment has to target the whole prostate.
The good news for me was that my Gleason Score was 7 and my PSA was 8 ng/ml. This meant the chances of a cure were very high – 92% success rate in British Columbia where we live. The success rate will vary depending on where you live and the treatment facilities available within your community. Now our task was to ascertain what treatment suited us.
In my case I am a non-smoker in general good heath. My projected life expectancy was beyond 80 years so we needed to come up with a 20-year plan.
If you are in poor heath and/or your tumor was detected early, it is quite likely that your prostate cancer will never affect you during your natural lifetime, or growth of the tumor can be slowed by hormonal medications. Prostate cancer usually has no symptoms until it is very advanced: why make the treatment worse than the disease? Options for people in these situations include watchful waiting, surveillance, hormonal treatment (either surgical or medical) or herbal remedies.
While modern therapies for prostate cancer are highly effective and tolerated well in general, they all have side effects and require a personal investment which can affect your emotional, social, financial, physical and/or functional well-being. On the other hand, we know people who have had lengthy battles with prostate cancer and regrettably died from it. If you are young and healthy when you are diagnosed, or have an advanced or aggressive tumor, waiting to start treatment will likely only decrease your chances of a full cure. Treatment designed to kill or remove the tumor makes the most sense for people in these situations.
This is a fundamental decision you will have to make as you investigate your options. The advice I was given by my urologist, which I took, was to explore ways to cut out or kill the cancer not ways to live with it. I was relatively young (61 years old) when diagnosed so my testicles were still producing the testosterone that feeds the cancer. This is why younger men are at greater risk than older gents whose testicles are often less productive. Since we choose the kill or remove options they are the only ones I have any experience with. I am not suggesting that you chose the options we did. You must decide what is best for you from the research you will carry out.
