Lesson 3: Prostate Cancer Treatment Options
Beginning Research and Treatment Options Worksheet
Again Marlene went to work on the Internet to explore treatment options. I would come home from work and find Marlene with volumes of material that she had gone through and highlighted the parts she felt I should read. This research book came to be 4 inches thick, with many different points of view. It became evident that the various camps all had their biases. We found similar biases when we discussed the various treatments with the heath professionals. We also found that generally the medical profession, outside of the specialists, has very little understanding of prostate cancer.
Use of worksheet: To assist us in organizing this mountain of information we were accumulating, we developed an electronic EXCEL spreadsheet. If you do not have MS Excel, you can download the Excel viewer here, or you can use these MS Word worksheets: Issues worksheet Patient Profile worksheet.
We plugged in the treatment across the top of the sheet and listed the treatment results, side effects we could expect and things we needed to consider, down the left-hand side of the spreadsheet. We then applied a subjective value to each side effect and consideration so we could grade the options. This spreadsheet went with us as we met with the heath professionals so we could ask specific questions and update our data on the spreadsheet as we got new information.
As you move towards a decision on your treatment there will be a number of questions that you will need answers to. It is helpful to you and your team of health professionals if you come to the meetings with your questions written. This will assure that you get your questions answered. In the stress of the moment it is not always easy to remember the questions that you want answers to. As you move from one specialist to another you may find that you will receive mixed answers to your questions. The surgeon will give you one answer regarding your expectations, while the Radiation Oncologist recommending beam radiation or planting of radioactive seeds will have different data to share with you. These mixed answers are a reflection of the lack of hard data on the long-term effects of the various treatments. It will be up to you to sort through the information and decide what is best for you. Grading out your priorities and applying your values to the worksheet could assist you with your decision-making.
Page one of the worksheet is your profile. Fill this out as best you can prior to visiting the health professionals. This will save your and the doctor’s time. You may be seeing more than one group of health professionals and be asked for the same data multiple times. The time is better spent discussing your treatment options than how old you are and if you smoke, etc.
Below you will find a summary of treatment options that will be discussed further in this lesson: Aggressive Therapeutic Options:
1. Surgery
- Open: retropubic approach (incision through abdomen)
- Open: perineal approach (incision through area between scrotum and rectum)
- Laparoscopic (newer technique): uses small incisions, through which small instruments and a small video camera are inserted. The surgeon can see what he is doing on a TV screen beside you.
2. External Beam Radiation (with or without hormone treatment)
3. Brachytherapy
Non-Aggressive Options:
1. Watchful Waiting (follow PSA levels)
2. Hormonal therapy (reversible blockage of testosterone)
3. Orchiectomy (removal of testicles, causing an irreversible removal of testosterone)
4. Herbal Therapies
