Overview Of Treatment Options
Your treatment options will depend in part on whether your disease is localized, high risk, recurrent or advanced.
For nearly eight in 10 men with prostate cancer, the disease is diagnosed early, in the local or regional stages. Most will be cured. Active surveillance, watchful waiting, radiation therapy and surgery are the most common treatments.
Two in 10 men with prostate cancer are diagnosed with high-risk disease â localized prostate cancer that has a tendency to spread. Among these men, three or four in 10 will have cancer that comes back after treatment.
Doctors use hormone therapy, along with surgery and radiation therapy, to treat prostate cancers that might have spread. Learn more about the special considerations for treating high-risk or recurrent prostate cancer.
If your cancer has already spread when you are diagnosed , new treatments may put your cancer in remission and give you a good quality of life for years, even though the cancer canât be cured.
SCCA offers immunotherapy, hormone therapy, chemotherapy, radiation therapy and access to promising therapies in clinical studies that your community doctor may not know about.
What Is Prostate Cancer
Prostate cancer refers to the uncontrolled growth of cells in the prostate gland. The prostate gland is a part of the male reproductive system. It is a small gland located just below the bladder and in front of the rectum , surrounding the urethra . The prostate has two main functions: producing and storing fluid that helps make semen and regulating bladder control.
Prostate cancer is the second most common cancer in males in the US . Certain conditions increase the risk for prostate cancer. These include
- Age: The chances of getting prostate cancer increase with age. Most experts recommend considering screening when a man is 50 years old.
- Race: African-American men are at a greater risk of developing prostate cancer.
- Family history: There is a higher risk of prostate cancer in men who have a close family member diagnosed with prostate cancer at an early age .
- Heredity: Certain genetic conditions may increase the risk of prostate cancer.
- Diet and lifestyle: Men who have a diet rich in animal fat and low in fruits and vegetables may have greater chances of getting prostate cancer. Being obese or having a sedentary lifestyle also raises prostate cancer risk.
- Smoking: It increases oxidative stress in the body, causing an increased risk of several cancers, including prostate cancer.
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Advances In Targeted Therapy
PARP inhibitors are a type of targeted therapy drug designed to prevent the DNA of cancer cells from repairing the damage caused by cancer treatment. In May 2020, the FDA approved two PARP inhibitors, rucaparib and olaparib, to treat patients with metastatic castration-resistant prostate cancer whose cancer tumors have certain homologous recombination repair genetic mutations and who meet other treatment-related criteria. These drugs are the first of their type to be approved by the FDA to treat prostate cancer.
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Some Things To Consider When Choosing Among Treatments
Before deciding on treatment, here are some questions you may want to ask yourself:
- Are you the type of person who needs to do something about your cancer, even if it might result in serious side effects?
- Would you be comfortable with watchful waiting or active surveillance, even if it means you might have more anxiety and need more frequent follow-up appointments in the future?
- Do you need to know right away whether your doctor was able to get all of the cancer out ? Or are you comfortable with not knowing the results of treatment for a while if it means not having to have surgery?
- Do you prefer to go with the newest technology , which might have some advantages? Or do you prefer to go with better proven treatments that doctors might have more experience with?
- Which potential treatment side effects might be most distressing to you?
- How important for you are issues like the amount of time spent in treatment or recovery?
- If your initial treatment is not successful, what would your options be at that point?
Many men find it very stressful to have to choose between treatment options, and are very fearful they will choose the âwrongâ one. In many cases, there is no single best option, so itâs important to take your time and decide which option is right for you.
Prostate Cancer Expertise At Scca
Data collected from cancer centers across the country show that men who begin their prostate cancer treatment at SCCA have higher survival rates on average than those who started treatment at other centers.
We have world-class urologic oncologists, medical oncologists, radiation oncologists and pathologists who specialize in prostate cancer the most advanced diagnostic, treatment and recovery programs and extensive support.
SCCA patients have access to advanced treatments being explored in ongoing prostate cancer clinical trials conducted at SCCA, Fred Hutch and UW Medicine. Our doctors and scientists are at the forefront of research to better prevent, diagnose and treat prostate cancer and to improve quality of life for survivors, including through the Institute for Prostate Cancer Research, a Fred HutchâUW Medicine collaboration.
Your SCCA doctors will explain all your options and recommend a treatment plan based on the grade and stage of your prostate cancer and several other factors, including your age, your general health, potential side effects and the probability of curing your disease, extending your life or relieving your symptoms.
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Weve Discovered A New Way To Treat The Deadliest Prostate Cancers
12th February 2021
Worldwide Cancer Research scientists in Argentina have made an exciting new discovery that could lead to the start of new clinical trials. Their findings reveal a new treatment strategy that helps make immunotherapy work more effectively to kill off the most aggressive types of prostate cancer.
Annual Report On Prostate Diseases
Most men eventually develop some type of prostate problem, and when they do there are usually no easy solutions. More than a primer on prostate conditions, this Special Health Report, the Annual Report on Prostate Diseases, includes roundtable discussions with experts at the forefront of prostate research, interviews with men about their treatment decisions, and the latest thinking on complementary therapies. This report will provide you with the information you need to understand the current controversies, avoid common pitfalls, and work with your doctor to make informed choices about your prostate health.
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Advances In Immunotherapy For Advanced Prostate Cancer
Immunotherapy is a type of precision medicine tool that stimulates the immune system to recognize and fight cancer cells. It isnt widely used in treating prostate cancer right now because studies show that while some patients with advanced prostate cancer have responded positively to treatment, most do not.
Two types of immunotherapy that may be used in some cases, however, are the Sipuleucel-T cancer vaccine and checkpoint inhibitors.
Sipuleucel-T is an FDA-approved vaccine designed to treat advanced metastatic castration-resistant prostate cancer. To create the vaccine, the patients own immune cells are collected from a blood sample and stimulated in the lab to help them recognize and fight prostate cancer cells. The inoculation is then injected back into the patient. The vaccine has been shown to extend the lives of some men with advanced cancer .
Checkpoint inhibitors are drugs that block signals between certain cancer cells and proteins on immune cells. A kind of miscommunication sometimes keeps the immune cells from recognizing the cancer cells as dangerous. When that signal is blocked, the immune cells may wake up to the danger and attack the cancer cells. In June 2020, the FDA approved pembrolizumab for prostate cancer with certain genomic biomarkers.
How Is Prostate Cancer Treated
Through a virtual conversation, Nathan can help you get ready to talk to your doctor about treatment options.
Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are
- Expectant management. If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you dont treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:
- Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen tests and prostate biopsies regularly, and treating the cancer only if it grows or causes symptoms.
- Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are expected to live for 10 more years or less.
Other therapies used in the treatment of prostate cancer that are still under investigation include
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What About Lycopene For Prostate Cancer
Lycopene is a powerful antioxidant. It’s found in abundance in some fruits and vegetables, particularly cooked tomatoes. Some studies show that people who eat diets high in tomatoes and other fruits high in lycopene have lower cancer rates, and some researchers even believe lycopene may retard the growth of prostate tumors. However, results of several studies have not been consistent.
Lycopene is found in large quantities in foods normally consumed. No side effects have been noted or precautions suggested when this “super nutrient” is eaten as part of a balanced diet.
Nutrition And Lifestyle Changes
Many studies have looked at the possible benefits of specific nutrients in helping to treat prostate cancer, although so far none have shown a clear benefit. Some compounds being studied include extracts from pomegranate, green tea, broccoli, turmeric, flaxseed, and soy.
One study has found that men who choose not to have treatment for their localized prostate cancer may be able to slow its growth with intensive lifestyle changes. The men in the study ate a vegan diet and exercised frequently. They also took part in support groups and yoga. After one year the men saw, on average, a slight drop in their PSA level. It isnt known if this effect will last since the report only followed the men for 1 year. The regimen may also be hard for some men to follow.
It’s important for men thinking about taking any type of nutritional supplement to talk to their health care team first. They can help you decide which ones you can use safely while avoiding those that might be harmful.
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How Does Prostate Cancer Kill You In The End
Prostate cancer is the most common cancer after skin cancer in men in the US and the second leading cause of cancer death. Prostate-specific antigen testing has made the detection of prostate cancer easier in its early stages. Ninety-two out of 100 men get diagnosed when the cancer is limited to the prostate.
Most men are diagnosed with prostate cancer in their senior years and only 1 out of 36 men die from it. Death from prostate cancer most often happens when cancer has spread to other organs in the body. This is known as the advanced stage of prostate cancer.
The chances of survival decrease as cancer spreads beyond the prostate. If cancer has metastasized to other parts of the body, only three out of 10 men will survive for five years after the diagnosis.
Advanced stage prostate cancer or metastasized prostate cancer
Cancerous cells may spread to organs other than the site of origin. In the case of prostate cancer, this tendency is decreased, but it can happen. Advanced stage prostate cancer is defined based on the Gleason score, which is based on the TNM staging of cancer. T stands for tumor size, N stands for lymph node involvement and M stands for metastasis.
Prostate cancer can kill in the end through metastases that can develop in
Metastasis to the liver can affect the livers ability to filter out toxins from the body. This can eventually lead to jaundice, nausea, loss of appetite and weight loss.
Active Surveillance And Watchful Waiting
If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.
Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.
ASCO encourages the following testing schedule for active surveillance:
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A PSA test every 3 to 6 months
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A DRE at least once every year
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Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years
Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.
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If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
How Do You Determine Whats Right For You
Whether youve recently been diagnosed with prostate cancer or youre dealing with recurrent or metastatic cancer, you may be facing difficult decisions about your treatment. Its normal to be unsure about what steps to take, and most patients have more than one choice.
Start by talking to your oncologist about the specifics of your case and your options. The American Society of Clinical Oncology has a helpful list of questions to ask your doctor about prostate cancer you may want to reference.
If possible, see a multi-specialty cancer care team to get a bigger picture of your case and your options. This is also important because, sometimes, factors outside of your cancer stage may impact your treatment options. For example, you may have an obstruction in your urinary tract that makes surgery a more appropriate choice than radiation. Or maybe you have another health condition that makes surgery more risky for you. In that case, radiation may be a better choice. You want these doctors to talk to one another about your case each has expertise that makes an important contribution to the decision-making process. To facilitate this coordination, you may have to set up appointments to see multiple doctors and ask them to discuss your case.
If youre interested in getting a second opinion for prostate cancer, or if youd just like to talk with someone at CTCA about your cancer care, or chat online with a member of our team.
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What Do We Know About Saw Palmetto Berry For Prostate Problems
Several antioxidants and other nutrients have been identified as potentially helpful supplements for conditions of the prostate. Those conditions include benign prostatic hypertrophy , or enlarged prostate. Clinical trials are being conducted to find out more about the benefits of these “super nutrients.”
In the U.S., men have relied more on the herb saw palmetto than on other natural therapies for relief from enlarged prostate. Men participating in several studies had better results when taking saw palmetto as compared to taking placebo. Saw palmetto hasn’t been shown to prevent or treat prostate cancer.
The most common side effect of saw palmetto is mild digestive distress. Saw palmetto also seems to have some health benefits when used with African plum tree bark extract. But researchers caution that not all extracts are the same. Some preparations of these herbs can have different properties. Because herbs and dietary supplements are not regulated by the FDA, there are no guarantees about the quality of natural products.