Monday, March 18, 2024
HomeCancerProstate Cancer Treatment Options By Age

Prostate Cancer Treatment Options By Age

Choosing To Stop Treatment Or Choosing No Treatment At All

Treatment options for early (localised) prostate cancer

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but its important to talk to your doctors and you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

Cancer Incidence And Death Rates By Sex And World Region

Worldwide, the incidence rate for all cancers combined was 19% higher in men than in women in 2020, although rates varied widely across regions. Among men, incidence rates ranged almost 5-fold, from 494.2 per 100,000 in Australia/New Zealand to 100.6 per 100,000 in Western Africa among women, rates varied nearly 4-fold, from 405.2 per 100,000 in Australia/New Zealand to 102.5 per 100,000 in South Central Asia. These variations largely reflect differences in exposure to risk factors and associated cancers and barriers to high-quality cancer prevention and early detection. For example, the highest overall incidence rates in Australia/New Zealand are caused in part by an elevated risk of NMSC because most of the population is light-skinned, and excessive sun exposure is prevalent, in conjunction with increased detection of the disease.

The gender gap for overall cancer mortality worldwide is twice that for incidence, with death rates 43% higher in men than in women , partly because of differences in the distribution of the cancer types. Death rates per 100,000 persons varied from 165.6 per 100,000 in Eastern Europe to 70.2 per 100,000 in Central America among men and from 118.3 per 100,000 in Melanesia to 63.1 per 100,000 in Central America and South Central Asia among women. Notably, the cumulative risk of dying from cancer among women in 2020 was higher in Eastern Africa than in Northern America , Western Europe , and Australia/New Zealand .

CANCER SITE

Treatment Options For Localized Or Locally Advanced Prostate Cancer

A man diagnosed with localized or locally advanced prostate cancer has 3 major treatment options: Active Surveillance, surgery, and radiation therapy. For patients whose cancer appears more aggressive, combination treatment may be recommended. For example, radiation therapy may be combined with hormone therapy, and surgery may be followed by radiation, sometimes with the addition of hormone therapy.

Choosing the best treatment for localized or locally advanced prostate cancer is generally based on age, the stage and grade of the cancer, the patients general health, and an evaluation of the risks and benefits of each therapy option.

Health care providers think about localized or locally advanced prostate cancer in terms of risk groups, which are assigned before the patient undergoes any treatment. There are 3 general risk groups based on the PSA, DRE, and biopsy, which can further be subdivided to better personalize treatment for each patient.

Learn more about Risk Groups.

The treatment options for each risk group have some differences ask your doctor which risk group you belong to so you can better understand the most appropriate next steps. Deciding between radiation and surgery? Dr. Dan Spratt offers 4 things to consider as you make your choice.

Don’t Miss: Success Rate Of Proton Therapy For Prostate Cancer

Questions To Ask Your Doctor Or Nurse

You may find it helpful to keep a note of any questions you have to take to your next appointment. If youre choosing a treatment, you might find it helpful to ask your doctor or nurse some of these questions.

  • What treatments are suitable for me?
  • How quickly do I need to make a decision?
  • What are the advantages and disadvantages of each treatment? What are their side effects?
  • How effective is my treatment likely to be?
  • Can I see the results of treatments youve carried out?
  • Is the aim to keep my prostate cancer under control, or to get rid of it completely?
  • If the aim of my treatment is to get rid of the cancer, what is the risk of my cancer coming back after treatment?
  • If the aim of my treatment is to keep the cancer under control, how long might it keep it under control for?
  • What treatments and support are available to help manage side effects?
  • Are all of the treatments available at my local hospital? If not, how could I have them?
  • After treatment, how often will I have check-ups and what will this involve? How will we know if my cancer starts to grow again?
  • If my treatment doesnt work, what other treatments are available?
  • Can I join any clinical trials?
  • If I have any questions or get any new symptoms, who should I contact?

Who Is Most At Risk Of Being Diagnosed

Urology

The average age of a prostate cancer diagnosis is 66, according to the ACS, and its rare to be diagnosed with prostate cancer before the age of 40. This is why testing isnt usually suggested until you are at least 45. The men most affected by prostate cancer are older than 50. Your chance of being diagnosed with prostate cancer increases with age, too. According to the Prostate Cancer Foundation, the following is a list of a mans chances of developing prostate cancer at different age ranges:

  • Before 50: 1 in 403
  • Between 50 and 59: 1 in 58
  • Between 60 and 69: 1 in 21
  • Between 70 and 79: 1 in 14

The chances of being diagnosed with the disease continue to rise after 80.

In addition to age being a telling factor in how likely it is a male will develop prostate cancer, so is race. While diagnosis rates fell for all races between 1999 and 2022, according to the Centers for Disease Control and Prevention, black men consistently were diagnosed with prostate cancer far more frequently than any other racial group. Some trends over the 16 years include:

  • Black men were diagnosed with prostate cancer more than 50 percent the national average per 100,000 people.
  • Whites and Hispanics were diagnosed at similar rates, both of which fell just below the national average.
  • American Indian/Alaska Natives and Asian/Pacific Islanders both fell more than 50 percent below the national average of diagnosis rates per 100,000 people.

Also Check: Long Term Side Effects Of Prostate Removal

Symptoms Of Prostate Cancer

Now that we know what prostate cancer is, how can we tell if we have it aside from being tested regularly? A lot of the symptoms of the disease have to do with discomfort while urinating while ejaculating. According to the Prostate Cancer Foundation, these can include:

  • Blood in your urine
  • Frequently having to urinate especially at night and not being able to hold it back
  • Pain while urinating
  • Trouble getting and maintaining an erection
  • Loss of control of your bladder and bowels
  • Pain in your hips, back, spine, and other parts of your body close to your prostate, indicating the cancer may have spread
  • Pressure in your rectum

In its earliest stages, none of these symptoms may be present, which is why its important to get ahead of the disease with testing.

Prostate Cancer In Central America/caribbean

Among the Central American countries, Costa Rica leads with an ASR of 53.8 cases per 100,000 people, followed by Mexico and Cuba with 28.9 and 24.3 cases per 100,000 people respectively . Unfortunately, epidemiological data are scarse for those regions. Trends are available only for Costa Rica which showed an annual increase in incidence of 3.8% per annum over the period 19972008. ASR on mortality put Belize at first place with 28.9 cases per 100,000 people followed by Cuba and Mexico with 24.1 and 17.0 cases per 100,000 people for the period 20032010, respectively. Costa Rica stops at 14.8 cases per 100,000 people . The most recent data on Central America published by GLOBOCAN 2020 shows an ASR incidence of 43.8 and mortality of 11.0 cases per 100,000 people . No active screening program are currently in place in Central America. Between 2004 and 2006, in Monterrey a screening program was run, using PSA and DRE screening of 973 men, 40 years of age, showed that only 44% of the men who had an abnormal result underwent prostate biopsy, and 27% of these were diagnosed with prostate cancer, mostly with high grade lesions .

Dont Miss: How Do They Do A Biopsy Of Your Prostate

Read Also: Novel Hormone Therapy Prostate Cancer

Are There Side Effects Of The Combination Approach

There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

What Questions Should I Ask My Healthcare Provider

Treating High-Risk Gleason 8: A Modern Approach | Mark Scholz, MD | PCRI

If you have prostate cancer, you may want to ask your healthcare provider:

  • Why did I get prostate cancer?
  • What is my Gleason score? What is my Grade Group? What do these numbers mean for me?
  • Has the cancer spread outside of the prostate gland?
  • What is the best treatment for the stage of prostate cancer I have?
  • If I choose active surveillance, what can I expect? What signs of cancer should I look out for?
  • What are the treatment risks and side effects?
  • Is my family at risk for developing prostate cancer? If so, should we get genetic tests?
  • Am I at risk for other types of cancer?
  • What type of follow-up care do I need after treatment?
  • Should I look out for signs of complications?

A note from Cleveland Clinic

Prostate cancer is a common cancer that affects males. Most prostate cancers grow slowly and remain in the prostate gland. For a small number, the disease can be aggressive and spread quickly to other parts of the body. Men with slow-growing prostate cancers may choose active surveillance. With this approach, you can postpone, and sometimes completely forego, treatments. Your healthcare provider can discuss the best treatment option for you based on your Gleason score and Group Grade.

Don’t Miss: How Does A Urologist Check For Prostate Cancer

Choosing The Best Treatment

It can be difficult to choose the best treatment for you. Your doctor and specialist nurse will explain the different treatment options and help you make a decision. The Predict Prostate tool can also help you decide between monitoring and radical treatment. We have more information about this tool further down this page.

A UK trial showed that there can be very little difference in survival between the treatments especially if you are diagnosed with early prostate cancer.

The table below shows how many men survive different treatments for CPG 1, 2 and 3 localised prostate cancer after 10 years.

Treatment

Prostate Cancer Clinical Trials

A clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. We currently have several clinical trials open for prostate cancer patients diagnosed at various stages of the disease. Talk with your RMCC cancer care team to see if a clinical trial is right for you.

Also Check: Sloan Kettering Prostate Cancer Nomogram

Your Age And General Health

Your doctor takes your age into account because some prostate cancers grow very slowly. If you are older and your prostate cancer is not causing you any symptoms, you may live just as long without having any active treatment. So you might be offered regular checkups instead of treatment.

You may find it hard to wait and see if you are offered regular checkups. But it could be the right choice for you if the side effects from the treatment might be worse than the effects of the cancer. This is particularly so if you have other health problems. If your cancer starts to cause symptoms you and your doctor can then consider which treatment is best for you.

Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation

vastbranddesign: Prostate Cancer Treatment Jacksonville

Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.

Recommended Reading: Side Effects Of Prostate Cancer

How Is Prostate Cancer Treated

Lorenzo asked his doctors about survival and side effects and talked to friends and family members before deciding on treatment. He shares his story in this blog post.

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.
  • Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
  • Radiation therapy. Using high-energy rays to kill the cancer. There are two types of radiation therapy
  • External radiation therapy. A machine outside the body directs radiation at the cancer cells.
  • Internal radiation therapy . Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
  • Quality Of Life With Advanced Stage Prostate Cancer

    Since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of advanced prostate cancer. It is associated, however, with significant cost in terms of morbidity as well as economics. Side effects of androgen deprivation therapy include hot flashes, osteoporosis, loss of libido or impotence, and psychological effects such as depression, memory difficulties, or emotional lability. Recently Harle and colleagues55 reported insulin resistance, hyperglycemia, metabolic syndrome, and metabolic complications being associated with castration and thus being responsible for increased cardiovascular mortality in this population.

    Because of the palliative nature of androgen ablation, quality of life is an important component of evaluating competing therapies. Intermittent androgen deprivation is one approach to hormonal therapy that has been developed with the aim of minimizing the negative effects of therapy while maximizing clinical benefits and the patients quality of life. It can be used in any clinical situation where continuous androgen deprivation treatment could be applied.56

    Recommended Reading: Long Term Side Effects Of Cyberknife For Prostate Cancer

    Treating Advanced Prostate Cancer

    If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

    Treatment options include:

    • hormone treatment

    If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

    Radiation Therapy And Radiopharmaceutical Therapy

    Dr. Carlos Vargas – Prostate cancer – Screening and treatment options

    External-beam radiation therapy

    Candidates for definitive radiation therapy must have a confirmed pathologic diagnosis of cancer that is clinically confined to the prostate and/or surrounding tissues . Staging laparotomy and lymph node dissection are not required.

    Radiation therapy may be a good option for patients who are considered poor medical candidates for radical prostatectomy. These patients can be treated with an acceptably low complication rate if care is given to the delivery technique.

    Long-term results with radiation therapy are dependent on stage and are associated with dosimetry of the radiation.

    Evidence :

  • A retrospective review of 999 patients treated with megavoltage radiation therapy showed that cause-specific survival rates at 10 years varied substantially by T stage: T1 , T2 , T3 , and T4 . An initial serum PSA level higher than 15 ng/mL is a predictor of probable failure with conventional radiation therapy.
  • Several randomized studies have demonstrated an improvement in freedom from biochemical recurrence with higher doses of radiation therapy as compared with lower doses . None of the studies demonstrated a cause-specific survival benefit to higher doses.
  • After a median follow-up of 10 years, despite a statistically significant improvement in biochemical PFS with the higher dose of radiation, the 10-year OS rate was the same in both groups: 71% . Likewise, there were no differences in prostatecancer-specific survival.
  • Evidence :

    Brachytherapy

    Don’t Miss: What Are The Symptoms Of Prostate Infection

    RELATED ARTICLES

    Most Popular