Surgery Vs Radiation For Prostate Cancer: Uses Benefits Side Effects
Prostate cancer is the most common form of cancer other than skin cancer in people who have a prostate . Depending upon the stage of the cancer, different treatment options are available. These treatment options include:
This article will review how surgery and radiation are used to treat prostate cancer. Both can be very effective forms of treatment in men with the disease. Although they may have the same goals of therapy, there are differences between these treatments.
Be sure to see your healthcare provider for the diagnosis, so you can receive the best treatment for you.
The Good Brigade / Getty Images
How Common Is Recurrence
The recurrence of prostate cancer depends on when it was caught and treated the first time. If your doctor was able to remove the cancer while it was still confined in the prostate gland, your chances of recurrence are fairly low. If your cancer spread before treatment, such as in the case of about 10% of men, recurrence is more likely to occur. Recurrence, therefore, occurs if not all of the cancer cells were treated the first time or if the cancer was more advanced than originally believed.
Also Check: Is There Any Cure For Prostate Cancer
How Does Radiotherapy Work
Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells. External beam radiotherapy is high-energy X-ray beams targeted at the prostate from outside the body. These X-ray beams damage the cancer cells and stop them from growing and spreading to other parts of the body . Radiotherapy permanently damages and kills the cancer cells, but healthy cells can repair themselves and recover more easily.
Radiotherapy treats the whole prostate. It aims to treat all the cancer cells, including any that have spread to the area just outside the prostate. The treatment itself is painless but it can cause side effects that may cause you problems.
You may have radiotherapy to a wider area, including the nearby lymph nodes, if there is a risk that the cancer has spread there. Lymph nodes are part of your immune system and are found throughout your body. The lymph nodes in your pelvic area are a common place for prostate cancer to spread to. If you do have radiotherapy to a wider area, you will be more likely to get side effects.
Also Check: What To Do After Prostate Surgery
What Is The Success Rate Of Radiation Therapy
Radiation therapy is an option for men who are suffering from prostate cancer. Radiation is used to kill the cancer cells, but side effects are possible, especially if the treatment is too large. This type of treatment is generally given in 20 sessions over four weeks. However, some hospitals offer this treatment in 37 sessions over seven or eight weeks, which may increase the overall dose of radiation, but lower the individual dose in each session.
The choice of radiation therapy is based on the severity and location of the disease. It is often recommended for patients whose cancer has spread to the lymph nodes or edges of the prostate. However, radiation therapy is not always successful. While the success rate is 94%, researchers are still monitoring patients to see if it affects their overall survival rate.
External-beam radiation therapy is a highly effective treatment option for prostate cancer. It has a cure rate of 95 percent in men with high and intermediate-risk cancer, and a 5-year survival rate of 98.8%. It was also found to be as effective as other common treatments, including brachytherapy.
Low Dose Rate Brachytherapy Implants
The most common form of brachytherapy for prostate cancer, LDR involves surgically placing small radioactive pellets, about the size of a grain of rice, within the prostate. Once put in place, they remain there for life, but the radiation weakens over weeks or months, until it almost completely goes away.
Don’t Miss: Cryotherapy For Prostate Cancer Side Effects
Symptoms Of Peripheral Neuropathy
Peripheral neuropathy may feel different for everyone. It may range from pain to numbness. The symptoms of peripheral neuropathy that you have depend on the types of nerves that are damaged.
Autonomic nerves control your blood pressure, heart rate, digestion and urination, among other functions. Autonomic nerve damage symptoms include:
- New onset constipation or diarrhea
- Dizziness or lightheadedness
- Urinary problems, such as difficulty emptying your bladder
Motor nerves help your muscles function properly. Peripheral neuropathy symptoms associated with motor nerves include:
- Achy or weak muscles, which may lead to falling easily or having trouble with tasks like buttoning shirts
- Coordination problems
- Difficulty walking
- Muscle cramping or twitching
Sensory nerves help you feel sensations like pain, heat and cold. Peripheral neuropathy in the sensory nerves may cause the following symptoms:
- Inability to feel cold or hot sensations
- Inability to feel pain from an injury
- Numbness or tingling in your feet or hands
- Pain that may feel like burning, pinching or sharp stabbing
- Problems walking or picking things up, especially in the dark
How Is Prostate Cancer Treated
Treatment for prostate cancer depends upon the stage of the prostate cancer and an understanding of the pros and cons of treatment. Treatment options include:
- Watchful waiting. No active treatment is started. This may be appropriate for older men with other serious medical conditions
- Active watching. May involve regular PSA tests and prostate biopsies
- Brachytherapy. Small radioactive pellets are placed permanently into the prostate gland
You May Like: What Are The Statistics Of Prostate Cancer
Image Guided Radiation Therapy
In this type of radiation therapy, CT scans are taken both during the planning process and just before treatment begins. Comparing the two images allows doctors to adjust treatment as needed, since tumors can move between treatments. This allows precision targeting of the cancer while avoiding nearby healthy tissue.
In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT to account for organ/tumor motion even if the body is immobilized.
Calypso is another form of IGRT where the prostate can be tracked during the treatment.
Intensity Modulated Radiation Therapy
IMRT, an advanced form of 3D-CRT therapy, is the most common type of external beam radiation therapy for prostate cancer. It uses a computer-driven machine that moves around the patient as it delivers radiation. Along with shaping the beams and aiming them at the prostate from several angles, the intensity of the beams can be adjusted to limit the doses of radiation reaching nearby normal tissues. This lets doctors deliver an even higher radiation dose to the cancer.
Some newer radiation machines have imaging scanners built into them. This advance, known as image guided radiation therapy , lets the doctor take pictures of the prostate just before giving the radiation to make minor adjustments in aiming. This appears to help deliver the radiation even more precisely and results in fewer side effects.
A variation of IMRT is called volumetric modulated arc therapy . It uses a machine that delivers radiation quickly as it rotates once around the body. This allows each treatment to be given over just a few minutes. Although this can be more convenient for the patient, it hasnt yet been shown to be more effective than regular IMRT.
Also Check: Can You Get An Erection Without A Prostate
Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will work with you to develop a specific treatment plan based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
Swelling Bruising Or Tenderness Of The Scrotum
Symptoms generally resolve on their own within three to five days. Oral anti-inflammatory medications such as ibuprofen are usually sufficient for pain relief, if necessary. You should avoid hot tubs and Jacuzzis for at least two to three days after the procedure. Postpone bike riding until the tenderness is gone.
Also Check: How Can I Relieve Prostate Pain
Patient And Family Safety
Sometimes safety measures are needed to protect the people around you from the systemic radiation in your body. This is because the radioactive materials can leave your body through saliva, sweat, blood, and urine, and that makes these fluids radioactive. It’s very important to keep radiation exposure to the people around you as limited as possible.
It’s important to remember that every patient is different, and your safety instructions may be different from other patients or people you know who have received radiation therapy to treat cancer. What you might need to do depends on what exactly is used in the treatment and how much of it is used. Your cancer care team will give you exact instructions so you know what steps to take and how long any precautions need to be followed. You should follow their instructions exactly.
In most cases, the safety precautions must be followed only the first few days after treatment. To learn more, see Radiation Therapy Safety.
It’s very important to be sure you understand what you need to do to protect the people around you. Talk to your cancer care team about your specific situation.
Prostate Cancer Nutrition And Dietary Supplements Health Professional Version
On This Page
This cancer information summary provides an overview of the use of various foods and dietary supplements for reducing the risk of developing prostate cancer or for treating prostate cancer. This summary includes the history of research, reviews of laboratory and animal studies, and results of clinical trials on the following foods or dietary supplements:
Each type of dietary supplement or food will have a dedicated section in the summary, and new topics will be added over time. Note: A summary on PC-SPES is also available.
Prostate cancer is the most common noncutaneous cancer affecting men in the United States. On the basis of data from 2017 to 2019, it is estimated that 12.6% of U.S. men will be diagnosed with prostate cancer during their lifetimes.
Many studies suggest that complementary and alternative medicine use is common among prostate cancer patients, and the use of vitamins, supplements, and specific foods is frequently reported by these patients. For example, the Prostate CAncer Therapy Selection study was a prospective study that investigated mens decision-making processes about treatment following a diagnosis of local-stage prostate cancer. As part of this study, patients completed surveys regarding CAM use, and more than half of the respondents reported using one or more CAM therapies, with mind-body modalities and biologically based treatments being the most commonly used.
Read Also: Can Prostate Cancer Metastasis To The Colon
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
External Beam Radiation Therapy
This is the most common type of radiation therapy, and it is painless. Before treatment, your radiation team will use computerized tomography scans and magnetic resonance imaging scans to map out the location of the prostate and tumor cells.
During each treatment session, X-ray beams are focused on the targeted cancer areas. Oncologists can change the intensity of doses and radiation beams to better deliver high doses of radiation to tumor cells while delivering lower doses to surrounding healthy tissues.
You May Like: How Long To Recover After Prostate Surgery
What Should Patients Know About Msks Approach To Treating Prostate Cancer
At MSK, we manage prostate cancer in a very comprehensive way, tailored to each patients disease. There is no one specific therapy that is best for everyone.
Our initial assessment includes a carefully evaluated biopsy and a very detailed MRI to show the location of the disease, the integrity or soundness of the capsule surrounding the prostate, and the amount of disease. We will often obtain next-generation imaging and do genomic testing. Then, based on that information and with input from the urologist, the radiation oncologist, and the medical oncologist we can provide a comprehensive recommendation.
The radiotherapy we do here at MSK is state-of-the-art and unparalleled. We are one of the few centers in the world to do MRI-based treatment planning and one of the few centers in the US to offer MRI-guided treatment. When we give brachytherapy, we use computer software that provides us with real-time information about the quality and accuracy of the seed implant during the procedure. It requires a great deal of collaboration with our medical physics team to try to get the most accurate positioning of the prostate during the actual three or four minutes of the treatment.
We make adjustments while the patient is still under anesthesia, so that when the procedure is completed, we have been able to achieve ideal placement of the radiation seeds. This translates into improved outcomes.
How Can I Reduce Skin Reactions
- Gently cleanse the treated area using lukewarm water and a mild soap such as Ivory, Dove, Neutrogena, Basis, Castile, or Aveeno Oatmeal Soap. Donât rub. Pat your skin dry with a soft towel or use a hair dryer on a cool setting.
- Try not to scratch or rub the treated area.
- Donât put any ointment, cream, lotion, or powder on the treated area unless your radiation oncologist or nurse has prescribed it.
- Donât wear tight-fitting clothing or clothes made from harsh fabrics like wool or corduroy. These fabrics can irritate the skin. Instead, choose clothes made from natural fibers like cotton.
- Donât apply medical tape or bandages to the treated area.
- Donât expose the treated area to extreme heat or cold. Avoid using an electric heating pad, hot water bottle, or ice pack.
- Donât expose the treated area to direct sunlight. That could intensify your skin reaction and lead to a severe sunburn. Choose a sunscreen of SPF 30 or higher. Protect the treated area from direct sunlight even after your course of treatment is over.
Recommended Reading: Can You Get Prostate Cancer Without A Prostate
How Much Radiation Therapy Costs
Radiation therapy can be expensive. It uses complex machines and involves the services of many health care providers. The exact cost of your radiation therapy depends on the cost of health care where you live, what type of radiation therapy you get, and how many treatments you need.
Talk with your health insurance company about what services it will pay for. Most insurance plans pay for radiation therapy. To learn more, talk with the business office at the clinic or hospital where you go for treatment. If you need financial assistance, there are organizations that may be able to help. To find such organizations, go to the National Cancer Institute database, Organizations that Offer Support Services and search for “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for information on organizations that may help.
Treatment To Lower Testicular Androgen Levels
Androgen deprivation therapy, also called ADT, uses surgery or medicines to lower the levels of androgens made by the testicles.
Even though this is a type of surgery, its main effect is as a form of hormone therapy. In this operation, the surgeon removes the testicles, where most of the androgens are made. This causes most prostate cancers to stop growing or shrink for a time.
This is done as an outpatient procedure. It is probably the least expensive and simplest form of hormone therapy. But unlike some of the other treatments, it is permanent, and many men have trouble accepting the removal of their testicles. Because of this, they may choose treatment with drugs that lower hormone levels instead.
Some men having this surgery are concerned about how it will look afterward. If wanted, artificial testicles that look much like normal ones can be inserted into the scrotum.
Luteinizing hormone-releasing hormone agonists are drugs that lower the amount of testosterone made by the testicles. Treatment with these drugs is sometimes called medical castration because they lower androgen levels just as well as orchiectomy.
With these drugs, the testicles stay in place, but they will shrink over time, and they may even become too small to feel.
- Leuprolide mesylate
Possible side effects
Many side effects of hormone therapy can be prevented or treated. For example:
Recommended Reading: Prostate Cancer And Blood In Urine