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What Is The Most Successful Prostate Cancer Treatment

Hormone Therapy For Prostate Cancer

Prostate cancer: State-of-the-art diagnosis and non-invasive treatment

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Hormone therapy is also called androgen suppression therapy. The goal of this treatment is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cell growth.

Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgens are made by the testicles, but the adrenal glands as well as the prostate cancer cells themselves, can also make androgens.

Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.

Choosing A Treatment Option

Treatment Options for Localized or Locally Advanced Prostate CancerA 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 …

Remission And The Chance Of Recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA recurrence or biochemical recurrence.

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Treatment For Cpg 1 Localised Prostate Cancer

You might not have treatment straight away. Instead, your doctor recommends monitoring your cancer closely and then discussing treatment if the cancer begins to grow. This is called active surveillance.

If you decide to have treatment, it might include:

  • surgery to remove your prostate or
  • external radiotherapy

Help To Continue The Work

17 Best images about Home Remedies on Pinterest

The Prostate Cancer Free Foundation, reviews the results of hundreds of thousands of men treated for prostate cancer. Tracking them for years. This information is available to you, and others like you, to help find the best prostate cancer treatment. This work takes time, effort, resources all of it done by volunteers. Please help us continue. Please Donate!

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What Else Should You Consider

Remember, you have options, and itâs important to choose the one that works best for you. When choosing a treatment, think about:

  • The risks. Talk to your doctor about the pros and cons of each type of therapy.
  • The side effects. Consider whether or not youâre willing to deal with how the treatment might make you feel.
  • Whether or not you need it. Not all men with prostate cancer need to be treated right away.
  • Your age and overall health. For older men or those with other serious health conditions, treatment may be less appealing than watchful waiting.

Show Sources

American Cancer Society: âCan Prostate Cancer be Found Early?â âConsidering Prostate Cancer Treatment Options,â âHormone Therapy for Prostate Cancer,â âHow is Prostate Cancer Treated,â âProstate Cancer,â âWhat is Prostate Cancer?â âCryotherapy for Prostate Cancer,â âRadiation Therapy for Prostate Cancer,â âSurgery for Prostate Cancer,â âVaccine Treatment for Prostate Cancer.â

National Cancer Institute: âProstate Cancer Treatment.â

Prostate Cancer Foundation: âOther Treatment Options,â âProstatectomy ,â âRadiation Therapy,â âSide Effects,â âTreatment Options.â

UpToDate: âBone metastases in advanced prostate cancer: Management.â

Cancer.Net: âProstate Cancer: Types of Treatment.â

Radiopharmaceuticals That Target Psma

Prostate-specific membrane antigen is a protein that is often found in large amounts on prostate cancer cells.

Lutetium Lu 177 vipivotide tetraxetan is a radiopharmaceutical that attaches to PSMA, bringing radiation directly to the prostate cancer cells.

This drug can be used to treat prostate cancer that has spread and that has already been treated with hormone therapy and chemotherapy. The cancer cells must also have the PSMA protein. Your doctor will order a PSMA PET scan before you get this drug to make sure the cancer cells have PSMA.

This drug is given as an injection or infusion into a vein , typically once every 6 weeks for up to 6 doses.

Possible side effects

Some of the more common side effects of this drug include:

This drug can lower blood cell counts:

  • A low red blood cell count can cause tiredness, weakness, pale skin, or shortness of breath.
  • A low blood platelet count can lead to bleeding or bruising more easily than normal, or bleeding that is hard to stop.
  • A low white blood cell count can lead to an increased risk of infections, which might show as a fever, chills, sore throat, or mouth sores.

This drug might damage the kidneys. Your doctor or nurse will likely advise you to drink plenty of fluids and to urinate often before and after getting this drug, to help protect the kidneys. Tell your doctor or nurse if you start to pass less urine than is normal for you.

Read Also: Prostate Cancer Hormone Therapy Life Expectancy

Treatment To Lower Androgen Levels From Other Parts Of The Body

LHRH agonists and antagonists can stop the testicles from making androgens, but cells in other parts of the body, such as the adrenal glands, and prostate cancer cells themselves, can still make male hormones, which can fuel cancer growth. Some drugs can block the formation of androgens made by these cells.

Abiraterone blocks an enzyme called CYP17, which helps stop these cells from making androgens.

Abiraterone can be used in men with advanced prostate cancer that is either:

  • Castration-resistant

This drug is taken as pills every day. It doesnt stop the testicles from making testosterone, so men who havent had an orchiectomy need to continue treatment with an LHRH agonist or antagonist. Because abiraterone also lowers the level of some other hormones in the body, prednisone needs to be taken during treatment as well to avoid certain side effects.

Ketoconazole , first used for treating fungal infections, also blocks production of androgens made in the adrenal glands, much like abiraterone. It’s most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer working.

Ketoconazole also can block the production of cortisol, an important steroid hormone in the body, so men treated with this drug often need to take a corticosteroid .

Expert Review And References

Surgery vs radiotherapy: what is the most effective treatment for prostate cancer?
  • American Cancer Society. Treating Prostate Cancer. 2019: .
  • American Society of Clinical Oncology. Prostate Cancer. 2020: .
  • Tracy, CR. Prostate Cancer. eMedicine/Medscape 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Patient Version. Bethesda, MD: National Cancer Institute 2020: .
  • PDQ® Adult Treatment Editorial Board. Prostate Cancer Treatment Health Professional Version. Bethesda, MD: National Cancer Institute 2020: .
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer . 2020: .
  • Zelefsky MJ, Morris MJ, Eastham JA. Cancer of the prostate. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds.. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer 2019: 70: 1087-1136.
  • Parker C, Castro E, Fizazi K et al . Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatmentand follow-up. Annals of Oncology. 2020: 31: 1119-1134. .

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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.

How Is Yale Medicines Approach Unique

âAt Yale Medicine, we take a number of approaches that set our care apart,â says Dr. Yu. âFirst, we have a large physics staff that is essential to designing and verifying our radiation treatment plans. Second, we make it a point to evaluate new radiation technologies critically. We dont hold onto old approaches, but neither do we jump on the latest trends without seriously assessing what they will contribute.â

Third, adds Dr. Yu, we are running a growing prostate cancer research program and Yale Medicine is home to leading voices in urology, medical oncology and radiation oncology. âWere also on the forefront of MRI-guided prostate biopsy,â he says, âand, our bedrock is Yales multidisciplinary prostate cancer program, which brings together multiple insights collaboratively.â

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After A Diagnosis Of Prostate Cancer

After finding out you have prostate cancer, you may feel shocked, upset, anxious or confused. These are normal responses. Talk about your treatment options with your doctor, family and friends. Ask questions and seek as much information as you need. It is up to you as to how involved you want to be in making decisions about your treatment.

After non-melanoma skin cancer, prostate cancer is the most common cancer in Australia. In 2016, 19,305 Australian men were diagnosed with prostate cancer.

Prostate cancer is unusual in that it is slow growing in some men and not a threat, but for others the cancer can be aggressive. Cure rates for prostate cancer are improving, however side-effects of treatment may affect your lifestyle including sexual function and continence.

To ensure that you receive the best care, your specialist will arrange for a team of health professionals based on your needs and preferences

Learn more about the best prostate cancer care for each step of your treatment:

Active Surveillance And Watchful Waiting

Patient Guide to Prostate Specific Antigen (PSA)

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:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • 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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What Affects My Treatment Options

Your treatment options will depend on whether your cancer is contained within the prostate gland , has spread just outside of the prostate or had spread to other parts of the body .

You may have a choice of treatments. Your doctor or specialist nurse will explain all your treatment options, and help you to choose the right treatment for you.

Your treatment options and which treatment you choose may depend on several things, including:

  • how far your cancer has spread
  • how quickly your cancer may be growing
  • the advantages and disadvantages of each treatment
  • what each treatment involves
  • the possible side effects of each treatment
  • practical things, such as how often you would need to go to hospital, or how far away your nearest hospital is
  • your own thoughts about different treatments
  • how the treatment you choose now could affect your treatment options later if your cancer comes back or spreads
  • your general health
  • how long youre expected to live for.

The first treatment you have may affect which treatments you can have in the future, if you need further treatment. Speak to your doctor or nurse about this.

It can help to write down any questions you want to ask at your next appointment. And to take someone to appointments, such as your partner, friend or family member.

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How Prostate Cancer Is Treated

In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.

The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.

Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.

Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:

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The Best Method For Measuring Prostate Cancer Treatment Success

Measuring the Prostate Specific Antigen level is the most important, and most common test to measure success of treatment of prostate cancer.

Why?First, regardless of the treatment you receive, it is the test you will have each time you have a medical visit, and it is the test you and your doctor will use to determine if your cancer is controlled or not.

Second, if PSA levels become elevated after treatment, it will mean you need further tests and very likely further treatment. The tests and subsequent procedures following an elevated PSA level after treatment can significantly worsen the quality of your life. Before deciding on an initial treatment, you need to understand how well that treatment does at controlling the cancer. What is the chance that you will need further treatment? PSA progression rates provide a level playing field to compare the different treatments.

Initially, PSA is used as a cancer screening tool. But after treatment, PSA is used to monitor for the recurrence of cancer.

At What Age Should You Start Getting Prostate Cancer Screenings

Mayo Clinic Q& A podcast: What happens after a prostate cancer diagnosis?

Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. Approximately one out of eight men will be diagnosed with prostate cancer in their lifetime and one in 41 will die from it. In 2022 alone, the American Cancer Society recorded nearly 270,000 new cases of prostate cancer. Of those, almost 35,000 were fatal .

The silver lining is that comparable to most cancers, the survival rate of prostate cancer is high. While individual cases can vary, many doctors believe that the earlier prostate cancer is caught, the more likely it is that the patient can make a full recovery. In fact, statistics show that in 80 to 85% of prostate cancers detected in stages 1, 2, or 3, most of the men will be disease-free within five years .

Given the chances of developing prostate cancer, as well as the potential of successful treatment if caught early, it’s important that men get regular screenings . However, most men don’t consider getting screened for prostate cancer until it is too late so when is the right age for men to be taking prostate cancer screening seriously? The answers can vary, and there are factors to consider.

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Proton Beam Radiation Therapy

Proton beam therapy focuses beams of protons instead of x-rays on the cancer. Unlike x-rays, which release energy both before and after they hit their target, protons cause little damage to tissues they pass through and release their energy only after traveling a certain distance. This means that proton beam radiation can, in theory, deliver more radiation to the prostate while doing less damage to nearby normal tissues. Proton beam radiation can be aimed with techniques similar to 3D-CRT and IMRT.

Although in theory proton beam therapy might be more effective than using x-rays, so far studies have not shown if this is true. Right now, proton beam therapy is not widely available. The machines needed to make protons are very expensive, and they arent available in many centers in the United States. Proton beam radiation might not be covered by all insurance companies at this time.

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