I've Been Diagnosed with Prostate Cancer, Where Do I Go From Here?
You or a loved one has prostate cancer. What do you do?
It can be scary, but often times, you have control over your situation—and how to fight it.
To choose the best course of action, consult with your doctors and talk with those close to you. Also, take time to learn about various treatments, how they work, and their side effects. This way, you can opt for the treatment option that suits you and delivers the results you need.
Here’s what you need to know:
You have three major choices
The most common three options that exist right now are radiation, surgery, and active surveillance. There are nuances to each of these, so selecting one isn’t as straightforward as it seems.
In addition, realize that many do a combination of two or more treatment options. Hormone therapy may become a necessity for fast-growing prostate cancers as well. The treatment strategy when using more than one method really depends on your situation.
For example, if your cancer has spread beyond the prostate gland and into nearby tissues, radiation plus hormone therapy is common practice. Radiation is often paired with surgery if the cancer can’t be removed completely by the operation (or comes back).
Now, the question is: How do you decide what’s right for you?
The best answer is that it really depends on what kind of a person you are. Some good questions to ask include:
- How risk averse are you?
- Which side effects might be most difficult for you? Different treatment options incur different side effects, like fatigue, bowel dysfunction, or impotence.
- Are you comfortable with monitoring your cancer or do you want to fight it? Answering this could help you decide between active surveillance and surgery or radiation.
- If your initial treatment plan wasn’t successful, what would be the next step? For instance, would you be comfortable with something like hormone therapy if the cancer comes back after surgery?
- Review our article on “Questions to Ask Your Ask Your Doctor About Prostate Cancer” for more.
Of course, answering these questions becomes easier for you when you understand everything about the main treatment options. Let’s take a look at why you’d choose one of the three options, along with detailing some potential side effects of each.
Here’s why radiation therapy may be the right choice:
- It’s a first line of treatment for low-grade prostate cancer that remains within the prostate, as the American Cancer Society notes. It’s typically for stage II patients but sometimes those in stage 1 opt for it.
- It can complement other treatment options (like hormone therapy or surgery) if the cancer has spread beyond the prostate.
- It can control or mitigate symptoms for those with advanced prostate cancer.
Now, it’s important to know the two types of radiation therapy, which are:
External beam radiation
When undergoing external beam radiation, a machine shoots beams of radiation to your prostate gland (from outside your body). The advantages of this are:
- It’s non-invasive and the procedure itself is painless.
- The treatment only lasts a few minutes and you come and go as an outpatient.
- Newer techniques and technologies enable more radiation to be applied to the cancer, while limiting exposure to nearby healthy tissues.
- Success rates are roughly 95% for those with intermediate-risk prostate cancer and 91% for those with high-risk prostate cancer, according to the Journal of Medical Imaging and Radiation Oncology.
There are side effects you should be aware of, such as:
- Bowel and urinary dysfunction
- Erection problems, including impotence
Thankfully, advanced techniques and innovative products are helping to mitigate the side effects of prostate cancer therapies like external beam radiation.
For instance, since the rectum can be exposed to radiation during treatment, it can create bowel, urinary, and sexual issues. SpaceOAR Hydrogel works to combat these side effects by acting as a spacer between the rectum and prostate. The gel is a non-painful fluid that can be harmlessly absorbed by the body, protecting areas around the prostate during radiation therapy.
The great results of such products prove their effectiveness. Consider the following results from patients who used SpaceOAR hydrogel:
- Bowel: 66% fewer had clinically significant declines in bowel functioning (1X the Minimal Important Difference).
- Urinary: 65% fewer had clinically significant declines in urinary functioning (2X the Minimal Important Difference).
- Sexual: 78% were more likely to retain sexual function at three years if they had erections sufficient for sex at baseline.
Learn How SpaceOAR Hydrogel Can Help Protect Quality of Life for Men Undergoing Radiation Therapy for Prostate Cancer
Brachytherapy (Internal Radiation)
When undergoing brachytherapy, small seeds of radioactive pellets are placed into your prostate. It’s usually used for men with early-stage, slow-growing prostate cancer. It can be combined with external radiation if there is a risk of the cancer spreading beyond the prostate.
The advantage of brachytherapy is that it’s quite a precise treatment. When combined with external beam radiation, it has a higher success rate than any treatment alone, according to Dr. John Sylvester, a radiation oncology specialist. The treatment is also done in an outpatient setting.
Side effects from internal radiation are about the same as external radiation.
Surgery for prostate cancer may be an attractive option for you if, especially if you want something that’s one-and-done: Successful surgery means you won’t have any doubts about the cancer’s status. It also requires fewer trips to the doctor for treatment compared to radiation therapy.
There are two types of surgery for prostate cancer:
Radical retropubic prostatectomy
- The surgeon makes an incision in the abdomen and removes the prostate gland.
- This is the more common option because the surgeon can remove nearby lymph nodes if there’s concern will spread there.
- You’ll stay in the hospital for a few days, with full recovery taking several weeks.
Radical perineal prostatectomy
- The surgeon makes an incision between the scrotum and anus and removes the prostate gland.
- This operation is the shorter option, but it’s used less often because the potential for erection problems is more likely and lymph nodes don’t need to be removed.
- Recovery time can take a few weeks, but is often the shorter and less painful of the two.
Both types of surgery for prostate cancer come with potential side effects. These include:
- Major common side effects
- Erectile dysfunction: Problems or inability to get and/or keep an erection.
- Urinary incontinence: Inability to control your urine or have leakage/dribbling.
- Other possible side effects
- Not reacting well to the anesthesia
- Surgery causing excessive bleeding
- Legs and lungs getting blog clots
- Nearby organs getting damaged
- Surgery site infections
Active surveillance is an option if you have a Gleason score of 6 or less, which means the cancer should grow slowly, and a prostate-specific antigen level less than 10 ng/ml, which means your chances of having a fast-growing prostate cancer are low.
Here’s why active surveillance may be the course of action you choose if you’re in the early stages of prostate cancer:
- You’re risk averse: Active surveillance is a low-risk treatment option for prostate cancer.
- You want to maintain your quality of life: Active surveillance means not having to deal with side effects caused by radiation or surgery, such as erectile dysfunction, bowel irritability, and fatigue.
- Your cancer is in the early stages and is slow-growing: Many doctors may even say surveillance is the recommended course of action.
- You’re older or have other serious health problems: In such cases, monitoring a slow-growing prostate cancer is advised so you can focus on staying healthy and enjoying life.
Patients who have decided to monitor and wait have had success. Consider your situation and work with your doctor to determine if it’s the right fit for your situation.
Keep in mind that, if you’re in the later stages but decide to monitor the cancer due to other health concerns, prostate cancer symptoms in later stages are very similar to the side effects of the treatments. These include:
- Difficulty holding or starting urination, weak or interrupted flow of urine, and/or pain during urination
- Erectile dysfunction, painful ejaculation, and/or a decrease in the amount of fluid ejaculated
- Blood in your urine or semen
- Rectum pain or pressure
- Stiffness or pain in the thighs, pelvis, hips, and/or lower back
Making the right choice for your prostate cancer treatment
Without a doubt, it’s never easy making such life-changing choices. The good news is that, as technology advances, your decisions become easier.
New technologies are appearing all the time, such as the immunotherapy treatments currently being explored. Even personalized plans based on your genetic makeup are already in the works. Products already on the market, like SpaceOAR Hydrogel, can mitigate side effects from radiation treatment—meaning you protect your quality of life and also treat your prostate cancer.
By educating yourself, assessing your situation, exploring all options (including new techniques and technologies), and talking with medical professionals and loved ones, you can make the right choice for yourself. And you can beat prostate cancer and get back to living life the way you wish.