September 15th, 2015
The treatment of choice for the management of prostate cancer depends on several factors such as; intensity and severity of disease, age at diagnosis, co-morbid health issues, patient preferences, available treatment options and potential side effects in conjunction with overall health status of the patient.
Active surveillance is usually adopted in the initial stages when there are no problematic symptoms and the malignant lesion of prostate gland is restricted i.e. no signs of capsular penetration or nodal involvement. Additionally, it is also helpful in men who have serious health issues or those who are not ideal candidates for aggressive treatment plans. Depending upon the patient factors and preferences, the surgeon may not advice immediate intervention (surgical or medical) and instead opt for active surveillance.
This active surveillance of prostate cancer includes regular rectal examination, serological testing for PSA levels, and frequent biopsies (in many instances). Other reasons for choosing active surveillance are;
One classic limitation of using this approach is; high risk of metastatic spread to distant organs. Additionally, a lot of people may not remain compliant to the surveillance regimen and may end up developing aggressive illness.
One of the most commonly used methods of treating prostate cancer is the use of radioactive isotopes to inhibit the growth of cancer cells. The primary indications for using radiation therapy includes:
Radiotherapy for the management of prostate cancer can be delivered via:
Other types of radiotherapy include; Three-dimensional conformal radiation therapy (also referred to as 3D-CRT), Intensity modulated radiation therapy (also known as IMRT), Stereotactic body radiation therapy (SBRT) and Proton beam radiation therapy.
Although radiation therapy is highly effective against the prostate cancer and other malignancies, the risk of serious side effects is fairly high. For example, according to a new study reported in the New England Journal of Medicine (3), investigators suggested that 94% males have erectile dysfunction at 15-year follow-up after radiation therapy for prostate malignancy; yet only 43.5% report significant sexual dysfunction. Other common adverse effects include;
Read more about Hormone Therapy and its side effects, Chemotherapy and Biological therapy in the upcoming blog post.