What are the treatments for prostate cancer?

Early stage prostate cancer

If the cancer is small and contained - localized - it is usually managed by one of the following treatments:

§  Watchful waiting - not immediate treatment is carried out. PSA blood levels are regularly monitored.

§  Radical prostatectomy - the prostate is surgically removed.

§  Brachytherapy - radioactive seeds are implanted into the prostate.

§  Conformal radiotherapy - the radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment, thus minimizing healthy tissue exposure to radiation.

§  Intensity modulated radiotherapy - beams with variable intensity are used. An advanced form of conformal radiotherapy usually delivered by a computer-controlled linear accelerator.
Treatment recommendations really depend on individual cases. In general, if there is a good prognosis and the cancer is in its early stages, all options can be considered. However, they all have their advantages and disadvantages. The patient should discuss available options thoroughly with his doctor.

More advanced prostate cancer

If the cancer is more aggressive, or advanced, the patient may require a combination of radiotherapy and hormone therapy. Radiotherapy requires treatment on an everyday basis for up to about eight weeks. Radical surgery is also an option - the prostate is removed. Traditional surgery requires a hospital stay of up to ten days, with a recovery time that can last up to three months. Robotic keyhole surgery has the advantage just a couple of days in hospital, followed by a much shorter recover period. However, even robotic keyhole surgery may not be ideal for very elderly patients.

In advanced prostate cancer hormone therapy is very effective in slowing down, and even stopping the growth of cancer cells. Even if the hormone therapy stops working after a while, there are still other options the patient will be able to discuss with his doctor, such as participating in clinical trials.

Radioactive injection helps advanced prostate cancer patients live longer - scientists at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, UK, reported in NEJM (New England Journal of Medicine) that radium-233, a radiation injection, directly targets tumors in the bone delivering short range radiation, causing minimal damage to healthy tissue. Radium, like calcium, is absorbed by the bone.

Dr Chris Parker and colleagues found that late-stage prostate cancer patients who were given the radioactive injection lived for an average of 15 weeks longer than those given an inert placebo injection.

Dr Parker said "We're excited by the prospects for this ingenious new treatment, which takes advantage of the properties of tumors growing within bone to home in and deliver a highly targeted dose of radiation. We were delighted to show that radium 223 allowed many men in our trial to live to see a few extra, precious months. Not only did they live longer, these men had a much better quality of life."

Delivering estrogen through skin patches may be an easier and safer way to treat prostate cancer than the hormone therapies that are currently used, British researchers explained in Lancet Oncology (March 2013 issue).

In May 2013, the US FDA approved Xofigo (radium Ra 223 dichloride) for metastatic castration-resistant prostate cancer that has reached bones but not other organs. Enzalutamide is taken in combination with docetaxel, another cancer medication.

Richard Pazdur, M.D., from the FDA, said "Xofigo binds with minerals in the bone to deliver radiation directly to bone tumors, limiting the damage to the surrounding normal tissues. Xofigo is the second prostate cancer drug approved by the FDA in the past year that demonstrates an ability to extend the survival of men with metastatic prostate cancer."

Xtandi (enzalutamide) was approved by the FDA in August 2012 for patients with metastatic castration-resistant prostate cancer that has spread or recurred.

The problem with the Internet for many prostate cancer patients

Researchers from Loyola University Medical Center reported in the Journal of Urology that one third of American lay people find it hard to understand most information websites regarding prostate cancer. Senior author, Gopal Gupta, MD, said: "This is problematic for one-third of Americans who seek to further educate themselves using online resources."

Coffee and prostate cancer

Heavy coffee drinking may prevent cancer recurrence or progression - men with prostate cancer who consume at least four cups of coffee per day may have a lower risk of disease progression or recurrence, researchers from the Fred Hutchinson Cancer Research Center reported in the journal Cancer Causes and Control.

Recent developments on prostate cancer from MNT news

Accurate test for aggressive prostate cancer steps closer with genetic study - Researchers behind a new genetic study led by the University of Pittsburgh School of Medicine, PA, suggest their findings will lead to a more accurate test for aggressive prostate cancer and new ways to treat it.

Writing about their work in the American Journal of Pathology, the team explains how they found prostate cancer patients with certain genetic mutations have a 91% chance of their cancer coming back.

Specific baldness pattern linked with increased prostate cancer risk - Men with a specific pattern ofbaldness at age 45 have a 40% increased risk of later developing aggressive prostate cancer, according to a new study published in the Journal of Clinical Oncology.

Physical activity linked to lower death risk in men with localized prostate cancer - Around 1 in 7 men will develop prostate cancer in their lifetime. But a new study suggests men with localized prostate cancer could reduce their risk of all-cause and prostate cancer-specific mortality simply by exercising more.

Scientists reveal genetic root of prostate cancer - An international team of scientists have revealed the genetic root of prostate cancers in individual men, demonstrating that tumors share common gene faults which could potentially offer new targets for treatment.