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Prostate Cancer Treatment

There are many treatment options for those with prostate cancer. Men with prostate cancer may have a single type of treatment or a combination of treatments.

Your doctor — either your personal physician, urologist (specialist in urinary issues), or cancer specialist — will talk with you about the pros and cons of the recommended treatment.

Treatments for Prostate Cancer

Watchful waiting: Watchful waiting (also known as active surveillance) is often used with men who have slow-growing, low-risk cancer. Watchful waiting is also used when it’s unclear whether a man has cancer or benign prostatic hyperplasia (BPH). BPH is when normal prostate cells reproduce too fast causing an enlarged prostate.

In watchful waiting, your doctor will carefully monitor your prostate, watching for any growth or symptoms. You will have medical exams and follow-up tests every three to six months. Tests might include blood tests, biopsies, and rectal exams.

It may feel unusual to live with cancer — not removing it with surgery or radiation therapy. However, men often choose watchful waiting over more aggressive treatment with side effects, since slow-growing cancer usually does not cause symptoms.

Other treatments:
If the cancer is faster growing, recommended treatments could include one or more of the following:

Surgery: If the cancer is confined to the prostate — stage 1 or 2, and sometimes 3 — the surgeon can remove part or all of the prostate. This is known as radical prostatectomy. If cancer has spread to nearby tissues or other organs — stage 3 or 4 — surgery is sometimes an option, in combination with other treatments.

Often surgery also removes lymph nodes in the pelvis. The lymph nodes are tested to find out if the cancer has spread to other areas in the body.

There are several types of surgery:

  • Open surgery: The surgeon makes a cut through the abdomen or through the area between the scrotum and anus to remove the tumor or prostate.
  • Laparoscopy prostatectomy: The surgeon uses a thin lighted tube inserted through a small cut or cuts in the abdomen to remove the prostate.
  • Robotic laparoscopy: The surgeon uses a computer and a robot’s arms to remove the prostate in a laparoscopy.
  • Resection: The surgeon removes tissue from the inside of the prostate. This helps relieve symptoms of advanced prostate cancer and restores the flow of urine if the urethra is blocked. the resection process is called channel TURP (transurethral resection of the prostate). This surgery isn’t a cure, but may be used to release obstruction in the prostate.
  • Cryotherapy: The surgeon uses cryotherapy (extremely low temperatures) to treat the cancer. In this procedure the surgeon inserts a probe into the prostate using an ultrasonic guide.

Each type of surgery has benefits and risks. Your doctor can give you more information and discuss which of these options might be right for you.

Radiation therapy:
Radiation therapy can be used for many stages of prostate cancer. It can be given in a series of treatment sessions by a machine that precisely focuses energy on the tumor. It can also be given through radiation implants (brachytherapy).

We have a specialist in brachytherapy at Kaiser Permanente as well as the latest radiation equipment, such as a Varian Clinac iX (linear accelerator). This system pinpoints tumors and regulates a precise path of cancer-killing radiation.

One option we're often asked about is proton treatment — is it the best treatment for prostate cancer? The best research on proton therapy has not shown that it is either more effective or produces fewer side effects than current forms of radiation therapy. We're convinced that our Kaiser Permanente treatment options are the proven standard for safe and effective prostate cancer treatments.

Hormone therapy:
Hormone therapy can slow the growth of prostate cancer cells by stopping or reducing the production of male hormones. This therapy is sometimes used along with other treatment. While this therapy is not considered a cure for prostate cancer, it can stall or even prevent recurrence for many men.

Chemotherapy: Chemotherapy is used if cancer has spread outside the prostate and other treatments aren’t effective. It is not considered to be a cure, though it may prolong life.

Reactions to Treatment

Men who have had surgery to remove their prostate can have problems with urinary, bowel, and sexual function for some time after treatment. These problems can also occur with other treatments, such as radiation.

These problems sometimes get better over time. Your doctor can suggest medicine or other ways to help manage these side effects of cancer treatment.

Men who are treated with hormone therapy can have side effects that include hot flashes, enlarged breasts, weight gain, osteoporosis, increased risk of heart trouble, and problems with sexual function.

Side effects from radiation depend on the radiation type and dose. Some common effects include fatigue, urinary trouble, and blood in the urine and stool.  

Your doctor, nurse, nutritionist, or oncology pharmacist can help you manage side effects. They will work as a team to help you address your unique side effects and symptoms.

Contacting Your Care Team at Group Health

As you discuss your treatment and possible side effects with your care team, also talk about what signs and symptoms require medical attention right away. When you experience those symptoms, you should call your care team for help or advice. After clinic hours, you should call our Consulting Nurse Service for help, available 24 hours a day, 7 days a week.

Taking Care of Yourself

It might seem like your life is revolving around cancer treatment during this time. But it’s important to take care of your other physical needs and your emotional needs as well.