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How is prostate cancer treated?
The treatment approaches to prostate cancer vary. The choices depend on the patient's prostate cancer treatment preferences, the prostate cancer stage, the patient's life expectancy, and the general physical and medical condition of the patient. A prostate cancer cure means the patient has achieved a prostate cancer-free state. If prostate cancer is caught early, the patient can become cancer-free.
Currently, there is no one best treatment for clinically localized prostate cancer (cancer that has not spread).
Early stage. For patients with early stage prostate cancer and a projected life expectancy of less than 10 years, watchful waiting (or doing nothing, but monitoring the patient's condition) is a reasonable course of action.
Localized prostate cancer. Prostate cancer surgery or surgery to remove the prostate is generally performed in patients with localized prostate cancer and a life expectancy greater than 10 years. Radiation therapy (external beam irradiation or implantation of radioactive pellets or "seeds") is an alternative in patients with localized prostate cancer.
Advanced disease and shorter life expectancy. Patients with advanced disease and projected life expectancy of less than 10 years are candidates for radiation therapy and prostate cancer drug therapy with diethylstilbestrol, luteinizing hormone-releasing hormone analogues, and antiandrogens. These patients may undergo surgery to remove both testes, also known as a bilateral orchiectomy.
Regional disease and longer life expectancy. Treatment of patients with regional metastatic prostate cancer with projected life expectancy of 10 years or more includes radical prostatectomy, radiation therapy, and hormonal therapy.
Metastatic disease. Androgen-deprivation therapy is a common treatment for metastatic prostate cancer. Additional treatment with gonadotropin-releasing hormone (GnRH) agonists (goserelin, leuprolide, or triptorelin) plus antiandrogens (flutamide, bicalutamide, or nilutamide), when started with external irradiation, improves control of the cancer and survival in patients with metastatic prostate cancer. Pamidronate prevents bone loss in the hip and lumbar spine in men receiving GnRH.
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