Sometimes prostate cancer is slow-growing and less likely to cause death
than other health issues. For men over age 70, or for those with other
health problems whose life expectancy is less than ten years, “watchful
waiting” can spare them from unnecessary treatment and the side effects that
can accompany it.
Surgery
Open Surgery – traditional prostatectomy surgery involves removing
the prostate entirely. It is only a viable choice if the cancer is
confined to the prostate area. [
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Laparoscopic Surgery – with laparoscopic surgery, several small
incisions are made in the abdomen through which micro-surgical
instruments are used to remove the prostate. [
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Robotic surgery -- the third option is robotic-assisted surgery. In
2003, Aurora St. Luke's Medical Center acquired the state-of-the-art
daVinci® Surgical System. We were the first Wisconsin hospital to
perform this minimally invasive form of surgery. Since that time, we
have performed hundreds of operations using robotic surgery – more than
any other hospital in the state. Worldwide, removing the cancerous
prostate, using this surgical system, has been done over 7,600 times.
These precise procedures require smaller incisions and help speed the
recovery process for most patients. [
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Cryosurgery – a probe is inserted into the prostate and freezes the
prostate to kill cancer cells. It can be repeated multiple times if
needed. Though this technique has improved in the last few years,
long-term data is not yet available as to its long-term effectiveness
and it is still considered experimental. Impotence and urinary
incontinence are possible side effects.
With all types of surgery, there are risks of side effects including
possible urinary incontinence or impotence, though these side effects may
lessen over time. The risk of having these side effects increases with age.
External
beam – a computer aims radioactive rays at the prostate from outside
the body to kill cancer cells.
3D Conformal Radiation Therapy (3D-CRT) – 3D-CRT uses special
computers to precisely map the location of the prostate. This mapping
makes it possible to aim the radiation treatment directly at the
prostate, avoiding other structures.
CyberKnife Radiosurgery – surgeons are now utilizing the CyberKnife®
Radiosurgery System, a robotic arm that can provide large and precise
doses of radiation to tumors and reduces the number of treatments needed
from 40 over an eight-week period to five or so over a week. The
placement of fiducial markers is needed to accurately identify the
prostate. Similar to surgery, radiation treatment can cause impotence,
though it may not occur right away after the surgery, but rather over
time
Intensity Modulated Radiation Therapy (IMRT) – IMRT is an advanced
form of 3D-CRT with the same 3D mapping capability. IMRT uses a
computerized machine that moves around the patient to deliver radiation
beams from different angels. IMRT allows physicians to adjust the
strength of each radiation beam, to minimize the doses that reach more
sensitive tissue. The placement of three gold markers within the
prostate, are required to indicate the precise location of the prostate
before treatment begins. [
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Brachytherapy – brachytherapy involves implanting radioactive seeds
in the prostate to kill cancer cells. This method of treatment may have
fewer side effects.
Hormone therapy
By impeding testosterone, physicians can slow cancer growth. While
hormone therapy will not cure prostate cancer, it is often recommended in
addition to another form of treatment, or to keep it from spreading too fast
when no treatment is the recommended way to proceed. Side effects often
include hot flashes, a loss of sex drive, as well as impotence and muscle
and bone loss (osteoporosis).
Chemotherapy
Chemotherapy uses anti-cancer drugs that go throughout the entire body.
It is usually only used in patients that have advanced cancers that are not
responding to hormonal therapy. The side effects vary for the different
kinds of drugs utilized and should be discussed with your physician.
Physicians stimulate the patient's own immune system to identify and
destroy cancer cells on its own without destroying healthy tissue. Cancer
vaccines use a patient's cells to trigger an immune system attack on the
cancerous prostate cells.
