If cancerous cells are found during testing, your doctor will use the Gleason System to rate the cells on a scale from 1 to 5, with 1 being the most normal and 5 being the most abnormal. The Gleason Score is used to indicate your prostate cancer’s aggressiveness, which helps determine the best treatment. Your options may include:
Active surveillance: For some men, a “watch and wait” approach may be an option. In that case, your doctor will perform a PSA test and a digital rectal exam every 3 to 6 months. You may also need an annual prostate biopsy. If the disease begins to progress, you’ll require further treatment.
Surgery: Risks of surgery include urinary incontinence or impotence, though these side effects may lessen over time. The older you are, the greater your risk of complications.
Prostatectomy: Traditional surgery involves removing your prostate entirely. It is only a viable choice if the cancer is confined to your prostate area and hasn’t spread.
Laparoscopic surgery: Micro-surgical instruments are inserted through small incisions in your abdomen and then used to remove your prostate.
Robotic surgery: These precise procedures require smaller incisions, which can help speed the recovery process. Since acquiring the state-of-the-art daVinci® Surgical System in 2003, Aurora St. Luke's Medical Center has performed thousands of operations using robotic surgery – more than any other hospital in Wisconsin.
Cryosurgery: A probe inserted into your prostate freezes the tissue to kill cancer cells. This procedure can be repeated if needed. Unfortunately, data is not yet available as to the long-term effectiveness.
Radiation therapy: Just like surgery, radiation treatment can cause impotence, though it may not occur right away, but rather over time. There are 2 types of radiation therapy:
- External beam radiation sends beams of high-energy X-rays through your skin to target and kill cancer cells. There are several different methods, including 3D conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT), Calypso 4D System, CyberKnife®.
- Brachytherapy involves implanting radioactive seeds in your prostate to kill cancer cells. This method of treatment may have fewer side effects than external beam radiation. On May 21, 2014, Aurora St. Luke's Medical Center performed its 1,000th radioactive seed implantation.
Hormone therapy: Although hormone therapy won’t cure prostate cancer, it can slow cancer growth. It’s often recommended in addition to another form of treatment.
Chemo may be used after removal of your prostate to reduce the chance of the cancer coming back. It's also used if you have advanced prostate cancer that isn’t responding to hormonal therapy.
Immunotherapy: This treatment stimulates your immune system to identify and destroy cancer cells without affecting healthy tissue. Cancer vaccines use your own cells to trigger your immune system to attack prostate cancer cells.