Medically Reviewed by Virginia L. Clyburn-Ipock, MD

A man facing prostate cancer also faces one of the widest range of treatments for any cancer. “Watchful Waiting” is unique to cancer of the prostate, a walnut-sized gland that sits in a man’s pelvic area.

“In most cases, prostate cancer is a slow-growing cancer that may be monitored by a man’s personal physician closely instead of pursuing treatment right away,” says McLeod Radiation Oncologist Virginia Clyburn-Ipock, MD. “Fortunately, prostate cancer mortality rates have been decreasing since the mid-1990s in both African-American and Caucasian men. This decrease is often attributed to an improved ability to detect and, then, treat the disease in its early stages.”

The most appropriate treatment for prostate cancer should be based on the man’s age, life expectancy and other medical problems, as well as the stage and aggressive nature of the cancer.

Treatment options for localized prostate cancer include:

• Observation (Watchful Waiting). The patient sees his physician on a regular basis for digital rectal exams, PSAs and, if needed, a repeat prostate biopsy. If necessary, the physician may recommend moving to a more aggressive treatment plan.
• Radical Prostatectomy. Surgeons can perform a radical prostatectomy to remove the prostate. Some men may be candidates for minimally invasive surgery, which involves smaller incisions, less pain and a speedier recovery.
• External Beam Radiation Therapy. Radiation Oncologists treat prostate cancer using intensity modulated radiotherapy (IMRT). With IMRT, radiation is delivered directly to the prostate, minimizing harm to the surrounding organs, including the bladder, rectum, top of the thigh bone (femoral head) and the small bowel. IMRT has also been shown to be beneficial in reducing long-term side effects of prostate cancer.
• Stereotactic Body Radiation Therapy (SBRT). Treatments with a highly focused TrueBeam linear accelerator allow for improved images of the tumors and normal organs, while allowing for faster treatment times. Traditional radiation treatments for prostate cancer can take 15 to 20 minutes, while the SBRT treatments can take only five minutes.
• Brachytherapy – the implanting of radioactive seeds into the prostate.

When men receive radiation therapy for prostate cancer, the side effects of treatment impact organs in the pelvis. Men may notice an increase in urination, experience some burning when urinating or have trouble starting their stream. There could be an increase in bowel movements or loose bowel movements as the end of treatment nears. Usually, these side effects fade away when radiation ends. However, about 20 percent of men require a medication like Flomax to help them with their urination long term.

ACTION YOU CAN TAKE
There is no single treatment option that is better for all men. If you are diagnosed with prostate cancer have a thorough discussion with your physician of all treatment options so you can decide together, which approach is best suited for you.

Have a question?  Ask a Cancer Specialist.