Finding out You Have Prostate Cancer
Prostate cancer is the most common cancer in American men. It accounts for one quarter of all men’s cancers. Finding out you have prostate cancer is difficult, of course. But in some cases, making decisions about your treatment is the hardest part of having this disease.
According to the American Cancer Society, more than 80 percent of prostate cancers are in the “local” stage, meaning the cancer hasn’t spread. If your doctor has told you your cancer is in the early stages, that’s the kind of news you want to hear. But for most men in this situation, there are quite a few treatment decisions they, along with their doctor, have to make.
If the cancer has spread to other parts of your body, your treatment options are generally more clearly defined. For most men, it’s actually easier to make decisions about their treatment when the cancer has spread.
Types of treatment
When it gets down to it, you and your doctor will make a treatment decision based on the following factors
- The stage and grade of the cancer—this shows how abnormal the cancer cells look and how likely it is the cancer will spread
- Your age
- Your overall health status
- The way you feel about the potential side effects of the different treatment options
Most cancers are the slow-growing type. If this is the case for you, you can take your time as you sift through the treatment possibilities and learn how they’ll affect you.
What are the typical options?
Watchful waiting: This is often the treatment of choice if your cancer seems to be slow-growing and contained in a small area. In other words, many men choose watchful waiting if their cancer isn’t an aggressive type. Older men often choose watchful waiting because there’s a good chance the cancer will not progress much during their lifetimes. The benefit of watchful waiting is that there are no side effects. The down side is that some men can’t ever forget they have a tumor, and they never feel at ease with the idea that they’re doing nothing to treat it.
Surgery: This usually consists of removing the prostate gland entirely. It’s often the choice when the cancer has not spread beyond the walls of the tumor. One big benefit of surgery is that many men feel relieved to have their cancerous prostate taken away. But there are no guarantees, and in about 30 percent of surgery cases, the cancer has spread more than expected. The most negative side effect of surgery is that it almost always causes impotence and incontinence. These symptoms last at least to 12 months, even when nerve-sparing procedures are used. Many times, the symptoms last a lifetime.
Radiation therapy: This is often used when the cancer hasn’t spread outside the prostate gland or when it has spread only to nearby tissue. Radiation can be external or internal. For the external type, you would typically get a treatment five days a week for seven or eight weeks. Treatment itself is painless, but it can cause such side effects as diarrhea, sometimes with blood in the stool, intestinal irritation, frequent urination, burning sensation while urinating. About 30 to 60 percent of men who have external radiation therapy become impotent, or unable to have an erection, one or two years after the therapy begins. Impotence can often be treated, for example with Viagra, but this is an important issue for many men.
When internal radiation is the treatment choice, small radioactive pellets, about the size of a grain of rice, are implanted in the prostate gland itself. For a week after the implantation, you may experience, you may have pain in the area and urine that’s reddish-brown in color. Internal radiation can also cause impotence and the inability to control your urine and bowel movements. Be sure to talk to your doctor if you experience any of these symptoms.
Hormone therapy: This is used mainly for men who are not good candidates for surgery or radiation. It’s generally used to make shrink the tumor or to make it grow more slowly. It doesn’t cure the cancer, but it provides relief from symptoms. The goal of hormone therapy is to lower the levels of the male hormones, or androgens. Androgens help the prostate tumor to grow. Hormone therapy options include removing the testicles (which is not preferable for most men), receiving hormone shots or taking pills. This treatment can have serious side effects such as impotence, weakening of the bones, breast tenderness, anemia, loss of muscle mass, tiredness and decreased levels of “good’ cholesterol.
Treatment choice depends on you
Your doctor can help you learn about the risks and benefits of each type of treatment, but you are the one who has to decide which option is right for you. It’s a highly individualized choice. While you’re deciding, you’ll probably want to discuss it with your spouse or partner. Include the people in your life in your decision-making process. This will help you sort through the options and make a decision that’s right for you.
Be sure to tell your doctor if you’re having pain or any other symptoms that are affecting your quality of life. Some studies have shown that people whose pain is treated well may live longer than people who don’t have good pain management. When you don’t have a lot of pain, you’re able to focus on your recovery and on enjoying your life.
The American Cancer Society; The National Cancer Institute; The National Prostate Cancer Coalition