Questions about Treatment
How is prostate cancer treated?
All decisions about the right treatment pathway for you are taken after careful consideration of the classification of the tumour, your prognosis, your general state of health, the availability of treatment options in your hospital, and your personal preferences and values. The most important factor for selecting treatment are the stage and the aggressiveness of the disease. Prostate cancer can be treated by:
- Radical prostatectomy
- Radiation therapy
- Hormonal therapy
- Active surveillance
- Watchful waiting
- New experimental techniques
What is radical prostatectomy?
Radical prostatectomy is the surgical treatment in which the entire prostate and the seminal vesicles are removed.
What is radiation therapy?
Radiation therapy is a type of cancer treatment to control and kill cancer cells. Prostate cancer cells are generally responsive to radiation therapy.
What is hormonal therapy?
Hormonal therapy for prostate cancer aims to stop the production or block the action of male sex hormones that help the tumour grow. Another name for hormonal therapy is androgen deprivation therapy (ADT).
To block the action of the hormones, known as androgens, your doctor will prescribe anti-androgen drugs. The production of androgens can be stopped with a surgery to remove both testicles, or with drugs which cause chemical castration. When effective, hormonal therapy stops the growth of the tumour.
What is active surveillance?
Active surveillance is a type of treatment for prostate cancer in which the doctor monitors the tumour and its growth, based on a strict visiting schedule. During each visit, several tests are done including a test to check the level of prostate-specific antigen (PSA) in the blood. The aim is to switch to other treatment options if there are signs that the disease is progressing.
Active surveillance is a treatment pathway to cure localized prostate cancer. If the tumour has grown out of the prostate and invaded other tissue in the lower urinary tract, other treatments will be recommended.
What is watchful waiting?
Watchful waiting is a form of symptom-guided treatment for prostate cancer. The aim is to switch to other treatment options only when symptoms appear. Watchful waiting is part of a palliative care approach.
What is CSAP?
Cryosurgery of the prostate (CSAP) is an experimental technique to treat prostate cancer. It is a minimally-invasive surgery in which freezing temperatures are applied directly to the tumour cells to kill them.
What is HIFU?
High-intensity focussed ultrasound (HIFU) is an experimental technique to treat prostate cancer. It uses the energy of high-frequency sound waves to heat the cancer cells and kill them.
What is focal therapy?
Focal therapy is a term for several experimental techniques to destroy only small tumours in the prostate, without treating the entire gland. Because the treatment is focused directly on the tumour cells, there is not much damage to other tissue in the prostate or the lower urinary tract.
What is castration-resistant prostate cancer and how is it managed?
Castration-resistant prostate cancer is a type of prostate cancer that usually develops during treatment for metastatic disease. These tumours need much lower levels of androgens to progress. This means that even when your body produces almost no androgens, the tumour continues to grow. These cancers are called castration-resistant, because they no longer respond to hormonal castration treatment.
It is important to realize that castration-resistant prostate cancer cannot be cured. Instead, your doctor will try to reduce the size of the tumours. This will give you the chance to live longer and have fewer symptoms.
Research on castration-resistant prostate cancer is ongoing and treatment options change quickly. Your doctor may recommend:
- New hormonal agents
What are new hormonal agents?
New hormonal agents are drugs for castrationresistant prostate cancer when standard hormonal treatment is no longer effective. The most common hormonal agents for prostate cancer are abiraterone acetate and enzalutamide.
What is chemotherapy?
Chemotherapy is a type of cancer treatment that uses chemicals to destroy cancer cells. Chemotherapy drugs can be injected into the bloodstream to attack cells throughout the body. They can also be applied directly to the tumour. Docetaxel is the most commenly used chemotherapy drug for prostate cancer.
What is immunotherapy?
Immunotherapy is a type of treatment that uses your own immune system to fight the tumour cells. In prostate cancer the drug Sipuleucel-T is used as immunotherapy.