The main approaches to treating early-stage prostate cancer are:
Complete surgical removal of the prostate.
Side effects include urinary incontinence (bladder control problems) that can last for weeks, and erectile dysfunction. Options include:
- Nerve-sparing retropubic radical prostatectomy (NS-RRP)
- Radical perineal prostatectomy (RPP)
- Robotic and/or laparoscopic prostatectomy
- Nonnerve sparing wide excision RP
Radiation therapy:
There are two options:
- High-powered x-rays are used to kill the cancer cell. Side effects include reduced sexual function, urinary troubles, intestinal difficulty, loss of appetite and hair.
- Radioactive seeds. Your doctor will use a special needle to implant 80 – 120 pellets the size of a grain of rice directly into the prostate. There are fewer sexual side effects but more urinary ones, and there can be damage to the rectum and lower intestines.
Hormone therapy:
Because the male sex hormone, testosterone, stimulates cancer cells to grow, you can take drugs to block testosterone production. Hormone therapy is usually not a cure, it's just a way of stopping the tumor from growing any more. Side effects include breast enlargement reduced sex drive, weight gain, reduction in muscle mass.
Cryosurgery (also called cryotherapy):
This is an increasingly popular treatment that involves freezing the prostate gland in order to destroy the cancer within it. Cryosurgery is an FDA-approved treatment for localized and locally recurrent prostate cancer. It may cause more sexual side effects than other local therapies, but if you're interested, ask your doctor for more information.
Observation:
This can be a good options if your doctor believes your cancer is growing very slowly and won't spread to other parts of the body. The advantages are that you avoid all the risks associated with the various treatment options above. Disadvantages are that you'll need regular monitoring in something changes for the worse. This is also called "watchful waiting" or "active surveillance."