There is a dangerous trend of growing numbers in adult man with prostate cancer. For those under 60 years and in good health, having cancer treated right away seems to be the right decision. But is that really the case?
Most men with prostate cancer can choose from two treatments: surgery to remove the prostate gland and radiation therapy, sometimes combined with androgen deprivation therapy. Combination of both treatments can be recommended for some patients.
Patients that choose surgery can choose from: open incision radical prostatectomy or newer robot-assisted procedure. Robot-assisted procedure is performed through tiny cuts in the lower abdomen. Then a robot-like finger is manipulated through those holes to remove the prostate and surrounding lymph nodes. This treatment usually comes with a shorter hospital stay and faster recuperation time.
Sometimes laparoscopic prostatectomy is also an option. This is done with tiny cameras and surgical tools that are inserted through mid-size cuts in abdomen.
Radiation therapy can also come in two options: an external beam radiation and radioactive seed implants. External beam radiation is non-invasive therapy which includes high-energy X-rays to prostate gland. It is a longer treatment and it may come with various side effects such as fatigue, loss of appetite and nausea as addition to incontinence and sexual dysfunction. Radioactive seed implants or brachytherapy is a treatment in which a small implant is inserted into the prostate gland. Implant than releases low doses of radiation over a longer time period. Implants pose less risk for rectum damaging but higher risk for urinary incontinence.
None of this treatment is perfect and all come with possible side effects that can have a huge impact on a patient life. Surgery can cause leaking of urine or stool, impotence and shortening of the penis. Radiation therapy can cause impotence and urinary incontinence.
There are some treatments that help with some side effects, like nerve-sparing surgery that can save the nerves that control erection and with that help reduce impotence rates. But this is not a solution for every patient.
Many times it is just the level of expertise of your surgeon that can either save your life or make it worse. It has also been proven, that there is less side effects in the patients that did not have any problems before the treatment.