Surgery

Surgery to treat prostate cancer is usually reserved for men in good health who are younger than 70 and who choose to have surgery. Surgery may be done to relieve symptoms and to slow the growth of cancer.

Surgery Choices

• Radical prostatectomy, the removal of the prostate and its cancer. It is not usually done if the cancer has spread to other parts of the body.
• Orchiectomy, the removal of the testicles. This may cause the cancer to shrink and may improve symptoms because prostate cancer often needs the testosterone made by the testicles to grow.
• TURP, or transurethral resection of the prostate. This operation can help to relieve bladder problems because it removes part of the tumor that may be blocking the urethra, the tube that carries urine from your bladder through your penis. This can keep the tumor from growing for a while. But TURP does not take out the whole tumor.

What to Think About

Surgical removal of the testicles (orchiectomy) and hormone therapy medicines have some of the same side effects, including hot flashes, larger breasts, loss of sexual desire, and the inability to have an erection.

Other Treatment

Radiation therapy

Radiation therapy for prostate cancer may be used alone or combined with hormone treatment. In rare cases, it is used with surgery. It is most effective in treating cancers that have not spread beyond the prostate, but it can also be effective in treating cancer that is only in the tissue near the prostate (locally advanced prostate cancer). Radiation therapy also is used to relieve pain from metastatic cancer or cancer that comes back after surgery.

Radiation therapy for locally advanced prostate cancer is often combined with hormone treatment. Using both together improves your chances of being disease-free for longer and living longer.²

External-beam radiation therapy uses a large machine to aim a beam of radiation at your tumor to destroy cancer cells. The radiation damages the genetic material of the cells so that they can't grow. Although radiation damages normal cells as well as cancer cells, the normal cells can repair themselves and function, while the cancer cells cannot. If cancer has spread to your bones, radiation treatment may be given to specific areas to relieve pain.

Side effects

Radiation treatment commonly has side effects, including urinary incontinence, inflammation of the bladder and colon (colitis), diarrhea, and erection problems.

Side effects are common. Some men develop long-term problems that may have a significant impact on the quality of their lives. Long-term problems that can be caused by radiation treatment include:

• An irritated rectum and an urgent need to pass a stool. This is called proctitis.
• An inflamed bladder and urination problems. This is called cystitis.
• An inflamed intestine and diarrhea. This is called enteritis.
• Being unable to have an erection. This is called impotence.
• Being unable to control urination. This is called incontinence.
• Painful urination. This is called dysuria.

Immunotherapy

Researchers also are testing many new ways to treat prostate cancer using the body's immune system to destroy the cancer cells. This type of treatment is called immunotherapy. Much has been learned in the past 20 years about the body's ability to attack prostate cancer cells with help from the outside. And research is still being done in this area. This type of treatment either stimulates your immune system or adds to it, for example, by giving you immune cells from another person.

Vaccines such as Provenge use cells from a man's own body to stimulate his immune system. This can slow the growth of prostate cancer.

Complementary therapy

People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:

• Acupuncture to relieve pain. Acupuncture may also help reduce hot flashes from taking hormone therapy.
• Meditation or yoga to relieve stress.
• Massage and biofeedback to reduce pain and ease tension.
• Breathing exercises for relaxation.

Mind-body treatments like those mentioned above may help you feel better and cope better with treatment. These treatments also may reduce chronic low back pain, joint pain, headaches, and pain from cancer treatments.

Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. Complementary therapies are not meant to take the place of standard medical treatment, but they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.

Clinical trials

You may be interested in taking part in research studies called clinical trials. Clinical trials are designed to find better ways to treat prostate cancer patients and are based on the most up-to-date information. People who do not want standard treatments or are not cured by standard treatments may want to take part in clinical trials.

Check with your doctor to see whether clinical trials are in your area and whether you might be eligible.