Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Other Prostate Cancer Treatment Options
Prostate Cancer Treatment Options
When prostate cancer is believed to be localized, the following common treatment options available to a patient:
- Surgical removal of the cancerous prostate (radical prostatectomy)
- Radiation of the cancerous prostate, through either external radiation or radioactive seed implants (radiation therapy or brachytherapy, respectively)
- Freezing of the cancerous prostate (cryotherapy)
- Hormonal therapy, which is non-curative and often done in conjunction with radiation therapy or cryotherapy
- Observation (watchful waiting)
Radiation Therapy for Prostate Cancer
Radiation therapy uses high-energy x-rays, either beamed from a machine or emitted by radioactive seeds implanted in the prostate, to kill cancer cells. When prostate cancer is localized, radiation therapy serves as an alternative to surgery. External beam radiation therapy is also commonly used to treat men with regional disease, whose cancers have spread too widely in the pelvis to be removed surgically, but who have no evidence of spreading to the lymph nodes. In men with advanced disease, radiation therapy can help to shrink tumors and relieve pain.
It is important to be aware that radiation can cause long-term damage to the nerves and important structures involved in sexual function. Many patients undergoing brachytherapy or external beam radiation treatment develop erectile dysfunction (as many as 50% in several studies.) Many radiation patients are also placed on hormone therapy, which has an immediate negative impact on sexual function.
Freezing the Cancerous Prostate (Cryotherapy)
Cryosurgery uses liquid nitrogen to freeze and kill prostate cancer cells. The doctor places needles in preselected locations in the prostate gland. The needle tracks are dilated for the thin metal cryo probes to be inserted through the skin of the perineum into the prostate. Liquid nitrogen in the cryo probes forms an ice ball that freezes the prostate cancer cells; as the cells thaw, they rupture. The procedure takes about 2 hours, requires anesthesia (either general or spinal), and requires 1 or 2 days in the hospital.
Hormonal Therapy for Prostate Cancer
Hormonal therapy combats prostate cancer by cutting off the supply of male hormones (androgens) such as testosterone that encourage prostate cancer growth. Hormonal control can be achieved by surgery to remove the testicles (the main source of testosterone) or by drugs.
Hormonal therapy targets cancer that has spread beyond the prostate gland and is thus beyond the reach of local treatments such as surgery or radiation therapy. Hormonal therapy is also helpful in alleviating the painful and distressing symptoms of advanced disease. Further, it is being investigated as a way to arrest cancer before it has a chance to metastasize. Although hormonal therapy cannot cure, it will usually shrink or halt the advance of disease, often for years.
Observation/Watchful Waiting
Watchful waiting refers to closely monitoring a patient's condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early-stage disease. Watchful waiting is based on the premise that localized prostate cancers may advance so slowly that they are unlikely to cause men—especially older men—any problems during their lifetimes. Some men who opt for watchful waiting, also known as "observation" or "surveillance," have no active treatment unless symptoms appear. They are often asked to schedule regular medical checkups and to report any new symptoms to the doctor immediately.
Experimental/Out-of-Country Treatments
When faced with serious illness, many people explore alternative or experimental treatment options with the goal of easing their symptoms and controlling or eliminating the disease.
A treatment option for prostate cancer currently available outside the United States is High-Intensity Focused Ultrasound (HIFU). HIFU treatment uses the principle of ultrasound energy to destroy cancer cells. To treat prostate cancer, the energy is delivered to the patient using a transrectal probe under general or regional anaesthesia.
Current studies show HIFU has significant complication rates and failure rates in effectively treating cancer in both initial and recurrent prostate cancer cases. As a result, some leading urologists have suspended their use of HIFU pending further evidence of its safety and effectiveness.
Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen.
Prostate cancer is among the most common cancers diagnosed in men. In the U.S., one in six men will be diagnosed in his lifetimes. While no one will say facing prostate cancer is easy, the good news is with increased awareness and screening, more men are diagnosed early. That means most cancers are found while still localized in the prostate before the cancer has spread.
