Many men will be found with small prostate tumors and are advised against treatment because the tumors are known to be slow-growing and low risk. Doctors prefer to keep a close eye on those tumors with active surveillance, sometimes called watchful waiting, with periodic biopsies and PSA testing.
The idea is to avoid treatment that's not needed. Prostate cancer is typically slow growing and can take from 10 to 30 years to become life threatening. The risk of prostate cancer grows with age; even men diagnosed at 70 or 80 will not live long enough for their cancer to cause problems.
To help reduce unnecessary treatment, new tests are being developed to better identify the genes involved in the most aggressive cancers.
All treatments for prostate cancer are associated with risks of significant side effects. However, for potentially aggressive cancers, treatment is advised. When treatment is carried out by an experienced doctor, the risks of side effects are minimized and most men report an excellent quality of life after treatment.
Many treatment options for localized prostate cancer are now available:
- Laparoscopic surgery or open surgery
- External radiation, brachytherapy
- Cryosurgery and other forms of non-surgical elimination of tumors
Radiation and surgery appear to have the same rate of effectiveness and side effects. Radiation should follow surgery, if that combination of therapy is chosen.
For advanced prostate cancer, chemotherapy may be the first treatment suggested.
Several factors need to be considered thoughtfully before choosing a specific therapy. Those factors may include:
- The aggressiveness and extent of the prostate cancer
- The patient's age, general health and symptoms
- What the patient wants
- The doctor's experience and expertise
Have a frank discussion with your doctor about expected cure rates and side effects. Do not hesitate to ask for a second opinion before making a final decision.