Treatment depends on several factors.  Many treatment options are now available for men with early stage disease and doctors cannot say whether any of them gives better results.  This presents a challenge to men faced with a decision of what to do.  In addition, many men do not need immediate treatment because they have a cancer that may never harm them.  They can be followed carefully and treated only if something suggests the cancer is behaving more dangerously.  This is called active surveillance.  Since every treatment has the potential to cause side effects, men should find out their odds of getting a good result and the odds of getting the different side effects.  Then they can decide which treatment is most appropriate based on their age, health, type of tumor and goals and fears.  Hormone therapy, chemotherapy and immunotherapy are used to treat metastatic disease.

Localized and Locally Advanced Therapy Options

The options for treating cancers that have not spread to the bones or other organs:

1. Watchful waiting
2. Active Surveillance
3. Radical prostatectomy using four different approaches
4. External Beam Radiation using 3D conformal therapy, Intensity Modulated Radiation, Cyberknife, and Proton Beam Therapy.
5. Brachytherapy or Seed Implantation.
6. Combination therapy using Brachytherapy and External Radiation.
7. Hormone Therapy with or without external radiation.
8. Cryotherapy or freezing the prostate.
9. High Intensity Focused Ultrasound

All the treatments for local and locally advanced disease can cause a decreased ability to have erections, a decreased ability to control urine and a stricture in the urethra.  Radiation can also cause changes in bowel function.  Some of the side effects of Hormone therapy include hot flashes, a decreased sex drive and weight gain.  The chances of getting side effects depend on a man’s age, health, co-morbid illnesses and the experience of the doctor who does the treatment.

Treatment for Progressive Disease

In some cases, men will develop recurrent disease after primary therapy.  Doctors are not sure which treatment is best or when is the best time to initiate treatment. 

Treatment of Metastatic Disease

The primary therapy is called hormone therapy or androgen deprivation therapy.  It involves lowering the male sex hormone called testosterone or blocking the action of the male hormones.  For men no longer responding, second line hormone therapy, chemotherapy and immunotherapy can help prolong survival.

Erectile Dysfunction and Prostate Cancer

Erectile dysfunction is a common side effect of prostate cancer treatments. Generally, erectile function improves within two years after surgery. Improvement may be better for younger men than for those over 70. You also may benefit from ED medications. Other treatments, such as injection therapy and vacuum devices, may help.

Diet

A cancer-conscious diet may be the best choice for survivors who want to bolster their health and those hoping to lower their risk. That means:

• Five or more fruits and veggies a day
• Whole grains instead of white flour or white rice
  Limit high-fat meat
• Limit or eliminate processed meat (hot dogs, cold cuts, bacon)
• Limit alcohol to 1-2 drinks per day (if you drink)
• Foods high in folate may have some action against prostate cancer (spinach, orange juice, lentils).
• Studies found mixed results on lycopene, an antioxidant found in tomatoes.

Medical Disclaimer: The information on these pages is not intended to substitute for the advice of a physician