Prostate cancer cells tend to grow slowly. When doctors discover that a patient has prostate cancer, they might not start treating it right away. In most cases, doctors monitor the cancer’s growth, watching to make sure that it doesn’t spread to other parts of the prostate or other areas of the body.

If the cancer does begin to spread (or metastasize), doctors have several effective treatment options. Alaska doctors usually don’t administer chemotherapy for prostate cancer unless the cancer has entered the lymph nodes and spread to other parts of the body. Typical alternatives include hormone therapy, surgery and radiation therapy.

Doctors use different forms of treatment depending on how far the prostate cancer has advanced and the patient’s. Treatments include medications, chemotherapy, surgery and radiation therapy.

Hormone Therapy

Different types of prostate cancer benefit from hormone therapy in different ways. For men with advanced tumors, blocking testosterone can help to shrink cancerous tumors and to keep cancer cells from spreading. For prostate cancer in its early stages, doctors might use hormones to shrink tumors before starting radiation therapy. However, hormone therapy does produce side effects, including erectile dysfunction, weight gain, lower libido and hot flashes.

Surgery

Prostate removal surgery might become necessary with advanced types of prostate cancer. However, prostate removal can damage the sensitive nerves in the prostate area, which can cause urinary and sexual dysfunction. Doctors remove the prostate using a few different surgical methods:

• An incision in the abdomen. Through an incision in the abdomen, doctors can remove the prostate. This technique helps to decrease the potential for nerve damage, but it requires a longer recovery period.
• Perineal surgery. Doctors can remove the prostate by making an incision in the perineum, which is the area between the scrotum and the anus. Although this type of surgery allows for faster recovery than an abdominal incision, it carries a higher risk for nerve damage.
• Robotic surgery. Using a robot to control surgical instruments, surgeons can make extremely precise movements that protect the prostate nerves from damage. Surgeons sit at a console and operate the robotic arms during the procedure.

Radiation Therapy

Doctors can use radiation therapy to treat both early and advanced prostate cancers. Radiation kills cancer cells and keeps them from spreading throughout the body. Oncologists might use radiation therapy alone to treat prostate tumors, or they might use radiation in conjunction with surgery to shrink tumors. Radiation therapy can be delivered in one of two basic ways:

• HDR/LDR Brachytherapy. Instead of undergoing a series of radiation treatments, some Alaska patients opt to have radioactive wires or seeds placed near their prostate tumors. Doctors insert the radioactive material surgically through the rectum.
• External radiation beams. Radiation delivered non-invasively and accurately from outside the body can target prostate cancer cells. The CyberKnife® System used by the doctors at the Alaska CyberKnife Center at Providence Cancer Center is one of the most advanced external beam systems, and it’s both pain-free and non-invasive.