December 2014

Deciding on Treatment for Prostate Cancer

When it comes to your health, some decisions are easier than others to make. For example, it may be a no-brainer to opt for regular blood pressure checks. Deciding on treatment for prostate cancer can be a lot trickier. Men with early stage disease have a number of choices. And according to recent research, it isn’t always clear which treatment may be best.

Which treatments work

Prostate cancer is one of the most common cancers in men. But it’s usually a slow-growing disease. It can often be cured if it hasn’t yet spread outside the prostate. For these cases, one or more of the following treatments may work:

• Surgery to remove the tumor from the prostate

• Radiation therapy. This uses high-energy X-rays or another form of radiation to kill or stop the growth of cancerous cells.

• Watchful waiting. This means not taking action right away. Instead, your doctor keeps an eye on the cancer to see if it starts to cause symptoms.

So which approach is best? It’s hard to tell. No study to date has directly compared all types of treatment over a long period of time. But one recent study tried to do so using statistical analysis.

Researchers compiled 21 past studies that included more than 7,300 men with early stage prostate cancer. They used data from these studies to compare the safety and effectiveness of several standard treatments. These included watchful waiting, a type of surgery called prostatectomy, and several forms of radiation therapy.

No treatment was rated superior in terms of survival. Some therapies did fare better when the researchers looked at certain side effects. Overall, though, they caution that more research is needed.

What to consider

When deciding on treatment for early stage prostate cancer, it’s best to work closely with your doctor. He or she can help you consider all the benefits and risks of each approach. For example, if you don’t have any symptoms, watchful waiting may be a good choice. The cancer may never grow large enough to become life threatening. So treating it may cause needless side effects.

You may also want to consider cost. One study found that many men don’t look at cost, especially if they have health insurance. They may instead choose more aggressive and more expensive treatments. One example is robotic prostatectomy. It’s a type of surgery in which a mechanical arm helps surgeons make more precise incisions in the prostate. Despite its growing popularity, it hasn’t been shown to be any better than more traditional surgery.

Taking an active part in the decision can help you choose the best treatment. Below are some questions to ask your doctor:

• Do I need to have treatment right away?

• Which treatment do you recommend and why?

• What are the benefits of the treatment?

• Does it have any side effects, such as urinary or sexual problems?

• What do I need to do to get ready for treatment?

• How long will it take me to recover afterward?