Prostate Cancer Treatment: Symptoms, Classification, Diagnosis & Recovery

Before initiating any kind of treatment, it is important to diagnose prostate cancer clearly to see whether it is in an early stage or advanced stage. In addition, the type and stage of prostate cancer should be clearly diagnosed.

Prostate Cancer Diagnosis

After the physical examination, your doctor might go for prostate-specific antigen (PSA) blood test. It is used mainly to screen for prostate cancer in men without symptoms. Other than this,  transrectal ultrasound (TRUS) and other pathology tests can be done for diagnosis of prostate cancer. However, the final and confirmed diagnosis of prostate cancer are only possible by conducting a biopsy. 

Another test used for the diagnosis of prostate cancer is a digital rectal exam (DRE). In this test, the doctor inserts two lubricated, gloved fingers inside the rectum of the patients to examine the prostate gland. Any change in the shape and size of the prostate can be identified during DRE.

The doctor may also conduct an ultrasound or collect a sample of tissue from the prostate gland to conduct a biopsy and confirm whether cancer cells are present in the tissue or not. In this test, the prostate cancer stage is also confirmed.

Treatment for prostate cancer can be divided into early stage and advanced stage. Your doctor will choose the best suitable treatment for you, depending on the stage and classification of prostate cancer, your age, and overall health status. Although, your feelings, expected lifespan, and your opinion will play a major role in choosing the right kind of treatment.

The most common treatment options for prostate cancer include the following:

Watchful waiting or active surveillance

No immediate treatment is carried out, but the patient is followed up at regular intervals to see the progression of the disease. This method is used in elderly patients with short life expectancy and in case of an early disease.

Surgery

The main type of prostate surgery is called radical prostatectomy. In this, cancerous tissues are removed by a surgical operation. A long cut in the abdomen is needed in this surgery, depending on the extent and stage of cancer.

However, a keyhole surgery for prostate cancer using a laparoscope or robot is also available. These treatments have good success rates but may result in certain long-term side effects such as sexual dysfunction, narrowing of the urethra, and urinary incontinence.

Radiotherapy

High-intensity beams are used in this treatment to destroy the cancer cells in the prostate. Radiotherapy can be administered via needles implanted into the prostate, under ultrasound guidance or as an external beam. Radiotherapy can be used after surgery if the resection of cancer tissue has not been completed.

There are two types of radiotherapy for prostate cancer:

Conformal radiotherapy

In this, the radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ that requires treatment. It minimizes healthy tissue exposure to radiation.

Intensity-modulated radiotherapy:

In this, the beams with variable intensity are used. It is an advanced form of conformal radiotherapy. It is usually delivered with the help of a computer-controlled linear accelerator.

Hormone therapy

Hormone therapy involves the use of medications that suppress testosterone levels. They are used as primary treatment and in advanced cases or Stage 4 prostate cancer.

Chemotherapy

Chemotherapy is a kind of advance drug treatment in which strong medications are used to kill the cancer cells and prevent it from spreading. It is used when the prostate cancer is not controlled by hormonal treatment. Chemotherapy is selected only for treatment of Stage 4 prostate cancer and when the patient can cope with it.

Cryotherapy

This treatment uses extremely cold temperatures to freeze and destroy cancer tissues in the prostate. Cryotherapy is the best option for treating recurrent prostate cancer, especially if initial radiation therapy did not kill enough cancer cells. The surgeon inserts an ultra-thin metal probe or needle into the prostate gland, from which a freezing liquid, such as liquid nitrogen or more commonly, argon gas, is infused into the prostate gland.  

Other local ablation

Some treatments such as radiofrequency and high intensity focused ultrasound (HIFU) are used to treat early prostate cancer or when the patient is not fit for a major surgery.

• Patients may suffer from some immediate and long-term side effects after the treatment. However, they may expect the doctor to guide them on how to control and manage the side effects.
• Recovery after prostate cancer treatment takes time. You may expect yourself to go for regular follow up visits with the doctor, who will check on your progress and any signs of cancer coming back. You may have to follow a strict diet and avoid certain physical activities for a speedy recovery.
• Additionally, a dietician will share a plan with you at the time of discharge. You should try to stick to the plan and maintain a healthy lifestyle to ensure that the recovery time after treatment is minimal.
• If you’ve had a prostate surgery, you will have a catheter in place to drain urine for a day or two. Hospital discharge takes place after about two days after the surgery. Most of the patients are able to return to their normal routine in about two weeks’ time.