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As with all medical interventions, particularly surgical interventions, the key to successful outcomes is patient selection. For instance, TURP has a high probability of retrograde ejaculation and would be a poor selection in a young man for whom fertility is an issue. In that patient population a less invasive and less aggressive approach such as microwave therapy or transurethral incision of the prostate would be more appropriate. Likewise, in older patients or patients in poor health, a laser-induced prostatectomy or a prostatic stent might be a better choice. Even after appropriate measures have been taken to exclude alternative causes of LUTS, the prevailing attitude of most clinicians and patients is that at least a trial of medical therapy should be tried. After that, a sober evaluation of the risks and benefits of surgical intervention should be undertaken. [Top] Complementary Therapies Prostate enlargement is one of the most common reasons that men over the age of fifty see a urologist. In fact, if men live long enough, they will all develop prostate enlargement. Just the same, men with mild to moderate prostate enlargement symptoms can usually be treated expectantly. On the other hand, men with severe prostate enlargement symptoms are best managed with either drug therapies or surgery. Plants or plant extracts have been used since ancient times to treat urinary problems. Popularly known as phytotherapy (‘phyto’ means plant), herbal therapies cost less, have fewer side effect than prescription medication, and they are often effective. Click here to download a PDF with complementary therapies for prostate enlargement, new window will open. Once the diagnosis of prostate cancer is made, the physician will review all treatment options available to the patient. Further studies to evaluate the extent or stage of disease may be necessary to assist in making a decision about treatment. An alternative approach to the management of early prostate cancer is known as "active surveillance," in which patients do not have surgery right away but are closely followed by their doctors to see if their tumors begin to grow or spread. A study published in the September 12, 2002, issue of the New England Journal of Medicine, reports that Scandinavian men with early prostate cancer who had surgery were less likely to die of prostate cancer itself than men who received active surveillance. However, after an average of six years of follow-up, overall survival was about the same in the two groups of patients. A second article in the same issue of the journal, reports that quality of life was also similar in the two groups, although surgery and active surveillance have different adverse effects. Sexual problems and urinary incontinence were more common in men who had surgery, whereas difficulty passing urine was more common in men who received active surveillance. Questions still remain about the long-term benefits of surgery vs. active surveillance for patients with early prostate cancer, said Richard Kaplan, M.D., of the National Cancer Institute's Cancer Therapy Evaluation Program. "Six years is a relatively short follow-up period," he said. "It's possible that with longer follow-up an overall survival advantage for surgery will emerge." Subsequent studies with longer follow-up have demonstrated a statistically significant survival advantage for surgery vs. active surveillance. Click here for more information about active surveillance, new window will open.
There are many different treatment options and combinations of treatments depending on the stage of disease and the age and health of the patient. Generally the treatments available for prostate cancer include the following: Surgery Patients in good health who are younger than 70 years old are usually offered surgery as treatment for prostate cancer. The following types of surgery are used:
[Top] Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Impotence and urinary problems may occur in men treated with radiation therapy. Hormone therapy Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working. Hormone therapy used in the treatment of prostate cancer may include the following:
Hot flashes, impaired sexual function, and loss of desire for sex may occur in men treated with hormone therapy. [Top] Complementary Therapies A substantial body of in vitro laboratory and animal data and evolving epidemiological and human in vivo data suggest that complementary therapies such as dietary and lifestyle interventions and botanical and nutritional supplements and vitamins can complement conventional therapies to modulate the initiation, promotion, and progression of prostate cancer, improve quality of life, and prolong survival. Click here to download a PDF with further information about complementary therapies for prostate cancer. Advanced prostate cancer is comprised of a heterogeneous population of androgen-dependent, androgen-sensitive, and androgen-insensitive (castrate-resistant) prostate cancer cells, which explains why androgen deprivation therapy – the primary treatment for advanced prostate cancer – is not curative. This article explores an accumulating body of scientific evidence that natural therapies can alter biology of androgen insensitive prostate cancer cells and slow PSA doubling time. Click here to download a PDF with further information about complementary therapies for androgen – insensitive prostate cancer. [Top] Additional Information about cancer For more information on the diagnosis of prostate cancer and the treatment options available visit the American Cancer Society's Web site.
Cancer is a major illness, but not everyone who gets cancer will die from it. Close to 9 million Americans alive today have a history of cancer. For them, cancer has become a chronic (on-going) health problem, like high blood pressure or diabetes. Just like anyone with a chronic health problem, people who have cancer must get regular checkups for the rest of their lives, even after cancer treatment ends. But unlike other chronic health problems, if you have cancer you probably will not need to take medicine or eat special foods once you have finished treatment. Click here to visit the National Cancer Institute website. If you have cancer, you may notice every ache, pain, or sign of illness. Even little aches may make you worry. While it is normal to think about dying and healthy to explore your feelings about death, it is also important to focus on living. Keep in mind that cancer is not a death sentence. Many people with cancer are treated successfully. Others will live a long time before dying from cancer. So, make the most of each day while living with cancer and its treatment. For additional information about prostate cancer diagnosis and treatment, visit the Memorial Sloan-Kettering Cancer Center’s website.
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Prostate Problems - Treatment 
