Prostate cancer typically grows slowly, giving men some time to evaluate their treatment options before therapy or surgery is needed. Because of this, you’re not usually rushed into making a decision. Most men have time to learn about the treatment choices available to them. Let’s explore what your oncologist and urologist will consider when recommending a plan tailored specifically for you.
What Determines When and How Prostate Cancer Is Treated?
Several factors help determine the best treatment method and the timing of prostate cancer treatment:
- Stage of prostate cancer: This tells the oncologist how much the cancer has grown at the time it was diagnosed. Prostate cancer that is detected early is typically at an earlier stage, while cancer found later may have spread beyond the prostate, which influences the pace and types of treatments needed.
- Gleason score: The Gleason score reflects how much the prostate cancer cells differ from healthy cells, with scores ranging from 1 to 10. A score of 8 or above usually requires immediate treatment. If the score is between 6 and 7, treatment may be delayed. A score lower than 6 typically indicates that cancer is not present.
- Grade of cancer: This is a combination of the Gleason score and the stage to determine if the cancer is slow-growing or aggressive. Aggressive cancers grow at a much faster pace, and treatment will likely be needed right away.
- Personal preference: Treatment choices can also depend on your feelings about specific methods. Some men may prefer to delay treatment to avoid certain side effects, while others may want to start treatment immediately.
Learn more about Gleason scores and prostate cancer staging here.
Your urologist will go over the results of all diagnostic tests. They may also discuss surgery with you. It’s a good idea to see an oncologist who specializes in prostate cancer to learn about other treatment options before scheduling surgery. In some cases, surgery can be delayed or avoided entirely.
Watchful Waiting or Active Surveillance May Be Appropriate Before Starting Treatments
If your prostate cancer specialist determines that your prostate cancer is slow-growing, they may recommend active surveillance. This means the doctor will monitor you for signs of the cancer growing. In the meantime, you do not need to undergo cancer treatments.
Your oncologist may recommend active surveillance if you have:
- No symptoms
- A lower PSA level
- A slow-growing tumor
- A small tumor confined to the prostate gland
Your biopsy will be repeated periodically to see if the cancer is growing. If it does, or if symptoms appear, treatments may begin.
Advantages of Waiting to Start Prostate Cancer Treatment
The main benefit of postponing prostate cancer treatment is to avoid potential side effects from certain treatment options. For example, prostate surgery may lead to negative side effects such as urinary incontinence and erectile dysfunction. These effects can have a long-term impact on your lifestyle and should be weighed against all treatment options. Radiation therapy may also cause temporary side effects, which may not be necessary if the cancer has not significantly progressed.
Delaying treatment allows you to continue living your life largely as you did before. Starting cancer treatment can require considerable energy and time, and these drawbacks may not be justified when the cancer is still in its early stages.
What Treatments Are Used for Prostate Cancer?
If your prostate cancer requires treatment, the prostate cancer specialist will review the latest test results so they can develop a personalized treatment approach. It may include several treatments, such as radiation therapy, hormone therapy, and/or surgery.
Radiation Therapy for Prostate Cancer
Radiation therapy uses high-energy radiation to kill cancer cells and is suitable for men with any stage of prostate cancer. It can be delivered either externally or internally.
External beam radiation therapy is administered by a machine outside the body. It often utilizes techniques like 3-dimensional conformal radiation therapy (3D CRT) or intensity-modulated radiation therapy (IMRT). These methods are designed to accurately target the cancer while minimizing damage to surrounding tissues.
Internal radiation, known as brachytherapy, involves placing radioactive seeds directly into the prostate. These seeds gradually release radiation to eliminate cancer cells. Depending on your specific situation, these seeds may be given in either high or low doses.
Hormone Therapy to Treat Prostate Cancer
Since male hormones can promote the growth of prostate cancer, hormone therapy may be used to lower these hormone levels, which are often referred to as androgens. Typically, hormone therapy is combined with other treatments to help shrink prostate cancer tumors.
Surgery to Remove the Prostate
In some cases, surgery is recommended to remove the prostate. This option is mainly for men whose cancer has not spread beyond the prostate. Surgery is commonly followed by radiation therapy to be sure all the cancer cells are destroyed. Some patients may also receive chemotherapy or targeted therapy to enhance treatment effectiveness.
Additional treatments are currently being researched, and others have been approved for specific situations. Clinical research trials may be available to you depending on the stage and if the cancer is recurrent. Your oncologist will review recommended options based on your unique case.
Read our blog: Treating Prostate Cancer: Know Your Options Beyond Surgery
When Should I Consider Starting Prostate Cancer Treatment?
Every situation is different, making it challenging to determine precisely when to start prostate cancer treatment. If your test results indicate that the cancer is spreading or your Gleason score is increasing, it may be time to begin treatment. Additionally, if you start experiencing symptoms that interfere with your daily life, this can also signal that treatment should start.
Personalized Prostate Cancer Treatment In Colorado
If you or a loved one is newly diagnosed with prostate cancer, the specialists at Rocky Mountain Cancer Centers can help guide you through the next steps and develop a personalized treatment plan. When detected early, immediate treatment may not be necessary.
Prostate cancer specialists are available at RMCC locations throughout Colorado, including Boulder, Colorado Springs, and Denver. Request an initial consultation or a second opinion to ensure you have the best treatment plan to meet your needs.
