In principle, several methods are available for the treatment of prostate cancer, which are used individually and sometimes in combination. Which method is used depends primarily on how far the prostate cancer has grown into the surrounding tissue and whether metastases have already formed. In addition, previous illnesses and age also play a role in prostate cancer treatment. The goal is cure (curative therapy) – which is easier to achieve the earlier the prostate cancer is detected. If it has not yet broken through the capsule of the prostate gland, the chances of curing prostate cancer are up to 100 percent. If the tumor is already far advanced and has metastasized, sometimes only symptom-relieving intervention is possible and attempts can be made to prevent or slow down further tumor spread (palliative therapy).
Treating prostate cancer in many ways
Possible forms of treatment for prostate cancer (prostate carcinoma) include:
- Surgery of the prostate
- Radiotherapy
- Hormone therapy
- Chemotherapy
- Other forms
Prostate surgery for prostate cancer
Prostate surgery is the method of choice when the tumor is still confined to the prostate gland. In this procedure, the prostate gland is completely removed (radical prostatectomy), and in addition, both seminal vesicles are also removed.
Prostate surgery is also performed in cases of more advanced prostate cancer with metastases, but then it rarely leads to a cure, but rather to a reduction in symptoms. Affected lymph nodes are also removed. Prostate cancer surgery is possible either through an abdominal incision or by means of laparoscopy – however, according to studies, the surgical results depend more on the experience of the surgeon than on the access route.
Radiation therapy for prostate cancer
Radiation is an alternative to surgery, for example, when surgery cannot be performed because of age or health reasons. In percutaneous radiotherapy, radiation is delivered from the outside; in brachytherapy, a radiation source is delivered directly to the prostate cancer in the prostate gland and destroys the cancer cells from the inside.
Radiation can also be used to kill cancer cells left over after prostate surgery, thereby reducing the risk of the cancer returning (recurrence). In addition, radiation therapy for prostate cancer is also used to target metastases for destruction and as part of palliative therapy to relieve pain.
Hormone therapy for prostate cancer
The treatment method called hormone therapy (also hormone deprivation therapy) is used for advanced prostate cancer. In this procedure, the male sex hormone testosterone is inhibited permanently or at intervals with medication, thereby slowing or stopping cancer growth from prostate cancer. Hormone therapy involves either suppressing the formation of testosterone (with LHRH analogs or GnRH antagonists) or blocking its action on cells (with anti-androgens).
Chemotherapy for prostate cancer
Chemotherapy treatment uses drugs administered as infusions (cytostatics) to destroy cancer cells in various ways to treat prostate cancer. However, healthy cells are also affected in the process – which explains the side effects. For this reason, chemotherapy for prostate cancer is given in several cycles – with recovery breaks in between. It is used for advanced prostate cancer and delays the progression of the disease.
Other forms of treatment for prostate cancer
Pain from bone metastases is treated with targeted radiation and drug inhibitors of bone resorption (bisphosphonates). Active surveillance is also a way to treat prostate cancer: Since prostate cancer treatment also has side effects and the tumor usually grows very slowly, in some cases (small tumor, older age) the “wait and watch” strategy is also used initially. In this way, prostate cancer therapy can be bypassed or at least delayed.
Besides, additional therapy is provided for pain, side effects of chemotherapy, for example, and the after-effects of surgery; moreover, psychological support is offered in the treatment of prostate cancer.
