Even though prostate cancer is common—1 in 9 men will be diagnosed with prostate cancer during their lifetime—most men do not die from it. That’s because prostate cancer grows very slowly and prostate cancer treatments are better than ever.
“Almost always [prostate cancer] treatments are very effective if the cancer is confined to the prostate,” says William K. Oh, MD, chief of hematology and medical oncology at Mount Sinai Health System.
The prostate is a gland that makes fluid that’s part of semen. It’s below the bladder and forms a ring around the urethra (where urine comes out). Prostate cancer happens when normal cells in the prostate gland become abnormal and then grow out of control.
If the cancer is confined within the primary organ, which in this case is the prostate, it’s considered localized prostate cancer. If the cancer has spread (metastasized) beyond the prostate, this is called advanced, or metastatic, prostate cancer. Localized prostate cancer and advanced prostate cancer are treated differently.
Treating Localized Prostate Cancer
If a patient has localized prostate cancer, he and his doctor may discuss these three options:
Surgery for prostate cancer can be done in different ways. The most common approach is to remove the entire prostate gland and some surrounding tissue.
“Nowadays most of the surgeries are done using a robot-assisted approach,” says Dr. Oh. During a robot-assisted approach, a surgeon sits at a control panel in the operating room and moves robotic arms to operate. With robot-assisted surgery, “patients are in the hospital for shorter periods of time with less pain and less bleeding,” says Dr. Oh.
Radiation kills cancer cells. Radiation can be given from a machine that moves around your body, or a doctor might target the radiation directly into the prostate gland.
Because prostate cancer grows so slowly, some patients don’t need to be treated right away. “For some prostate cancers, you can monitor it,” says Dr. Oh.
Men who choose this method will likely have routine tests, such as a prostate-specific antigen test, to check if the cancer is growing more quickly. If that’s the case, the patient can then discuss treatment options with their doctor.
Treating Advanced Prostate Cancer
“If you present with advanced or metastatic prostate cancer, sometimes that means that the cancer has already escaped the prostate before you were diagnosed,” says Dr. Oh. “Unfortunately in this setting, the treatments are not curative. In other words, removing the prostate or radiating the prostate will not be enough to get rid of the cancer.”
Still, there are many treatments available that can control the cancer—sometimes for many, many years.
Male hormones in the body help the prostate cancer grow. Hormone therapies help reduce the number of these hormones, which in turn can shrink the cancer.
Chemotherapy is a term for medicines that kill rapidly dividing cells, which include cancer cells. Patients with advanced prostate cancer might get chemotherapy if hormone therapy stops working. Chemotherapy and hormone therapy may also be given at the same time.
Choosing the Right Prostate Cancer Treatment
Before deciding on a treatment, it’s important for patients to know all their options and work with their doctor to determine the right treatment for them. “I think the most important thing for any man dealing with prostate cancer is to balance the pros and cons of treatment—the effects of treatment versus the effects of cancer,” says Dr. Oh.
The right treatment will depend on:
“In most situations, the goal, as with all cancers, is to cure the cancer, to eradicate it,” says Dr. Oh. “It is absolutely possible in patients with [localized] prostate cancer to cure it.”