Talking With Your Doctor About Prostate Cancer Treatment
More than 200,000 new cases of prostate cancer are diagnosed in the United States each year. If you have a prostate cancer diagnosis, you’ll want to work with your doctor to determine the best treatment plan. Come to your doctor appointment knowing some basic facts about current prostate cancer treatments. This will help you make the most of your time with your doctor. It’ll help you make the treatment decision together.
Know Your Treatment Options
Your treatment options depend on a number of factors:
- Your age
- Your Gleason score, which is the result of your prostate biopsy that determines the tumor’s likeliness to spread
- Stage of the disease
- Your symptoms
- Your general health
Your options may include:
- Watchful waiting or active surveillance: This means avoiding treatment until tests determine that your prostate cancer is changing. You’ll be closely monitored through digital rectal exams (DREs), protein-specific antigen (PSA) blood tests, and possibly biopsies to see if the cancer is changing.
- Surgery: Radical prostatectomy, in which the surgeon removes the entire prostate gland in addition to surrounding tissue, is the main surgery for prostate cancer. It’s often an option if cancer hasn’t spread beyond the gland.
- Radiation: This therapy uses high-energy rays aimed at the prostate gland to kill cancer cells from outside the body.
- Brachytherapy or internal radiation therapy: This technique involves inserting small radioactive “seeds” into the prostate gland or inserting tubes with radioactive material into the prostate to kill cancer cells from the inside.
- Cryosurgery: This ultrasound-guided therapy destroys the prostate with cold gases applied through hollow needles inserted in the skin between the anus and the scrotum.
- Hormone therapy: Your healthcare team will give this by medication or by surgical removal of the testes. This treatment suppresses levels of androgens in the body. These male hormones feed prostate cancer cells, causing them to grow.
- Chemotherapy: With this therapy, drugs that destroy cancer cells are injected into the body or taken by mouth in the form of a pill. Treatment cycles typically last several weeks followed by periods of rest.
- Bone-directed treatment: This treatment uses bisphosphonates, a group of drugs that strengthen bones when prostate cancer has metastasized. It may reduce the occurrence of bone-related adverse events.
- Vaccine treatment: Sipuleucel-T (Provenge) is a prostate cancer vaccine that uses the body’s immune system to attack prostate cancer cells. The vaccine is custom-made, using white blood cells from the patient’s own blood.
Treatments may be combined, but they’re generally done one at a time. Work with your doctor and your cancer care team to develop the right treatment plan for you.
Key Questions to Ask Your Doctor About Treatment
It helps to be prepared for your medical appointments. Here’s a list questions to bring with you that can help you make an informed decision about your care.
At Your Appointment
What to Ask Your Doctor About Prostate Cancer
- Is active surveillance an option in my case?
- What are the chances my cancer has spread beyond the prostate gland? How can we find out for sure?
- Do you recommend any other tests? Why?
- Why are you recommending this particular treatment for me?
- How long will treatment last, and what will it involve?
- What results do you typically see with the treatment you advise for me? Do you have results to share?
- Will the radical prostatectomy you’re recommending be nerve sparing? Cutting as few nerves as possible during prostate surgery may reduce the risk of side effects, such as impotence.
- What type of radiation might work best in my case?
- What treatment side effects can I expect?
- Will my insurance cover the cost of treatment?
- What can I do to take care of myself during treatment?
- How much time away from work and other activities can I expect with this treatment(s)?
Feel free to add your own questions to the list. Consider getting a second or third opinion from specialists, such as a urologist, medical oncologist, and radiation oncologist. Receiving different medical opinions can outline all your options and help you feel confident about the ultimate treatment decisions you make.