Prostate Cancer: Latest Treatments and Emerging Therapies

If you've been diagnosed recently with prostate cancer, you might find the latest treatment options somewhat confusing. Each has its benefits and risks. And no single treatment is right for every man with prostate cancer. In this article, WebMD examines the various treatment options and their side effects. We'll consider the options in terms of:

• The grade and stage (severity) of cancer
• Your age
• Lifestyle considerations
• Other important factors

Ultimately, though, you'll need to decide for yourself, with the help and guidance of your doctor, which is best for you.

What are the options for early stage prostate cancer?

Early-stage prostate cancer refers to cancer that is contained entirely within the prostate gland. It has not spread -- metastasized -- either to local tissues or to distant body parts, such as bone. This type of cancer, which doctors often call low-risk disease, is the most curable.

One out of every two men diagnosed with prostate cancer is aged 72 or older. Since prostate cancer often grows very slowly, many of these men may die from other causes before the prostate cancer causes any significant problems. In other words, many men will die with prostate cancer but not from prostate cancer. Another thing to keep in mind is that therapies for prostate cancer can have significant side effects and complications. So trying for a cure - what doctors call "definitive therapy" -- may not always be the right choice.

There are three basic options for early stage prostate cancer. The two active treatment options -- surgery and radiation -- can often lead to a cure when used alone. Men with intermediate-risk or high-risk disease usually need a combination of therapies to achieve a high likelihood of cure or disease control.

The three options for early-stage/low-risk prostate cancer are:

• Surgery
• Radiation therapy - either external beam radiation or radioactive tumor seeding (brachytherapy)
• Active surveillance, also known as expectant management or watchful waiting

The third option is not actually a form of treatment. Instead, it's a form of close patient management.

There is a fourth basic treatment option: hormone therapy. It is usually reserved for older men and for treatment of men with more advanced disease.

Chemotherapy plays only a limited role in prostate cancer treatment. It's reserved primarily for the treatment of men with advanced or recurrent prostate cancer that does not respond to hormone therapy.

Your choice of surgery, radiation, or expectant management may depend on several factors:

• Your age and life expectancy
• Other serious health problems you may have, such as heart disease
• Your personal preference, informed by your doctor's opinion, about whether to begin treatment or to wait
• Your concerns about the side effects common with prostate cancer therapies

Side effects may include things that affect your lifestyle. For example, erectile dysfunction and incontinence, or urine leakage, are both possible side effects.