Treatment

What is the current treatment for prostate cancer?  

There are a variety of treatments available for prostate cancer depending on the extent of the cancer.

Surgery

Some patients may have surgery to remove their prostate, particularly if the cancer is confined to the prostate gland. This is referred to as a radical prostatectomy, of which there are currently two types:

Retropubic prostatectomy – where the prostate gland is removed through an incision in the abdomen.

Perineal prostatectomy – where the prostate gland is removed through an incision in the perineum.

A prostatectomy can either be done by making a large incision or laparoscopic (keyhole surgery) where a number of small cuts will be made. Thanks to advances in research and technology, patients can now opt for a robotic prostatectomy which is a laparoscopic surgery where a robot assists the surgeon.

Radiotherapy

Radiotherapy is another way of treating prostate cancer. It can come in two forms, either external or internal radiation therapy.

External beam radiotherapy – radiation is directed from a machine outside of the body towards the prostate.

Internal radiation therapy – small radioactive implants called ‘seeds’ are placed inside the prostate and give off radiation in low doses.

Androgen deprivation therapy (hormone therapy)

Androgen deprivation therapy involves reducing the levels of the androgen hormone (e.g. testosterone) within the prostate, to stop it from helping the prostate cancer to grow or in some cases helping it to shrink.

There are several types of hormone therapy for prostate cancer:

  • Surgical removal of male testicles, which produce androgens.
  • Administering medication that stops the production of androgen
  • Medication that blocks androgen receptors in prostate cancer cells so they can’t receive androgens to help the cancer survive.

Watchful Waiting

Where a patient will be monitored to see if any symptoms develop or change.

Active Surveillance

If a patient is diagnosed with localised prostate cancer that is low risk, doctors may decide to leave them on active surveillance. As prostate cancer often grows slowly, the side effects of treatment can be worse than the potential benefits for some patients. This surveillance process will include having regular PSA blood tests, along with occasional digital rectal examinations, biopsies or ultrasounds.

Immunotherapy

Sipuleucel-T is an immunotherapy treatment for prostate cancer which harnesses the patient’s own immune system to seek out and destroy the prostate cancer cells. This is used to treat prostate cancer that is either advanced or has spread to other areas of the body.