Treatment Options for Men With Prostate Cancer-Side Effects You Need to Know

Prostate Cancer is the most common cancer in middle aged and older men.  It is the second most common cause following lung cancer of death from cancer in men.

This article will discuss the most common treatment options for prostate cancer and what are the side effects of these treatments.

For younger men with localized disease, surgical removal of the prostate gland either with an open 6-8-inch incision or through a robotic prostatectomy-5 small pencil-sized holes in the lower abdomen that removes the entire prostate gland.

Temporary or even permanent erectile dysfunction (impotence) occurs in many of the men who undergo surgery.  Urinary incontinence, inability to control the flow of urine, occurs in 3-30% of men who have their prostate gland surgically removed.

For older men or for men who have prostate cancer beyond the prostate gland, radiation therapy is treatment option.   The side effects include temporary fatigue, diarrhea or other bowel problems, urgency of urination, and impotence (ED).

For men with spread of prostate cancer beyond the prostate into the bones or lymph nodes, then hormonal therapy is often recommended.  Hormone therapy is used in men with advanced, high-grade prostate cancer. Hormone therapy is also used in men who cancer has recurred after being treated with radiation therapy or surgery.  This is usually determined with an elevation of the PSA level.  Prostate cancer is very sensitive to testosterone, the male hormone produced in the testicles, and removal of testosterone reduces the cancer and helps control the disease but does not cure the problem.

The side effects of hormonal therapy include reduced libido, hot flashes, softening of bones or osteoporosis which leads to bone fractures, impotence, loss of muscle mass, fatigue, weight gain, and increased risk of heart disease and diabetes.

Chemotherapy is indicated for men who do not respond to removing the testosterone produced by the testicles.  Chemotherapy leads to hair loss, nausea\vomiting, diarrhea, fatigue, muscle pain, and weight loss.

Proton therapy is a similar to external radiation that targets difficult to reach tumors and is designed to allow higher doses of radiation to be delivered to the prostate with fewer side effects.

Bottom Line:  Over the past few years there have been numerous options available for the management of localized prostate cancer and even prostate cancer that has spread beyond the prostate gland.  New Orleans has several doctors who are national and even global experts in managing prostate cancer.  For more information, contact your doctor.

Advance To Every Cancer Patient

Cancer and cardiovascular disease are the most common medical causes of death in America. Tremendous advances have been in the treatment of cancer and there is often more than one treatment option for any disease. This is certainly true for prostate cancer where there are multiple treatments such as surgery, radiation, chemotherapy, and even no treatment at all but watchful waiting.

Here are my suggestions for each patient who has cancer:

1. Get a second opinion. Each patient needs to be aware of all the treatment options and to feel confident and informed about the options available. For example, a urologist who performs surgery is not likely to recommend radiation therapy when radiation therapy may be the better option for the patient. A second opinion is a chance to gain ore knowledge and insight into the accuracy of the diagnosis. Also if a pathologist looking at a biopsy or surgical specimen makes the diagnosis, I suggest that another pathologist provide a second opinion to confirm the diagnosis.

2. Find the right doctors. Nearly 20% of patients who receive a diagnosis of cancer have the disease in an advanced stage where the cancer has spread to other organs or other areas of the body. These patients with cancer that has spread, as well as all newly diagnosed patients, should get advice from physicians experienced in treating the specific type of cancer. You want to be sure that you are in the right hands.

3. Know what questions to ask. There are 10 questions compiled by the Cancer Treatment Centers of America (www.cancercenter.com/secondopinion) that would be helpful for newly diagnosed cancer patients to bring to their visit with the doctor. These are:

1 What types of diagnostic testing do you perform? An accurate diagnosis is critical because it is the basis upon which your treatment plan will be determined. For example, PET/CT scans help determine the precise location of cancer in the body to accurately plan treatment. Tumor molecular profiling identifies a tumor’s unique blueprint to choose targeted chemotherapy drugs. It’s important to have access to advanced diagnostic tests, as well as physicians who are experienced in performing them.
2 What does my diagnostic testing tell me? The information you should receive from diagnostic tests includes: where the cancer originated, the size of the tumor, the stage of cancer and whether or not it has spread to the lymph nodes or other parts of the body.
3 What treatment options are available? What do you recommend and why? Many types of cancer have a variety of treatment options available. Your doctor should be able to explain the potential benefits of each to help you understand your options, even if he or she doesn’t perform a specific treatment.
4 What happens if a treatment approach doesn’t work for me? At any point, you should feel comfortable asking your doctor about the status of your treatment. When choosing a care team, you may want to consider doctors willing to try new therapies, depending on your response. Look for professionals who will tailor treatments to your specific diagnosis, and who are willing to pursue other options if your treatment isn’t progressing as expected.
5 What are the side effects of treatment, and how often do your patients experience them? No two people will have the exact same response to cancer treatment, and side effects may vary depending on what type of treatment you choose. Ask your doctor what side effects you might experience, so that you can plan ahead and choose with all of the information you need.
6 How will you help me manage side effects? Integrative therapies can help prevent or manage side effects, so you stay strong and avoid treatment interruptions. Some therapies that can support your wellness during cancer treatment include: nutrition therapy, naturopathic medicine, mind-body medicine, acupuncture, oncology rehabilitation, spiritual support and pain management. Ask your doctor if any of these are available at your hospital, and how they can be incorporated into your treatment plan.
7 How many patients have you treated with my type and stage of cancer, and how successful have you been? Ask how much experience your doctor has treating your type and stage of cancer and whether he/she is a board-certified specialist. You may also want to ask about his/her facility’s treatment results so you can see how successful they have been in treating your cancer type.
8 Who will be involved in my care, how often will they meet and who is my main point of contact? An integrated care team including a surgical, medical, and/or radiation oncologist; dietitian; naturopathic oncology provider; clinical nurse and medical advocate (often a nurse care manager) can ensure you get support for your entire well-being during treatment. If you don’t already have a team like this in place, talk to your doctor about assembling a multidisciplinary team.
9 Where will all my treatments, appointments, tests, etc., take place? When looking for a treatment facility, consider the coordination and convenience of your treatment. Having appointments and procedures in one location can make treatment less stressful for you, and it may allow you to start treatment sooner.
10 How will you help me balance my cancer care with the demands of my normal life? Your cancer treatment should adapt to your individual needs, and family and professional obligations. Talk to your doctor about your personal needs, so that all aspects of your life are considered when choosing a treatment plan.

4. Stay strong. You will often experience significant side effects dealing with your treatment or the disease. I recommend that you consult with a nutritionist to be sure that you are receiving the right combination of calories, vitamins, and nourishment in order to be in the best physical shape to fight the disease. I also suggest a regular program of exercise that enhances your heart, lungs, and muscles to keep you in the best body-mind condition.

Bottom Line: The cancer diagnosis is often shocking and requires each patient to muster all of his\her energies to engage and fight cancer. These are a few suggestions that will help you prepared to carry the biggest fight of your life.