What Is the Most Used Treatment of Prostate Cancer? 9 Treatment Options

Prostate cancer is the second most common cancer in men and the fourth most prevalent cancer in general. 

Prostate cancer is often slow-growing, which means it may take years to grow large enough to be detected and even longer to develop and spread outside the prostate. Some cases, however, are more aggressive and require immediate treatment. 

Cancer cells that are separated from the malignant tumor in the prostate can spread to other regions of the body by passing through blood arteries or lymph nodes. These migrated cancer cells may attach to other tissues and create new tumors, inflicting more damage.

Although it is a slow-growing cancer, it can be life-threatening, especially if it metastasizes. There is also always a risk of regrowth of the tumor even after removal.

There are various treatment options for prostate cancer, and your doctor will decide on the best treatment for you. It is common to combine several treatments to achieve optimum results. Treatment options for prostate cancer include:

1. Radiation therapy

Radiation treatment can be used externally or internally to treat prostate cancer:

• External beam radiation is delivered to the tumor location through a linear accelerator, which creates high-energy rays. 
• Internal radiation therapy (brachytherapy) involves inserting small radioactive pellets into or near a prostate tumor.
• Proton beam radiation is a type of radiation therapy that uses extremely tiny particles to attack and kill cancer cells that have not spread.
• Stereotactic body radiation treatment may be beneficial for some patients and uses cutting-edge imaging technology to administer high doses of radiation. Fewer treatments may be required due to the high dosage rate.

2. Expectant management

Unless the prostate cancer is aggressive and fast-growing, you may be advised to watch for symptoms because it is typically a slow-growing cancer. This is done in two ways:

• Watchful waiting: In some cases, it may be preferred to delay treatment until signs of prostate cancer appear before beginning therapy because therapy with radiation or surgery can cause adverse side effects and discomfort, especially in people with other health conditions or a reduced life expectancy. The theory behind watchful waiting is that certain individuals may not benefit from definitive therapy, and it may therefore be better to postpone final therapy in favor of treating signs of local or metastatic progression as they arise.
• Active surveillance: Active surveillance is based on the assumption that some people, but not all, may benefit from therapy for primary prostate cancer. A program of active surveillance is intended to offer definitive treatment for men with locally advanced cancers and to limit the risk of treatment-related problems in men with cancer that does not progress actively. Clinical studies report that people with low-risk malignancies may be good candidates for this treatment method because they have a low probability of clinical progression within the first 10-15 years following diagnosis.

3. Surgery

Radical prostatectomy, which involves the removal of the whole prostate and several adjacent lymph nodes, is a standard treatment option for prostate cancer that has not progressed beyond the prostate. 

This surgery can be performed using minimally invasive procedures and/or robotic assistance that may result in faster recovery. In some cases, standard open radical prostatectomy may be done, which requires a longer recovery period. 

4. Chemotherapy

Chemotherapy may be used to target cancer cells that have spread from the prostate to other parts of the body. Powerful medications are injected orally or intravenously, then circulate throughout the body to destroy rapidly dividing cells.

5. Targeted therapy

Targeted therapy involves medications that can detect cancer cells without harming healthy cells. These modern medicines change the way cancer cells behave throughout their life cycle and are known as poly (ADP-ribose) polymerase inhibitors.

6. Immunotherapy

Immunotherapy does not directly target prostate cancer cells but instead stimulates the immune system to fight cancer. 

The FDA has approved Sipuleucel-T for use as a cell-based cancer immunotherapy for advanced prostate cancer. This personalized treatment uses your own immune cells by exposing them to a particular protein that enhances their capacity to recognize and attack prostate cancer cells.

7. Hormone therapy

Hormone therapy is referred to as androgen deprivation treatment. Since prostate cancer cells require testosterone to grow, hormone therapy works by inhibiting hormone absorption. 

Some hormone therapies reduce testosterone and other male hormone levels. Other types interfere with how those hormones act.

8. Cryotherapy

If you have early prostate cancer, your doctor may decide to freeze the cancer cells to kill them. This type of treatment involves inserting little needles or probes into your prostate to inject extremely cold gasses that kill the cells. 

However, the effectiveness of this therapy is unclear, since there are no long-term studies on how well they work in treating prostate cancer. 

9. High-intensity focused ultrasound

This technology generates sound waves that provide thermal energy to cancer cells, thereby killing them. It is uncertain how effective this treatment is, however, because it has not yet been compared to other standard prostate cancer therapies.