WATCHFUL WAITING 

• Not all men diagnosed with the disease require immediate treatment. Some cancer cells grow slowly and may take 10 years or more to cause problems or spread. The doctor will monitor his patient’s progress and provide regular examinations to check cancer growth by performing DRE and PSA tests.

SURGERY

• Surgery involves the complete removal of the prostate with a safe clear margin to prevent recurrence and progression. It is the recommended form of treatment only if the tumor is localized at the prostate. Types of surgery include:

1. Radical retropubic prostatectomy is a surgical procedure in which the prostate gland is removed through an incision in the abdomen.
2. Radical perineal prostatectomy is a surgical procedure wherein the prostate gland is removing through an incision in the area between the anus and scrotum (perineum).
3. Laparoscopic radical prostatectomy is minimally invasive and relies on modern technologies, such as fiber optics and miniaturization. It is not new treatment for prostate cancer. It is a modern form of the oldest treatment for prostate cancer.
4. Robotic prostatectomy procedure incorporates a state of the art surgical system that helps your surgeon see vital anatomical structures more clearly and to perform a more precise surgical procedure.

• The side effects:-

1. Urinary incontinence (loss of bladder control)
2. Impotence (inability to get erections)
3. Change in penis length

RADIATION THERAPY

• The goal of radiation therapy is to destroy the cancer cells and stop their growth. The rapidly reproducing cancer cells are more vulnerable to destruction by the radiation than are the neighboring normal cells.There are 2 types of radiation therapy:

1. External beam radiation therapy (EBRT) is a local treatment, meaning that the radiation is aimed only at a specific part of body.
2. Internal radiation therapy or also known as Brachytherapy is a form of treatment where a source of radiation is placed inside the body. It is generally used only in man with early stage prostate cancer that is relatively slow growing.
3. Intensity modulated radiation therapy (IMRT) is one of the latest and most advanced methods in prostate cancer treatment. IMRT uses thinner beams to precisely target the tumor and spare other nearby organs from radiation. Therefore, IMRT reduces side effects and burnt areas of a patient compared with more conventional methods.

• The side effects:

1. 1. Diarrhea or other disruption of bowel function
   2. Increased urinary urge or frequency
   3. Fatigue
   4. Rectal discomfort, burning or pain
   5. Impotence (inability to get erections)
   6. Urinary incontinence  

 
HORMONAL THERAPY

Hormonal treatment is an option for men whose prostate cancer has spread beyond the prostate. Hormone treatment may be given for some months before radiotherapy or surgery to help these treatment work better. The hormone treatment does not aim to cure the cancer but can help shrink the cancer or relieve symptoms for most men.

Hormone treatment with surgery

• Orchidectomy - This is the medical term for surgical removal of the testicles and is a small operation. The surgical removal effectively limits the amount of testosterone available to fuel the cancer.

Hormone Injection

• LHRH analogues - This group of drugs is usually given as an injection under the skin either monthly or 3 monthly depending on the depot preparation. They act by shutting down testosterone production in the testicles. Its actions are therefore similar to that of orchidectomy.
• Antiandrogen - This drugs act on the testosterone receptors in the prostate to prevent the action of the hormone on the gland and the cancer.

The side effects:-

1. 1. Loss of libido (sex drive)
   2. Weight gain
   3. Flushing (like hot flashes)
   4. Impotence (inability to get erections)
   5. Osteoporosis (softening of the bones)
   6. Swelling of the breasts
   7. Fluid retention
   8. Mood swing

CHEMOTHERAPY

• Chemotherapy is the use of powerful drug to attack cancer cells. There are many different chemotherapy drugs, each with it is own strengths and weaknesses. Often the drugs are used in combination. While some are injected directly into a vein or a muscle, others may be taken by mouth.

The side effects:

1. 1. Diarrhea
   2. Nausea
   3. Hair Loss
   4. Vomiting
   5. Reduced ability of the blood to clot
   6. Suppression of the bone marrow

Updated:: 04/04/2019 []