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Living with Prostate Cancer

Lewis Gale Physicians September 13, 2017

The prostate is a walnut-sized gland in men. It surrounds the urethra, the tube that carries urine out of the body. The prostate makes a fluid that is part of semen. Prostate cancer is a disease in which cancer cells grow in the prostate gland.

Diagnosis

A significant number of prostate cancers are found by a Prostate-Specific Antigen Test (PSA) screening before symptoms develop. Your doctor will ask about symptoms and medical history. A physical exam also will be done. Tests may include:

  • Digital rectal exam
  • Blood tests
  • Urine tests

Imaging tests evaluate the prostate and surrounding structures. These may include:

  • Transrectal ultrasonography
  • Intravenous pyelogram
  • Cystoscopy
  • Prostate biopsy

The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, prostate cancer is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.

Treatment

Cancer treatment varies depending on the stage of prostate cancer. You and your doctor will discuss the best treatment options for you. Treatment may include:

  • Watchful Waiting—your doctor monitors the cancer to see if it is growing. Watchful waiting may be appropriate if you:
    • Have early stage prostate cancer that is growing slowly
    • Are of an advanced age
    • Have serious health problems (risks of treatment outweigh the benefits)
  • Surgery—types of surgery that may be needed include:
    • Pelvic lymphadenectomy—removal of lymph nodes in the pelvis to determine if they contain cancer
    • Radical retropubic prostatectomy—removal of the entire prostate and nearby lymph nodes through an incision in the abdomen
    • Radical perineal prostatectomy—removal of the entire prostate through an incision between the scrotum and the anus
    • Transurethral resection of the prostate (TURP)—removal of part of the prostate with an instrument inserted through the urethra (may be done to relieve symptoms)
    • Since prostate cancer surgery may cause side effects, like erectile dysfunction, urinary incontinence, and fecal incontinence, there may be other surgery techniques that may be a good option for you. Some examples include nerve-sparing surgery, robotic surgery, and laparoscopic surgery.
  • Radiation Therapy—the use of radiation to kill cancer cells and shrink tumors:
    • Conformal radiation therapy—uses 3-dimensional radiation beams that conform to the shape of the diseased prostate. This treatment spares nearby tissue the damaging effects of radiation.
    • Intensity-modulated radiation therapy (IMRT)— uses radiation beams of different intensities to deliver higher doses of radiation therapy to the tumor and lower doses to nearby tissues.
  • Hormone Therapy—If prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones, called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth. Hormone therapy may include:
    • Luteinizing hormone-releasing hormone (LHRH) analogs
    • Luteinizing hormone-releasing hormone (LHRH) antagonists
    • Anti-androgens
    • Estrogen therapy—rarely used now unless other treatments are not working
    • Antifungal medications
    • Antineoplastic agents
    • In some case, a type of surgery called orchiectomy may be needed. This involves removing the testicles, which stops androgens from being produced.
  • Other Treatment Options:
    • Cryosurgery—this involves using an instrument to freeze and destroy prostate cancer cells
    • Chemotherapy
    • Immunotherapy—a drug treatment that builds your immune system to better fight cancer cells
    • Targeted therapies—focuses on the cancer cells, rather than attacking both cancer cells and healthy cells
    • High-intensity focused ultrasound—an endorectal probe (a probe that is inserted into the rectum) is used to destroy cancer cells with ultrasound energy

Lifestyle

By adopting certain lifestyle habits, you can help speed your recovery from prostate cancer:

  • Rest when tired—Radiation therapy and hormonal therapy can add to the fatigue you already feel from fighting cancer. Plan for rest periods during the day and ask for help at home when you need it. It is important to allow your body to rest.
  • Do not smoke— Smoking exposes your body to many cancer-causing chemicals. Some data shows that smoking makes your tumor less responsive to the effects of radiation. If you smoke, talk to your doctor about how to quit.
  • Eat a balanced diet— Good nutrition is essential for health and well-being. To aid in your recovery, make sure you are getting all the nutrients that your body needs for healing. Try to increase your intake of fruits, vegetables, whole grains, and high-fiber foods.
  • Exercise— Once you have been given the okay by your doctor, participate in an exercise program. For example, walking every day can help you to feel better, even when you are receiving treatment. Exercise may increase the amount of energy that you have during the day.

If you suspect you have symptoms of prostate cancer, please consult your healthcare provider immediately. Dr. Christopher Hicks of LewisGale Physicians can answer all of your questions and screen you for the disease. To schedule an appointment, call the practice at (540) 552-3670.

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