Also called prostate enlargement, one of the best known treatments for the condition is the transurethral resection of the prostate (TURP), in a surgical instrument called the endoscope or cytoscope is inserted in order to cut away the excess tissue. However, due to the limitations of that procedure, and to technological advancements that are meant to make everything that much easier, other techniques have been found to improve on the TURP. 

Prostate laser surgery is a minimally invasive therapy that is used these days for the treatment of BPH. Just like with the TURP procedure, in this operation a portion of the prostate is removed; however this time it is done by the aid of a specialized laser. With this surgery, the man being treated is afforded better urinary retention than previously; and he may undergo the procedure in the event of medical therapy failure, a recurrent infection, and renal insufficiency.

Incidentally, prostate laser surgery may be employed also for the treatment of various other conditions that generally affect the male urinary and reproductive systems, such as bladder stones, and prostatic bleeding. During the procedure, an anesthetic is given to the patient to help him relax for the length of the operation. The cystoscope is then inserted along with a specialized laser fiber in order to remove the portion of the prostate blocking the bladder’s drainage. Because of the loss of continence that result from the trauma to the region, a catheter is left in the bladder just long enough for the man to regain control of his bladder fluids – the catheter is usually removed the next day.

Some of the important advantages of prostate laser surgery, especially over TURP include the aforementioned minimal invasiveness of the surgery in dealing with bladder outlet obstruction, and a shortened recovery period, which most men can appreciate if they have to get back to work in a hurry. Certainly, because of the improved precision of the process, the patient also experiences lower blood loss than if he had to undergo the conventional prostate surgery. There are side effects still, though, and they include some initial discomfort with voiding after the procedure; however, this fades within days. Some patients also take longer to recover their bladder control, but again, that fades. And with fewer scars, the man certainly has a lot to be thankful for

In prostate cancer treatments, radiation therapy makes use of beams of x-rays or gamma rays to destroy or damage the DNA of cancer cells in the body – wherever they may have progressed to in the body. This allows for radiotherapy to be useful in treating all stages of the condition. Incidentally, other cells (normal ones) in the body are also damaged in the process; but whereas they can recuperate and regenerate, the cancerous cells cannot and die off. 

Brachytherapy is a form radiation therapy that makes use of an internal source of radiation in order to kill the cancer, usually used when the prostate cancer cells are still in the prostate gland and have not spread (or metastasized) to other locations across the body.

Brachytherapy for prostate cancer is administered using “seeds,” small radioactive rods implanted directly into the tumor. Also referred to as permanent implant brachytherapy, it actually is a popular treatment choice for patients who have low risk features of the disease or of relapse. Men with intermediate risk features may also be treated by it though.

Brachytherapy is a process in which about a hundred small ‘seeds’ of radioactive material are placed inside of the prostate gland with the aid of a needle through the skin of the perineum, and directly into the tumor while it is still in the prostate gland. The radioactive materials normally used in this procedure are iodine-125 or palladium-103, although there are others that have similar effects in the therapy. The operation may be carried out under a spinal anesthetic, but if the patient desires it or the surgeon thinks it is necessary, general anesthetic may be used also.

The seeds, once inserted in the prostate, carry on to emit lower-energy x-rays that typically travel only a short distance within the organ without doing a lot of damage to other organs or cells in the body. The seeds do eventually become inert, but they remain in the prostate gland permanently on permanent residency. But the risk of radiation exposure to others from patients treated with the implanted seeds is generally not thought to be significant enough to cause worry.

Advantages/Merits of Brachytherapy

One of the many merits of brachytherapy, especially over conventional external beam radiotherapy (EBRT) is that it can be performed on an outpatient basis.

Another advantage is that the procedure is associated with good 10-year outcomes while also guaranteeing relatively low morbidity.

However it is only applicable in early stage disease: later stages may employ a combination therapy of both EBRT and radiation therapy.

Disadvantages/Side Effects Of Brachytherapy

The side effects of both are similar – radiation proctitis, impotence, and incontinence; and typically they were off as the radiation does as well.

Advanced prostate cancer may be locally advanced, located in the prostate and in the pelvic region. (likely the lymph nodes would be swollen by this time); advanced prostate cancer proper is typically characterized by an extensive spread of the disease to various locations around the body, especially in the skeletal system. Curing the cancer at this time is often out of the question, but treatment may be offered in order to provide palliative care to the patient.

The treatment of advanced prostate cancer therefore is in the interest of delaying the disease’s progression as well as its symptoms, managing bone pain and metastasis, improving the quality of life of the patient, and prolonging his life.

Palliative care does this by focusing on extending life and relieving the symptoms of the metastatic adenocarcinoma. To that effect, some treatments already in use such as hormonal therapy, chemotherapy, and radiation therapy, that can slow disease progression and yes, relieve the symptoms that the patient is suffering from to some degree. However others are needed in order to further improve the outcomes of the treatments.

Abiraterone acetate is one such procedure that is showing some promise in late phase research for treating advanced prostate cancer. The drug causes the PSA levels in a patient to drop dramatically while also reducing the size of a prostate cancer tumor. 70% of the patients with aggressive advanced-stage prostate cancer that were treated with this mediation showed remarkable improvement. Chemo may slow disease progression and postpone symptoms, especially if used with corticosteroids.

Bisphosphonates are ideal for the prevention of fractures in bone metastasis. Zoledronic acid for instance has been shown to delay such skeletal complications and even the need for radiation therapy. It is most applicable then when a patient turns up who has hormone-refractory metastatic prostate cancer, one of the worst forms of the disease. For reducing pain, improving quality of life, and pr prolonged patient survival times, reduced pain and improved quality of life, alpharadin is the new alpha emitting pharmaceutical that will do the trick.

Patients treated by proton therapy are that much more fortunate than those treated with standard radiation therapy because protons are better able to aim at the tumors of the cancer without doing damage to other cells in the region, thereby making it possible for treatment to be administered with sincerely reduced side effects. Radiotherapy makes use of ionizing radiation of gamma rays or x-rays to do damage to the DNA of abnormal cancer cells; proton therapy simply makes use of protons.

Proton therapy is today described as a precise form of radiation therapy for cancer and other such conditions, which limits or minimizes the damage to healthy tissue and surrounding organs during the process of the treatment. As a result, proton therapy is highly successful and results in fewer side effects for the patient. Due to the precision of the treatment, the procedure is faster, which naturally causes the man to spend a shorter time in the hospital than he would have otherwise needed, and to recover more rapidly from the therapy.

In addition to the following, it has also been determined that proton therapy may reduce the risk of secondary cancers occurring after the primary one has been treated by the procedure.

A beam of protons was used instead of a scalpel in brain surgery for the first time at the Gustaf-Werner Institute for Nuclear Chemistry in Uppsala, Sweden, 1952 – that was the origin of proton therapy. The patient was conscious throughout the painless two-hour procedure; chronic acute pain and depression were relieved without the necessity of brain surgery, which a synchrocyclotron supplied the proton beam through a 60-ft-long tube; only the point of intersection got the full effect. The novel technique was developed at the University of California by Prof. C. A. Tobias who used it for pituitary gland operations. Today it is used to treat prostate cancer as well. 

The cost of proton therapy for prostate cancer treatment at the moment is manageable in fact, coverable also by health insurance policies, so that the patient should not have to worry about expense.

Prostatectomy – one of the most well known treatments for prostate cancer is a surgical procedure in which the entire prostate gland is removed, or at least parts of it. A radical prostatectomy may be performed by an incision in the abdomen of the patient, an incision in the perineum, or by a laparoscope to reduce the size of incisions. A surgical robot may also the used in order to limit the risks of complications, which are many. Side effects of prostate cancer surgery include impotence and incontinence, some of which may never be lived down.

Radiation therapy – a procedure that uses ionizing radiation from any number of sources to do damage to the DNA of cancer cells also hurts normal cells in the body. The radiation may be from a linear accelerator (external beam radiotherapy) or from radioactive seeds implanted in the prostate gland (brachytherapy). The damage to normal cells causes radiation proctitis, which results in mild rectal bleeding and diarrhea, and impotence and incontinence as well. These side effects generally fade a few weeks after the treatment stops though.

Hormonal therapy – attacking the hormones that contribute to the growth and progression of prostatic adenocarcinomas in the body is certainly a brilliant idea, except that it does not cure the disease. However while the therapy is on the patient will show signs of remission as disease progression slows and the tumors even start to shrink. In early stage, before the cancer can grow resistant, surgery or radiation can complete the cure; in late stage… well at least it slows the disease and gives the patient valuable time to appreciate life and put his accounts in order. 

Chemotherapy – something does have to pick up the ailing ball when hormonal therapy fails to curb the progression of advanced stage hormone refractory prostate cancer, and chemo is it. It is drugs that invade the entire body killing every cell in their path that divide rapidly – not appropriate for early stage disease because the cancerous cells look and act too normal then, but perfect for advanced stage prostate cancer because then the disease would have metastasized to various locations across the body.

Cryotherapy – might be construed to be an improvement on prostatectomy because it is also a surgical procedure, but one that uses extreme cold to kill the cancerous cells. High intensity focused ultrasound also is an improvement on the concept of radiotherapy, this one uses ultrasonic waves. Proton therapy is similar (using protons), while other therapies are popping up all the time. Until the final definitive cure for prostate cancer is found, this will continue to be the trend.

Early stage prostate cancer is generally depicted by the tumor growth still being confined to the prostate gland itself, at which point it can be caught and killed effectively; advanced stage prostate cancer is typified by disease metastasis through the bloodstream and lymphatic system, allowing it to invade various organs in the body, especially the bones, causing the later symptoms that come with advanced disease.

Treating advanced stage prostate cancer is often with the intention of palliating the patient, that is, extending his life, slowing the growth and progression of the disease, delaying the symptoms that cause him to suffer, and generally making him more comfortable as he… well, as he inevitably dies.

Usually the first treatment that may be considered for this purpose is hormonal therapy. Although also usable for early stage disease this intervention rarely ever cures the condition, which is why it is reserved for later stages.

Prostate cancer (at least the more common forms of it) depends on the hormones of the male sexual system to progress; without these hormones (testosterone, DHEA and DHT) that progression is stunted and the cancer may even shrink. Hormonal therapy removes the testicles (orchiectomy) to stop testosterone production, or uses antiandrogens to suppress the production of DHEA, DHT, GnRH and LH in the body, all hormones that are implicated in disease progression.

Should hormonal therapy fail, at least there is still chemotherapy. Chemo is not applicable for early stage disease because of the slow rate at which the cancer develops. Because the drugs administered by this treatment are intended to attack like cells that divide rapidly in the body, they may miss out on the actual tumor and attack healthy cells. They do this in fact even in this advanced stage of the disease, which is why most people lose their hairs and get mouth sores, and all of those other side effects of chemotherapy that are so well known.

There are other Prostate Cancer treatments too, most of which are aimed at extending life and relieving the symptoms of metastatic disease.

Abiraterone acetate causes a dramatic reduction in PSA levels and tumor sizes; bisphosphonates like zoledronic acid delays skeletal complications like fractures; alpharadin targets bone metastasis, prolongs patient survival times, reduces pain and improves quality of life; opioid pain relievers like oxydocone and morphine help the bone pain; and EBRT directed at bone metastases may provide pain relief.

And then there are the Injections of certain radioisotopes like strontium-89, phosphorus-32, and samarium-153, which also aim at bone metastases and try to help with pain relief.

The most important thing to note in deciding on treatment however is that the early stages of prostate cancer can be cured, but later (advanced) stage disease cannot. There are other factors too that have to be put into consideration, such as the sentiment of the patient, his state of health, and such the like, but disease stage is most important.

What most people would argue to be the best treatments for prostate cancer are prostatectomy and radiation therapy. This is because these two are often carried out in early stage disease with the intention of curing the condition.

Prostatectomy is a surgery during which the prostate gland is removed in order to remove the tumor growing within it. It is a straightforward process that may be varied by incision or procedure, but one with such side effects as impotence and incontinence.

Radiation therapy may be given at any stage of the disease, but for early stage prostate cancer it is often internal (brachytherapy), or sometime combined with external beam radiotherapy (EBRT). Ionizing radiation from a linear accelerator or from surgically implanted radioactive seeds attacks the DNA in cells in the body and makes them more predisposed to apoptosis (programmed cell death).

The problem with radiation is exposure, because other (normal) cells in body also suffer from the damage done by the rays. However they can recuperate while the cancerous cells cannot; but the patient is going to have to deal with radiation proctitis for a while before the symptoms fade.

The side effects of radiation treatment for prostate cancer are diarrhea and mild rectal bleeding from the proctitis, as well as incontinence and impotence.

The limitations of radiation therapy and radical prostatectomy have caused for other procedures to the sought after that may provide cure for prostate cancer with fewer complications. Nerve sparring attempts to reduce the risk of impotence, and cryosurgery (which is indeed better) tries to reduce other complications like scars and blood loss, while also extending the time during which the patient might not suffer a relapse of the disease.

Using similar concepts to radiation treatment, proton therapy, high intensity focused ultrasound (HIFU), and intensity modulated radiation therapy (IMRT) all work by making it easier to specifically target tumors without doing damage to other parts of the body, this limiting side effects.

Prostate cancer is a condition in which the normal cells in the prostate gland start to mutate suddenly and them multiply rapidly, affecting other cells, growing larger, and generally being a nuisance… a nuisance that kills if rapidly and properly taken care of. Cryotherapy is a surgical procedure in which extreme cold is applied to the prostate gland in order to freeze up the cells in it and cause them to die in the process.

The freezing temperature is obtained from a highly purified argon gas source and conducted into the prostate through two small metallic rods that have been inserted with the aid of ultrasound imaging into the organ. Because of the location of the prostate, the prostatic urethra is at risk as well from freezing over (the tube that links/leads from the bladder to the penis). In order to save it, a catheter of warm fluid is placed gingerly around it.

The temperature is dropped to the regions of – 186^oC, which is the same as – 302^oF. The water in the cells in the prostate freeze up at this point, and the patient is thereby cured of prostate cancer when the cells die off. It is unfortunate to think that the entire prostate would be destroyed in this way, but it is pleasant to consider that the patient now has a better ten year guarantee that the disease will not relapse than any other prostate cancer treatment can offer.

Cryosurgery generally causes fewer problems with urinary control than most other treatments that there are, but it has the sorry disappointment of resulting in impotence up to ninety percent of the time. Not pleasant at all, that. However, if the therapy is employed in the hands of an experienced cryosurgeon and in capacity as the initial treatment for prostate cancer, as mentioned earlier it has a 10 year biochemical disease free rate that is totally superior to all other treatments for prostate cancer that there are – even radical prostatectomy and any form of radiation don’t come close.

To date, cryosurgery has been demonstrated to be a better-quality procedure for the treatment of prostate cancer that recurs after a radiation therapy, than radical prostatectomy could ever be. It allows for the patient to suffer less blood loss, recover faster, and be back at work in record time. Sometimes the patient may require a night’s stay in the hospital, but only just so. The fewer incisions also makes for an aesthetically superior surgical process.

External beam radiation therapy (EBRT) makes use of a linear accelerator to produce the said high-energy x-rays and direct them in a beam towards the prostate, or the region in question where the tumor is meant to be located. EBRT generally has to be given to the patient over a period of several weeks, with the patient observing daily visits to a radiation therapy center.

There are side effects to this form of treatment though. Because it is difficult to conform the incident rays (or beam) or ionizing radiation to the shape of the contours of the tumor, more and more normal cells are affected by the treatment, and during the time span it takes them to heal, things could be really uncomfortable.

These side effects of EBRT typically occur a few weeks into treatment, causing diarrhea and mild rectal bleeding as a result of radiation proctitis. The side effects may also include potential urinary incontinence and impotence. The good news is merely that they symptoms tend to improve over time as the overall effect of the radiation exposure wares off of the body.

To aid in the spate of prostate cancer external beam radiation treatment, certain new types of radiation therapy are being realized. For instance, one new procedure called IMRT – intensity modulated radiation therapy – improves on the ability to conform radiation beams to the shape of the tumors, which is priceless for the patient and doctor alike. There are fewer side effects than traditional treatment, while the procedure also allows higher doses to be given to the prostate and seminal vesicles with less damage to the bladder and rectum.

There are other treatments that are springing up even at this time that use the same concept as EBRT. One such is proton therapy, also now preferred to EBRT because it can focus better on cancerous cells with fewer side effects and kill them; another is High Intensity Focused Ultrasound – HIFU, which uses sound waves instead to heat the cancerous tissue to death. External beam radiotherapy was the first, and remains still largely in use.

Running through a short list, vitamins from various vegetable and fruit sources have been found to have healing properties against prostate cancer, and may actually prevent the disease. For one thing, they certainly contribute to a lowered incidence of prostate cancer amongst those who feed more on them than on high fat meals, red meat, and processed foods.

Lycopene, for instance, a very powerful antioxidant that is found in tomatoes, watermelons, and some other red pigmented vegetables and fruit is already confirmed to at least lower prostate cancer risk by about 35% in men who consume certain portions of it daily.

In an interesting twist, fish oils have been found to also have health values against prostate cancer. In specific, polyunsaturated fatty acids omega-3 and omega-6 that are found richly in various forms of fish (especially the tuna and the salmon) are now believed to be able to contribute to a reduced incidence of the disease. For that reason, some scientists say that a vegan diet that allows for a little fish would be ideal for preventing prostate cancer, and can certainly help slow PSA doubling times in patients with the disease.

Prostate cancer is not believed to be curable after a certain stage, but it was recently found that capsaicin, an ingredient in red peppers that were harvested in South America, and that is abundant in various other species of the spice, can cause advanced prostate cancer cells to undergo programmed cell death or apoptosis. Even though this has not been concluded in findings, there is no telling the excitement about the discovery – for all that is known it may be the cure for the disease.

Various other natural treatments for prostate cancer  or disorders actually can help in the treatment of prostate cancer as well. The saw palmetto, well known for its medicinal value against BPH is one of them; the saw palmetto is another; a third is green tea; and fourth comes pomegranate – specifically pomegranate juice. Besides the fact that several doctors urge them now for patients undergoing treatment for prostate cancer, there is the reasoning that if they can aid in treating prostate disorders, they can aid in treating prostate cancer as well.