5 in 5: Take Five Minutes for Five Questions about Prostate Cancer |
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Mark A. Moyad, MD, MPH: Phil F. Jenkins, Director of Complementary/Preventive Medicine
Empower Yourself in Five Minutes For Newly Diagnosed Men Question 1: What types of treatments are available for prostate cancer? You and your physician will determine the best options based on a number of considerations, including the progression of your disease. Alternatives include: Surgery -- The goal of surgery is to remove the cancer. There are several different surgical options, appropriate for different stages of prostate cancer. Hormonal Therapy -- Decreasing the production of testosterone slows cancer growth. This is the first line of treatment for patients with advanced prostate cancer and for those whose cancer has not responded to curative treatment options (radiation, surgery, etc…) Drugs called luteinizing hormone-releasing hormone agonists (LH-RHa) are prescribed to shrink the tumor, slow the spread of cancer and to alleviate symptoms. Anti-androgen drugs block the small amount of testosterone produced by the adrenal glands. Radiation – Radiation therapy involves exposing cancer cells to high doses of radiation with the goal of killing the tumor. Two types of radiation (brachytherapy and external beam radiation) can be used to kill prostate tumors. External beam radiation therapy treats the prostate and other selected tissues with a carefully targeted beam of radiation administered from machines outside the body. With brachytherapy, tiny radioactive seeds (each about the size of a grain of rice) are implanted into the prostate through a surgical procedure. Chemotherapy – Chemotherapy is a common term used to describe cytotoxic drugs known to destroy cancer. These drugs target and destroy cells that divide rapidly, traits that define some cancerous cells. Unfortunately, chemotherapy also has specific side effects you should discuss with your doctor. Watchful Waiting -- Careful observation without other immediate treatment may be appropriate for men with less aggressive tumors, which typically grow slowly. Question 2: What are the side effects and risks associated with these treatment options? Again, you and your doctor should discuss treatments that make sense for your situation. Ask about the specific advantages and disadvantages of potential treatments. This should include side effects and other possible complications, how often they occur and if they can be effectively treated and how. Therapies for side effects are widely available. In some situations your doctor may recommend combining treatments. If this is the case, you should always ask about the combined advantages and disadvantages of using more than one treatment. For Men on Hormonal Treatment During or after your treatment, your doctor may recommend changing or adding something else to your therapy. It is very important that you understand exactly why she or he is offering this recommendation. Question 3: Is my current hormonal treatment making progress against my prostate cancer? Ask your doctor if your current hormonal treatment is working or producing the expected results. If not, why? Has your cancer progressed? Relying on treatments with a long history of being safe and effective against prostate cancer can be a strong defense against the disease. Question 4: Why are you considering another hormonal therapy for me? There are lots of reasons your doctor may recommend a different therapy. It may be to avoid side effects of the current treatment, or cancer may have spread to a point that requires a change or addition to the current treatment. Some changes may be suggested because of the personal experience or preference of the doctor. Other changes may be motivated by a desire on behalf of your physician to increase his or her reimbursement of your medication. Again, ask your doctor about the specific reasons for this new recommendation. What does the doctor hope to accomplish with the new therapy that the current one is not giving you? What other side effects can be expected with this new treatment? Question 5: How is this medication different from my current hormonal therapy? If your doctor recommends a change, you should ask how this new treatment is similar to or different from your current one. Does it attack the prostate cancer in a different way? Are the side effects similar? What new side effects can be expected? What side effects can be reduced or eliminated? Your doctor may recommend a change such as going from radiation therapy to hormone therapy, or having radiation after surgery. However, your doctor may also recommend a not-so-obvious change, like changing the brand of your medication. Changing the type of hormone therapy may mean giving you an injection in a different part of your body. For an objective overview of the hormonal therapies on the market go to ustoo.org. Putting It All Together and Moving Forward Remember, prostate cancer is treatable, and you ultimately are the person who controls your treatment decisions. While these five questions are a good start, don't limit yourself. You, your spouse or significant other and your doctor are a team. Ask a lot of questions, even the difficult ones, to ensure you have the best chance of beating this disease. |
