Prostate Cancer Treatment

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GRADES OF PROSTATE CANCER

Prostate cancer is also graded on the basis of the Gleason score, which will help your doctor determine the treatment plan. This score tells how well-differentiated the cancer cells are under the microscope.

Less aggressive cancers have cells similar to that of healthy tissue, whereas aggressive forms have a poor resemblance to healthy cells.

Prostate cells are examined from two different locations, and each is given a score from 3–5. A lower score means that the shape of the cells is closer to that of healthy tissue.

The scores of the two locations are added to give a final Gleason score of 6–10.

The Gleason score is considered along with staging to determine the treatment plan.

For example, patients with a Gleason score of 6 and low PSA levels may only need careful monitoring of cancer, whereas those with a Gleason score of 8 and high PSA levels may require intensive treatment.

  • Gleason score 6: Well differentiated cells; low-grade cancer
  • Gleason score 7: Moderately differentiated cells; medium-grade cancer
  • Gleason score 8,9,10: Poorly differentiated cells; high-grade cancer

Low-grade cancers are usually slow-growing and have less chance of spreading to other areas.

Treatment

In many cases, healthcare teams can deliver successful treatment regimens, with favourable outcomes and enhanced quality of life, even in low-resource environments.

Treatment options depend on the following factors:

  • Stage of the cancer
  • Gleason score provided by pathologist
  • General health of the patient
  • PSA level
  • Age

Treatment of prostate cancer include:

SURGERY

Radical Prostatectomy

This is a surgical procedure in which the entire prostate gland is removed during open surgery. Limited laparoscopic radical prostatectomy is also available, especially from private healthcare providers. Laparoscopic surgery inserts a tube with a camera to guide the operation. The patient has to use a catheter (tube leading to a bag through which urine passes) for 3–7 days after surgery.

RADIATION

External Beam Radiation – X-ray beams are focused on the targeted site.

Brachytherapy – It involves the insertion of radioactive seeds into the prostate. This is especially good for men with smaller prostate glands, and it may be given in combination with external beam radiation.

CHEMOTHERAPY

The use of chemicals in the form of pills or injections to kill or stop cancer cells from growing. Chemotherapy by itself does not cure prostate cancer but provides relief from many symptoms related to the disease such as pain, fatigue and loss of energy.

Side Effects from prostate cancer treatment

  • Hair loss
  • Mouth sores
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhea
  • Increased risk of infections (due to reduced white blood cells)
  • Easy bruising or bleeding (due to reduced blood platelets)
  • Fatigue (due to reduced red blood cells)

Treatment for Advanced Stage Prostate Cancer

Usually require a collaborative team effort of urologists, medical oncologists, radiologists, neurosurgeons and palliative care physicians.

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