Prostate Cancer Treatments: 4 Advances That Help Limit Side Effects

An estimated 1 in 8 men in the U.S. will be diagnosed with prostate cancer in their lifetime. Fortunately, there are more treatment options available than ever before for early-stage disease.

Thanks to technological advances and recent medical discoveries, these prostate cancer treatments do a better job of fighting cancer. And they do so with less risk of the side effects — urinary incontinence, erectile dysfunction — that can greatly impact a man’s quality of life.

Advanced Treatments for Prostate Cancer

1. Better Prostate Imaging = Better Biopsy

Magnetic resonance imaging (MRI) is now commonly used to diagnose prostate cancer because it provides better, more reliable visibility. It allows doctors to accurately identify high-risk prostate cancer lesions and pinpoint their location.

This makes decisions — about whether to biopsy and where, for example — easier to make. And it limits the risk of false or missed diagnoses, which can be stressful for patients.

2. A Move Toward Monitoring Less Aggressive Tumors

Although prostate cancer is very common, we now know that approximately 60 percent of these cancers are less aggressive and can be safely monitored for years without treatment. With MRI and a more precise biopsy, doctors can rule out more aggressive cancers, making active surveillance (close, consistent monitoring) an option for many patients.

Surveillance is easily manageable and may include:

• Regular PSA testing (a blood test to measure prostate-specific antigen levels)
• Digital rectal exams
• MRI and prostate biopsies to monitor for signs of increased cancer growth

3. Radiation Therapy Improvements

There have been many advances in radiation therapy that make this commonly prescribed treatment more precise, more effective and more manageable for prostate cancer patients. This approach has three components.

Arc-Based Intensity-Modulated Radiation Therapy (IMRT)

Utilizing beams of radiation of varying intensity, IMRT delivers a highly focused dose of radiation that conforms to the shape of the tumor. The therapy lasts just two to five minutes per session compared to traditional radiation therapy, which can last up to 45 minutes. This means there’s less risk the prostate will move during therapy and expose surrounding tissue to radiation.

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Brachytherapy

This procedure delivers focused radiation to the prostate using temporary radioactive implants. Doctors recommend it for patients with intermediate- and high-risk prostate cancer.

“This brachytherapy ‘boost,’ combined with IMRT, has resulted in excellent cure rates,” says radiation oncologist Timothy Showalter, MD. In addition, the use of brachytherapy may reduce the need for androgen deprivation therapy, which suppresses the male sex hormones that are necessary for prostate cancer to grow.

This allows men to skip the many side effects associated with hormone therapy, including weight gain, higher cholesterol levels, weaker bones, higher blood sugars and higher risk of cardiac events.

Prostate Rectal Spacer

The SpaceOAR® system consists of a soft hydrogel compound that doctors inject between the prostate and the rectum prior to prostate radiation therapy.

“By moving the rectum away from the prostate during radiation therapy, it is protected from radiation exposure. This lowers the risk for side effects of radiation, such as rectal bleeding and bowel incontinence,” explains Showalter.

4. Robotic Prostatectomy Reduces Risks

Doctors often recommend prostatectomy, the surgical removal of the prostate gland, for men with localized prostate cancer (cancer that hasn’t spread to other parts of the body). Prostatectomy may accompany radiation or chemotherapy depending on a patient’s diagnosis.

Today, doctors most often perform this procedure robotically. “Robotic prostatectomy is a minimally invasive surgery performed through small ‘keyhole’ incisions, which means there are fewer complications, less blood loss, less pain and a faster recovery compared to traditional open surgery,” says urologic surgeon Sumit Isharwal, MD.

In fact, a majority of the patients are able to go home the day after surgery. “During robotic surgery, doctors preserve nerves that control sexual function. The risk of urinary incontinence is lower with robotic surgery as well,” adds Isharwal.