What is the best prostate cancer treatment for my husband?

Hi,

Welcome to icliniq.com.

I understand your concern.

Prostate cancer is a disease in which abnormal cells grow in the prostate gland, a small gland in men located below the urinary bladder and in front of the rectum that produces part of the semen.

It often grows slowly, especially in older men, but how it behaves depends on:

• Cancer stage, which describes how far the cancer has spread, ranges from confined to the prostate to nearby tissues or other organs.

• Gleason score, a number between six and 10 that grades how abnormal the cancer cells look under a microscope, with higher scores meaning more aggressive cancer.

• Prostate-Specific Antigen (PSA) level, a protein made by the prostate; higher levels in the blood can indicate prostate cancer, but can also be raised in other prostate problems

• Overall health and life expectancy, or how healthy the person is overall, which affects treatment options and risks.

Treatment options and what they mean:

• Radical prostatectomy (complete removal of the prostate gland):

  • Urinary incontinence, leakage of urine, or loss of bladder control.

  • Erectile dysfunction is difficulty getting or keeping an erection.

  • Bowel changes, such as loose stools or urgency.

  • Surgical removal of the entire prostate gland and sometimes nearby tissues or lymph nodes.

  • It can cure the cancer if it has not spread outside the prostate.

  • Possible side effects:

• Radiation therapy (External Beam Radiation Therapy (EBRT) or brachytherapy (internal radiation))

  • Uses high-energy rays or particles to kill cancer cells.

  • Benefits: Can cure the cancer if it is still confined to the prostate.

  • Possible side effects include urinary incontinence, erectile dysfunction, bowel problems such as diarrhea, rectal bleeding, or irritation of the rectum

• Active surveillance (close medical monitoring without immediate treatment) includes

• Regular Prostate-Specific Antigen (PSA) tests, blood tests to measure PSA levels

• Digital Rectal Exam (DRE), a physical examination in which the doctor feels the prostate through the rectum

• Repeat biopsies, removal of small samples of prostate tissue for microscopic examination if needed.

  • Suitable for: Low-risk cancers that are not causing symptoms.

  • Goal: Avoid or delay treatment and side effects until necessary.

Newer and less invasive approaches

• Nerve-sparing surgery, which is a surgical technique to avoid damaging the nerves that control erections, reduces the chance of erectile dysfunction.

• Targeted radiation techniques, such as Stereotactic Body Radiotherapy (SBRT), which delivers a high radiation dose to the tumor with extreme accuracy over fewer sessions, reducing exposure to surrounding tissues.

• Focal therapies treat only the cancerous area of the prostate instead of the whole gland.

  • Example: High-Intensity Focused Ultrasound (HIFU) uses focused sound waves to heat and destroy cancer cells without cutting the skin.

How to decide on the best option

• Discuss choices with:

  • A urologist is a doctor specializing in diseases of the urinary tract and male reproductive system.

  • Radiation oncologist, a doctor who treats cancer using radiation therapy.

• I would suggest you consider the following:

  • Cancer stage.

  • Gleason score.

  • Prostate-Specific Antigen (PSA) level.

  • General health and expected lifespan.

  • Personal values, such as a preference for avoiding certain side effects.

  • Willingness to undergo regular follow-up if choosing active surveillance.

• Most early-stage prostate cancers grow slowly, so it is usually safe to take time to gather information and possibly get a second opinion before making a decision.

Your role in supporting him:

• Help prepare questions for his appointments.

• Keep track of test results and medical advice.

• Offer emotional support to reduce stress during decision-making.

• Encourage open discussion with his doctors about concerns and preferences.

 I hope this helps.

Kindly revert if there are any queries.