For patients that come to me with a second opinion for prostate cancer or they’ve come with a raised PSA and we’ve diagnosed prostate cancer we usually spend a long time discussing all the treatment options.
Some people may say that it’s quite bewildering to deal with this but I actually feel it’s very straightforward.
You need to take the time to explain the options to the patient and their family and discuss all the treatment alternatives, discuss the pros and cons of all these treatment alternatives and find out what’s important for the patient.
After you do all this it’s relatively straightforward for patients to end up choosing a particular treatment.
These treatments, there are a variety treatments and these include active surveillance, which is monitoring the patient.
It’s not wait and watch, it’s monitoring the patient quite closely.1
The second option is surgery and there’s three types of surgery.
You could have open surgery, robot assisted surgery and laproscopic surgery.
The next type of treatment is radiotherapy.
Radiotherapy can be either external beam radiation, high dose brachytherapy with the use of wires into the prostate or lose dose brachytherapy which involves the use of seeds.
There are two experimental treatments which are evolving and these include HIFU (High Intensity Focus Ultrasound) and cryotherapy.
And finally there’s the use of hormone therapy.
So really although there’s a list of these treatment options they are relatively straightforward and patients usually can decide quite easily which treatment is best for them once they’re given appropriate counselling and information.
References
1. Active Surveillance for Prostate Cancer: Progress and Promise - Matthew R. Cooperberg, Peter R. Carroll, and Laurence Klotz - Journal of Clinical Oncology Volume 29, Number 27 - https://ascopubs.org/doi/abs/10.1200/JCO.2011.34.9738