Best Treatment for Prostate Cancer
So you received some bad news: prostate cancer. It’s very distressing, but try to stay positive. The majority of people with prostate cancer have a good outcome and do quite well. In this report, I will summarize in brief the results of clinical research about the best treatments for prostate cancer. The research I summarize below consists of large clinical studies that were conducted over extended periods of time. Although many of these studies were retrospective studies, not randomized controlled clinical trials, they were performed by researchers at major research institutions and are regarded as highly reliable studies.
Before discussing treatments of prostate cancer, it is best to understand the main side effects of such treatments. The main side effects or bad outcomes are:
- urinary incontinence;
- sexual impotence;
- Colon damage and bowel difficulties;
- Cancer recurrence.
Cancer recurrence is obviously most alarming, since the objective of treatment is to eradicate the cancer. Therefore, it is wise to choose a treatment that has the best record of eradicating cancer, while minimizing the chances of harsh side effects.
The main treatments of prostate cancer are:
- Watchful Waiting
- Hormone Therapy
The Best Treatment of Prostate Cancer is Radiation
According to recent large-scale clinical studies, the treatment with the best record of eradicating prostate cancer is External Beam Radiation. For higher grade prostate cancers, some additional treatments are recommended, as follows:
- Low Grade Prostate Cancer: Best Treatment is External Beam Radiation
- Middle Grade Prostate Cancer: Best Treatment is a combination External Beam Radiation and Radioactive Seeds.
- High Grade Prostate Cancer: Best Treatment is a combination of External Beam Radiation, Radioactive Seeds, and Hormone Therapy (Adenoid Deprivation Therapy).
Studies show that, statistically, these are the most effective treatments for eradicating the cancer, although even these treatments cannot eradicate the cancer in all cases.
In cases of low and mid grade prostate cancers, radiation treatments also offer better outcomes for sexual function and for urinary continence.
Note that radiation therapy may potentially harm the colon and cause bowel injury. Long term clinical studies show that External Beam Radiation therapy causes bowel injury in about 12% of cases. Although bowel injury can be an inconvenience, it might a reasonably price to pay for longer cancer-free survival and for better sexual function and urinary continence. To minimize the potential for bowel injury, radiation treatment should be done at a hospital that treats a large number of cancer patients, using a radiation oncologist that treats a large number of prostate cancer patients.
Prostate cancer is usually diagnosed by a urologist – a physician specializing in diagnosis and treatment of that part of the body. Urologists, however, do not perform external beam radiation therapy; this treatment is performed by radiation oncologists – a different type of doctor. As a result, urologists most often recommend surgical treatment of prostate cancer, since this is the mode of treatment they can perform. Statistical data derived from large clinical studies shows that surgical treatment has a higher rate of cancer recurrence as well as a higher risk of sexual disfunction and urinary incontinence, when compared to external beam radiation therapy. (However, surgery has little risk of bowel injury.) To avoid one-sided advice, seek a consultation with a radiation oncologist, before deciding on your course of treatment.
Watchful Waiting – Is It A Good Option?
In watchful waiting, you do nothing to treat the cancer, but are under continuous supervision of a physician; if symptoms worsen, treatment is initiated.
Is watchful waiting a good option of treating prostate cancer? In a word: NO.
Large long-term clinical studies show that watchful waiting has a lower life expectancy than active treatment.
Disclaimer: The information presented here is based on statistical data derived from large clinical studies, and, like any statistical data, may not apply to your particular case. The only appropriate way to obtain medical advice is from a licensed and board certified physician. You should discuss your treatment options with at least three physicians: a Urologist, a Radiation Oncologist, and an Internist (a general practitioner).
Where Should You Receive Your Treatment?
Clinical studies about the outcomes of cancer therapy suggest that high-volume cancer hospitals (namely, hospitals that serve a large number of cancer patients) have better treatment outcomes. In these hospitals, physicians that treat the largest number of cancer patients have the best outcomes. This is a widely accepted principle in cancer medicine. It is also easy to understand why: good outcomes attract more patients. So the best advice is to use a high volume physician at a high volume hospital.
Based on this, the following list ranks hospitals in declining order of cancer patient volume, based on indicators of the number of cancer patients they treat. The top 10 hospitals on the list below offer the best chances of a good cancer-treatment outcome.