Medical Treatments for Prostate Cancer

There are many different medical treatments for prostate cancer that involve the clinical care of a healthcare professional. These treatments include expectant therapy, surgery, radiation therapy, hormone therapy, and chemotherapy. Expectant therapy is to carefully observe and monitor the prostate cancer. Because prostate cancer cells often spread very slowly, many older men who have the disease may not need more extensive treatment. However, expectant therapy usually includes routine physician examinations, including digital rectal exams and PSA tests. The different types of surgery for prostate cancer are radical prostatectomy - an open-surgery procedure in which the entire prostate gland and surrounding tissue are removed. Transurethral resection of the prostate (TURP) - surgery to remove part of the prostate gland that surrounds the urethra. Cryosurgery - this procedure involves killing the cancer cells by freezing them with a small metal tool placed in the tumor. Side effects of prostate cancer surgery include incontinence and impotence. Incontinence is the inability to control urine and may result in dribbling of urine, especially immediately after surgery. Normal control usually returns within weeks or months after surgery. Impotence is the inability to achieve an erection. For a month, or so, after surgery, most men are not able to get an erection. Eventually, approximately 40 to 60 percent of men will be able to get an erection sufficient for sexual intercourse, but without ejaculation of semen, since removal of the prostate gland prevents that process.

Radiation therapy uses high energy rays to kill or shrink cancer cells, and to decrease their ability to divide. Radiation is often used to treat prostate cancer that is still confined to the prostate gland, or has spread only to nearby tissue. If the disease is advanced, radiation may be used to reduce the size of the tumor and to provide relief from symptoms. Possible side effects of radiation for prostate cancer may include diarrhea, with or without blood in the stool, and colitis, problems associated with urination, a degree of impotence (inability to get an erection), which may occur within two years of radiation therapy.

The goal of hormone therapy is to lower the level of male hormones in the body, particularly testosterone. Hormone therapy does not cure the cancer, and is often used to treat persons whose cancer has spread or recurred after treatment. Produced mainly in the testicles, testosterone causes prostate cancer cells to grow. Thus, reduced testosterone levels can make the prostate cancer shrink and become less active. Most studies show that hormone therapy works better if it is started early. Chemotherapy is the use of powerful, anti-cancer medications to kill cancer cells.. Hospitalization may be needed to monitor treatment and chemotherapy's side effects. Common side effects of chemotherapy include: nausea and vomiting, hair loss, anemia, reduced ability of blood to clot, mouth sores, increased likelihood of developing infections, fatigue. Most side effects disappear once treatment is stopped.

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Meanwhile, Ochsner Clinic Foundation is now offering advanced robotic prostatectomy with a reduced risk for urinary incontinence and impotence.

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In 2001, the prostate cancer team within the Beth Israel urology department performed the first laparoscopic radical prostatectomy in Manhattan using

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Ochsner, the leader in robotic surgery in the Gulf South, is one of only six in the Gulf South to offer the robot-assisted laparoscopic prostatectomy.


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