Around 192,000 men are diagnosed with prostate cancer in the United States each year, with the average age at diagnosis being 72, and over 27,000 die from the disease. Prostate cancer often grows slowly and may not require any treatment at all. Knowing all the options helps making the decision on whether and how to treat prostate cancer easier.
Understanding the Gleason Score and What It Means in Prostate Cancer Treatment
Prostate cancer treatment depends to some extent on the grade and stage of the disease, which indicates how aggressive the cancer may be and how far it’s already spread. Prostate cancers are graded using the Gleason score, which looks at the degree of abnormality in the cells and assigns a number from 1 to 5 to the two most common types of abnormal cells seen in the tumor. The two numbers are then added together to give the Gleason score.
The higher the Gleason score, the more aggressive the cancer is likely to be. The average score is between 6 and 7, the Merck Manual states, and scores in this range indicate a less aggressive tumor, with scores of 10 and over indicating a more dangerous cancer.
Choosing to Have Surgery to Treat Prostate Cancer
Surgery is often the recommended option for early stage cancer that can be completely removed in a procedure called a radical prostatectomy, the Prostate Cancer Foundation states. Before prostatectomy is done, a lymphadenectomy may be done to check the nearby lymph nodes for signs of spreading cancer. If cancer is found in the lymph nodes, another treatment besides prostectomy may be recommended. Two approaches can be used for prostatectomy:
- radical retropubic prostatectomy, where the prostate is removed through an abdominal incision. This is the most common approach.
- radical perineal prostatectomy, where the prostate is removed through an incision in the space between the anus, the opening to the rectum, and the scrotum
Whenever possible, surgeons try to perform nerve sparing surgery, which avoids cutting the nerves that control erections. Inability to control urine, called incontinence, and impotence, the inability to have an erection, are the main side effects of radical prostate surgery.
If prostatectomy can’t be done because of age or health issues, transurethral resection of the prostate, called a TURP procedure, removes part of the prostate to relieve symptoms.
Radiation Choices to Treat Prostate Cancer: External Radiation and Internal Brachytherapy
Radiation can be aimed at cancer cells, with a number of treatments given over a seven or eight week period, the National Cancer Institute states. Alternatively, small radioactive pellets or “seeds” can be implanted in the testicles near the tumor cells. The pellets release radiation, killing cancer cells, over a several month period.
Radiation therapy may, like surgery, cause impotence and urinary incontinence and other problems controlling urine.
Hormone Therapies for Treatment of Prostate Cancer
Hormone therapy reduces the growth of tumors in prostate cancer, by interfering with male hormone production. Since male hormones often stimulate cancer cell growth, hormones slow or stop tumor growth. Hormone therapy can cause hot flashes, decreased sexual interest and osteoporosis.
Sources:
Merck Manual: "Prostate Cancer" Accessed June 8, 2010
MayoClinic.com: "Prostate Cancer" Accessed June 8, 2010
Sharon Perkins - Sharon is an RN with over 20 years experience in maternal child health, oncology, and ophthalmology. She was the RN coordinator for an ...
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