Treatment FAQ

what is observational treatment of prostrate cancer

by Dr. Herminio Grady III Published 1 year ago Updated 1 year ago

Active surveillance is often used to mean monitoring the cancer closely. Usually this includes a doctor visit with a prostate-specific antigen (PSA) blood test about every 6 months and a digital rectal exam (DRE) at least once a year. Prostate biopsies and imaging tests may be done every 1 to 3 years as well.Aug 1, 2019

Medication

Among these men, observation is more effective and costs less than initial treatment, and WW is most effective and least expensive under a wide range of clinical scenarios. National Cancer Institute, U.S. Department of Defense, Prostate Cancer Foundation, and Blue Shield of California Foundation.

Procedures

Depending on each case, treatment options for men with prostate cancer might include: Observation or Active Surveillance for Prostate Cancer. Surgery for Prostate Cancer. Radiation Therapy for Prostate Cancer. Cryotherapy for Prostate Cancer. Hormone Therapy for Prostate Cancer. Chemotherapy for Prostate Cancer. Immunotherapy for Prostate Cancer.

Therapy

Observation or Active Surveillance for Prostate Cancer. Because prostate cancer often grows very slowly, some men (especially those who are older or have other serious health problems) who have it might never need treatment. Instead, their doctors may recommend observation (sometimes called watchful waiting) or active surveillance.

Self-care

Initial Treatment of Prostate Cancer, by Stage. The stage of your cancer is one of the most important factors in choosing the best way to treat it. Prostate cancer is staged based on the extent of the cancer (using T, N, and M categories) and the PSA level and Gleason score at the time of diagnosis.

Nutrition

Is observation more effective than initial treatment for prostate cancer?

What is the best treatment for prostate cancer?

What is active surveillance for prostate cancer?

How is the initial treatment of prostate cancer determined?

What is observation in cancer?

Listen to pronunciation. (OB-ser-VAY-shun) In medicine, watching a patient's condition but not giving treatment unless symptoms appear or change.

What is the best treatment for prostate cancer that has spread?

If your cancer has spread beyond your prostate to other areas of your body, your doctor may recommend: Chemotherapy. Chemotherapy can slow the growth of cancer cells, relieve signs and symptoms of cancer, and prolong the lives of men with advanced prostate cancer.

What is the most recent treatment for prostate cancer?

The treatment is called lutetium-177-PSMA-617, or LuPSMA, and it has two components: a compound that targets a cancer cell protein called prostate-specific membrane antigen, or PSMA, and a radioactive particle that destroys the cells.

How long can you be on active surveillance?

Is active surveillance safe? Research shows active surveillance is a safe way for men with low risk prostate cancer to avoid or delay unnecessary treatment. And you have the same chances of living for 10 years or more as you would if you chose to have treatment with surgery or radiotherapy.

Does a high PSA mean cancer has spread?

In most cases, a higher PSA level indicates a poorer prostate cancer prognosis. PSA is a protein made by prostate tissue. Men with prostate cancer often have elevated PSA levels because the cancer cells make excessive amounts of this protein.

Is surgery better than radiation for prostate cancer?

Both radiation and surgery are equally effective treatments to cure prostate cancer." The choice of which treatment is best is up to individual patients and their care teams, Dr. King says. "Make sure you talk with a surgeon and a radiation oncologist before you make your decision.

What is the gold standard for prostate cancer treatment?

Radical prostatectomy remains the gold-standard treatment for clinically localised prostate cancer. Cumulative data suggest that it has a survival advantage over radiotherapy, but it is troubled by surgical morbidity especially erectile dysfunction and incontinence.

Can prostate cancer be completely cured?

The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases (more than 90 percent) are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesn't always have to mean surgery or chemotherapy, either.

Who is a candidate for active surveillance?

Some of the characteristics that might qualify you for Active Surveillance include grade group 1 or Gleason 6, a PSA level <10, cancer that is confined to the prostate, and/or cancer that is very low volume when biopsied. The ideal candidate for Active Surveillance has low-risk prostate cancer.

What is the difference between passive surveillance and active surveillance?

Definitions and Basic Concepts Active surveillance provides the most accurate and timely information, but it is also expensive. Passive surveillance: a system by which a health jurisdiction receives reports submitted from hospitals, clinics, public health units, or other sources.

What is the difference between watchful waiting and active surveillance?

Active surveillance may require you to have many biopsies to track cancer growth. Watchful waiting is a less aggressive system of monitoring prostate cancer without treating it. It does not involve regular biopsies or other frequent testing.

Which Treatments Are Used For Prostate Cancer?

Depending on each case, treatment options for men with prostate cancer might include: 1. Watchful waiting or active surveillance 2. Surgery 3. Radi...

Which Doctors Treat Prostate Cancer?

The main types of doctors who treat prostate cancer include: 1. Urologists: surgeons who treat diseases of the urinary system and male reproductive...

Making Treatment Decisions

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decisi...

Help Getting Through Treatment

Your cancer care team will be your first source of information and support, but there are other resources for help when you need it. Hospital- or c...

What are the treatment options for prostate cancer?

Depending on each case, treatment options for men with prostate cancer might include: Observation or Active Surveillance for Prostate Cancer. Surgery for Prostate Cancer. Radiation Therapy for Prostate Cancer. Cryotherapy for Prostate Cancer. Hormone Therapy for Prostate Cancer. Chemotherapy for Prostate Cancer.

What are the things to consider when making a decision about cancer treatment?

Some important things to consider include: The stage and grade of your cancer. Your age and expected life span.

Why is communicating with your cancer team important?

Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life. Different types of programs and support services may be helpful, and can be an important part of your care.

Why are clinical trials important?

Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they're not right for everyone.

What do people with cancer need?

People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

What are the services offered by the American Cancer Society?

These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. The American Cancer Society also has programs and services – including rides to treatment, lodging, and more – to help you get through treatment.

What is the name of the doctor who treats cancer?

Urologist: A surgeons who treat diseases of the urinary system and male reproductive system (including the prostate) Radiation oncologist: A doctor who treats cancer with radiation therapy. Medical oncologist: A doctor who treats cancer with medicines such as chemotherapy, hormone therapy, and immunotherapy.

What is watchful waiting for prostate cancer?

Observation, sometimes called watchful waiting, means doctors monitor a man’s prostate cancer over time to make sure it’s not getting worse, and only then consider surgery or other active treatment. This is a good option for many men because most prostate cancers grow very slowly and may never cause health problems.

How many men died from prostate cancer in the observation group?

After 20 years of follow-up, 61% of men in the surgery group had died; 7% of them died from prostate cancer. In the observation group, 67% of them died; 11% from prostate cancer. The differences between the two groups are not significant. However, the men in the surgery group were more likely to have side effects that needed treatment.

How many men were assigned to surgery to remove the prostate?

About half the men – 364 – were assigned to surgery to remove the prostate. The other half – 367 – were assigned to observation. The men in the observation group received surgery or other active treatment only if tests or symptoms indicated their prostate cancer might be growing.

Can men with prostate cancer live longer?

Even though men with high-risk disease may have a poor prognosis, surgery may not help them live any longer.

Can you live longer after prostate surgery?

However, others have found that those who have surgery might live longer. According to the study’s authors, the combined results from the studies show: Long-term, death from prostate cancer is low among men with early-stage prostate cancer who are treated with observation.

Does surgery help with cancer?

Surgery seems to help keep the cancer from coming back , but most cancer recurrences don’t cause problems. Therefore, the benefits of slowing cancer growth through surgery are unclear. Long-term side effects from surgery can include incontinence, erection problems, and other complications, some requiring treatment. Reviewed by.

What is the treatment for prostate cancer?

Radiation (external beam plus brachytherapy) with a course of hormone therapy. Radical prostatectomy in selected cases (often with removal of the pelvic lymph nodes ).

How is prostate cancer staged?

Prostate cancer is staged based on the extent (how much the cancer has spread) of the cancer (using T, N, and M categories) and the PSA level and Gleason score (Grade Group) when it is first diagnosed. For prostate cancers that haven't spread (stages I to III), doctors also use risk groups (based on how far the prostate tumor has grown, PSA level, ...

What stage of prostate cancer is not spread?

For prostate cancers that haven't spread (stages I to III), doctors also use risk groups (based on how far the prostate tumor has grown, PSA level, and prostate biopsy results) to help determine treatment options.

What to do if prostate cancer doesn't go away?

The options above are for the initial treatment of prostate cancer at different stages. But if these treatments aren’t working (the cancer continues to grow and spread) or if the cancer comes back, other treatments might be used, such as immunotherapy. (See Treating Prostate Cancer That Doesn’t Go Away or Comes Back After Treatment .)

Can prostate cancer grow outside the prostate?

These prostate cancers are small (T1 or T2) and have not grown outside the prostate. They have low Gleason scores (6 or less) and low PSA levels (less than 10). They usually grow very slowly and may never cause any symptoms or other health problems.

Can stage 4 cancer be cured?

Stage IV cancers have already spread to nearby areas such as nearby lymph nodes or to distant organs such as the bones. Most stage IV cancers can’t be cured, but are treatable. The goals of treatment are to keep the cancer under control for as long as possible and to improve a man’s quality of life.

Is treatment information official?

The treatment information here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.

Very-Low-Risk Group

Low-Risk Group

Intermediate-Risk Group

High-Risk Group

Medically reviewed by
Dr. Pawan Katti
Your provider will work with you to develop a care plan that may include one or more of these treatment options.
Treatments include chemotherapy, medications to stop hormone activity, radiation therapy, and surgery. These can be used alone or in combinations to treat cancer.
Medication

Hormone therapy - Luteinizing hormone-releasing hormone (LH-RH) agonists: Drugs to prevent production of the hormone testosterone.

Leuprorelin . Goserelin . Triptorelin


Anti-androgens: Drugs to prevent testosterone from reaching cancer cells.

Bicalutamide . Nilutamide


Chemotherapy: Drugs to kill cancer cells.

Taxotere . Cabazitaxel

Procedures

Radical prostatectomy: Removal of prostate gland, surrounding tissues, and lymph nodes by making small incisions in the lower abdomen.

Orchiectomy: Removing the testicles to reduce testosterone levels in the body.

Cryoablation: Freezing the prostate tissue to kill cancer cells.

Therapy

Radiation therapy:Uses high energy rays to kill cancer cells.

Self-care

Always talk to your provider before starting anything.

Take medications as prescribed, follow up regularly, remain physically active.

Nutrition

Foods to eat:

  • NA

Foods to avoid:

  • NA

Specialist to consult

Urologist
Specializes in the urinary tract disease.
Oncologist
Specializes in the diagnosis and treatment of cancer.

Very-High-Risk Group

Stage Iva

Stage Ivb

  • Radiation therapy (external beam or brachytherapy), often with ADT, is an option for men in this group. A radical prostatectomy with pelvic lymph node dissection (PLND)is also an option. Depending on the findings from surgery, treatments that might be discussed include: 1. External beam radiation therapy with or without ADT if the cancer is found in the lymph nodes or if it has …
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