hroughout North America, Europe and Japan, prostate cancer has touched the lives of approximately 38 million men. In many cases, it develops slowly and displays few if any symptoms. Because this form of cancer is most common in men over fifty, a large number of diagnosed cases will in fact die of unrelated causes, such as heart disease or even old age.
This, however, is of small comfort to that sizable minority of cases in which prostate cancer develops quickly and aggressively (roughly one-third of the total). For these unlucky patients, mortality rates are higher than those of all other forms of cancer, save cancer of the lungs. Finding alternatives to traditional prostate cancer treatments becomes more important since the best treatment option will vary based on the patient’s health, age and preferences.
The traditional treatment for this disease involves prostatectomy, a surgery to remove the entire prostate as well as the surrounding lymph nodes, deferent canals, and bladder neck. This operation will usually take one of three forms, the most common being a trans-urethral resection of the prostate, or TURP. A loop of wire charged with a mono-polar flow of electrical current is shunted through a resectoscope, in order to cut out the cancerous tissue.
An open prostatectomy, on the other hand, involves making an incision in the abdomen or perineum (located midway between the rectum and scrotum), through which the cancerous organ can be removed. A laparoscopic radical prostatectomy is very similar to this procedure. Here, a computerized device is inserted through a series of abdominal incisions, which a surgeon uses to remove the cancerous gland.
The problem with all three of these procedures is their attendant high risks of producing impotence and erectile dysfunction. The risk and extent of this complication will depend somewhat upon the surgeon, but there is very little chance that a patient’s sexual performance will be wholly unaffected by the operation. There are usually other numerous (and serious) complications, as well as a lengthy period of recovery.
In cases where the cancer is discovered later, or has continued to spread into the pelvis, radiation is often considered as a treatment option. Usually, radiation treatment is deployed through X-ray beams, or by the implantation of radio-active seeds implanted into the cancerous gland. As might be expected, there are a number of drawbacks to this kind of procedure. As with prostatectomies, the chance of being rendered impotent by doses of radiation is extremely high. The rectum and bladder are routinely impaired, producing incontinence, bleeding in the rectum and bladder, and blockage of urinary flow, among other side effects. Finally, radiation treatments are completely ruled out as a treatment possibility once the cancer spreads into the lymph nodes.
In cases where the disease spreads from the prostate into other parts of the body, or the cancer has recurred after a series of treatments, hormone therapy is considered as an option. By surgically removing the patient’s testicles, or injecting the body with androgen blockers, the cancer is deprived of hormones vital to its reproduction. While this option has been known to add decades to a patient’s life, it does not actually eliminate the disease. Also, erectile dysfunction and impotence are a major risk, as are depression, mood swings, and a significant loss of muscle strength.
A newer prostate cancer treatment alternative to the three treatment options outlined above is called High Intensity Focused Ultrasound (or HIFU for short). Using images gathered from a probe inserted into the rectum, doctors are able to map out an outline of the prostate, and deliver a precisely calibrated ultrasound wave through the rectal wall, destroying cancerous cells using heat energy. Because the wave is so precise – to a tenth of a millimeter, the tissue surrounding the affected area isn’t significantly damaged – this, in marked contrast to surgical, hormonal, and radioactive treatments. Of course, not everyone is eligible for the procedure, and it’s important to discuss the available options with one’s doctor. Nevertheless, HIFU represents a distinct new opportunity for men with prostate cancer, looking for a chance at recovery.