Determining
Your Choice of Treatment
Men
diagnosed with prostate cancer are confronted with a number
of daunting treatment choices. Different treatments may yield
comparable results, but bring a host of different, potentially
unpleasant side effects. Some new treatments look promising
but haven’t been around long enough to demonstrate long-term
effectiveness.
The research
and medical communities offer no definitive answer on the
one "best" treatment, particularly in early-stage cancer confined
to the prostate. Medical centers with extensive experience
in a specialized treatment may report significantly better
outcomes than centers with less experience.
Making an informed treatment decision
The more
you know, the better you will be able to make an informed
decision about the prostate cancer treatment most appropriate
for you.
- Learn
everything there is to know about your own cancer, including
your clinical stage, PSA
level and Gleason
score.
- Explore
all your treatment options. Realize that many treatment
options have not been compared to each other in unbiased,
randomized studies. Therefore, there is going to be some
degree of bias in many of the research studies you encounter.
This web site attempts to provide research studies with
the most optimistic view of each treatment option, based
on the professional literature.
- Your
local library or bookstore can be a useful resource for
general information on prostate cancer and cancer survivorship.
Many hospitals have patient libraries with books, brochures
and videos explaining prostate cancer and treatment options.
- Talk
to your doctor. Come prepared with a list of questions;
bring a notebook or a tape recorder so you have a permanent
record of the answers to review at your leisure.
- Get
a second opinion and a third if you need it. Be suspicious
if your doctor recommends that you not seek other opinions.
- Take
the time to include your wife or significant other in your
search for information and in your decisions.
- Research
the specialists who may be treating your prostate cancer.
Does the specialist have a proven track record in that procedure?
Find out about the specialist’s training, how often
he or she has performed the procedure and how well the patients
have fared after treatment.
- Prostate
cancer support groups give you the chance to talk to other
men who have faced the same questions about prostate cancer.
Factors in decision making
The
most effective and appropriate prostate cancer treatment for
you depends on a number of factors:
- Stage
After
the biopsy, the next step is to determine
the cancer’s stage:
the size of the tumor and how far it has spread. The stage
of your prostate cancer is one of the most important factors
in deciding how best to treat it.
When
prostate cancer is confined within the prostate gland and
hasn't spread to other parts of the body, radical prostatectomy and radiation therapy may be effective
treatments. However, when prostate cancer has spread outside
the prostate gland, early-stage options may not stop the
cancer from spreading further. Advanced cancers respond
more effectively to other localized treatments, such as
radiation, or to systemic treatments such as hormone therapy and chemotherapy.
- Age
A 55-year-old
man and an 85-year-old man, both diagnosed with localized
prostate cancer that may spread in 10 years, may come to
completely different and equally valid decisions about how
to treat it. Aggressive treatments for prostate cancer can
produce unpleasant side effects and potential complications
and may destroy a level of health more easily recovered
in a younger man. An 85-year-old man may be less concerned
about a cancer that may spread by the time he is 95. These
considerations may lead a 55-year-old to opt for surgery
or radiation, while an 85-year-old may opt for watchful
waiting.
-
Overall
health
Men
in good health have a better chance to recover more quickly
and completely from prostate cancer treatment than men
in poor health. Aggressive treatment may not greatly benefit
men with other serious medical conditions or whose life
expectancy is less than ten years. In fact, such treatment
may produce unpleasant -- and unnecessary -- complications
that could seriously compromise the quality of the remaining
years of life.
-
Priorities
Deciding
prostate cancer treatment is ultimately a personal decision
only you can make, based on what's most important to you.
In addition to considerations about age and general health,
you must consider quality of life issues, not the least
of which is deciding between living with the cancer and
facing the potential side effects of treatment.
The
Prostate Cancer pages of this Web site are part of the Comprehensive
Prostate Cancer Awareness Program (CPCAP), a major regional
effort to reduce the rates of death and illness caused by
prostate cancer in southwestern Pennsylvania. Funding for
CPCAP is provided by a grant from the Commonwealth of Pennsylvania.
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