Prostate cancer treatment: the options and side effects

Diagnosis is one thing, but facing prostate cancer treatment is another. Which means that knowing the facts about prostate cancer, so you can help support a loved one at any stage, is essential.

And, although it's a male-only cancer, recent research shows that women are just as likely to look up prostate cancer symptoms and treatments for male-only cancers as men are. 

Here, two experts explain what women need to know about prostate cancer stages and prostate cancer treatment.

What is prostate cancer?

Prostate cancer treatment is needed after a diagnosis of prostate cancer. Not sure what the prostate is? It's a small gland, about the size of a walnut. It is located beneath a man’s bladder, surrounding the upper part of the urethra, the tube that carries urine from the bladder. It produces the majority of fluid that makes up semen, the fluid that carries sperm.

Prostate cancer affects about one in eight men in the UK and is much more common in over-55s. The five-year survival rate is around 86%, according to Cancer Research UK. Although this is a high percentage, it doesn't mean it’s not still a worrying time.

Prostate cancer warning signs to look out for

Worried your partner might be showing signs of prostate cancer?

Urinary changes is one of the easiest prostate cancer symptoms to spot. “If your partner doesn’t like talking about his urinary habits, you’ll need to start paying attention,” says Karen Walker, clinical nurse specialist in prostate cancer at the Edinburgh Cancer Centre. “Ask yourself whether he has started going to the loo more, or getting up several times in the night.”

And that's not the only sign to look out for. “The most common early signs include difficulty starting urination, weak or interrupted flow of urine, the need to urinate more often, difficulty emptying the bladder completely, pain or burning during urination and loss of bladder control,” says Saheed Rashid of BXTAccelyon, leading providers of Brachytherapy.

But, remember, there’s a high chance these potential prostate cancer symptoms could be caused by conditions other than prostate cancer. It could be simply an enlarged prostate, the side effect of certain medications or a urine infection.

An enlarged prostate causing urinary difficulties can be treated with medication.

Prostate cancer stages of diagnosis

So, how is prostate cancer found and diagnosed? Usually, the following stages will take place...

1. INITIAL BLOOD TEST The first test is a simple blood test, known as a PSA. This determines whether levels of PSA, or prostate-specific antigens – a protein made only by the prostate gland – are raised in the blood. If the reading is above the normal parameters for the man’s age, further investigation will be required.
2. EXAMINATION The GP may also carry out a digital rectal examination (DRE) to see whether the prostate feels enlarged. “A doctor, or nurse, will insert a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps and other abnormalities,” explains Saheed.
3. BIOPSY Neither of the above tests can detect cancer, but they can reveal whether further tests are needed. If they are, the patient will probably be sent for a biopsy or an MRI scan.
4. CANCER SCORE Following the biopsy, if cancer is found, they will be given a Gleason score. This is normally between six and ten. The score is an indication of how quickly the cancer is likely to grow. A high Gleason score may prompt more investigation, such as a bone scan, to check for any disease outside the prostate.

What next if prostate cancer is diagnosed?

Prostate cancer diagnosed? You need to know that it’s still not something to panic about. In the vast majority of cases, the cancer will not have spread beyond the prostate, in which case the prognosis is excellent.

“Prostate cancer is very treatable,” says Karen. “However, in some cases, the prostate cancer found can be slow-growing, so prostate cancer treatment can be postponed.”

If the cancer has spread to other parts of the body it’s known as metastatic. At this stage, it’s no longer curable – but many men do continue to enjoy a long life.

“Many people think it’s a death sentence if they’re diagnosed with metastatic prostate cancer,” says Karen. “But it very often isn’t, and many men may live with it for several years with the right treatment.”

Prostate cancer treatment: the options and side effects

Just like other cancer treatments, which treatment is right for the patient will depend on where the cancer is. If it is just in the prostate, there are usually three treatments on offer.

“Each type of treatment has potential side effects,” says Karen. “However, the hope is that the side effects will disappear with time.”

Treatments include:

• PROSTATE REMOVAL
  This prostate cancer treatment is an operation carried out under general anaesthetic. Common side effects include erectile dysfunction and incontinence.
• EXTERNAL BEAM RADIOTHERAPY
  High-energy beams are targeted at the prostate from outside the body. Side effects can include bowel issues and bladder problems. This requires being in hospital five days a week for four to eight weeks.
• BRACHYTHERAPY (Low dose rate or LDR-B)
  Highly targeted low-level radiotherapy where tiny radioactive seeds are inserted into the prostate under general anaesthetic, to release a steady dose of radiotherapy over several months. LDR-B is a one-stop treatment, usually day surgery. Side effects may include erectile dysfunction, bladder problems and possible bowel problems, although often less so than other treatments.
• TRANSURETHAL RESECTION (TURP)
  This doesn’t treat the cancer but alleviates symptoms.
• HIGH-INTENSITY FOCUSED ULTRASOUND (HIFU) This kills cancer cells with heat. This is still undergoing clinical trials.
• CRYOTHERAPY
  It kills cancer cells by freezing them, but the long-term effectiveness is not yet known.
  
  Treatments for metastatic cancer will be different, and focused on controlling the condition rather than cure.