A Team Approach to Prostate Cancer
by Alan M. Nieder, MD
Prostate cancer is the most common non-skin-related cancer in American men. In 2009, over 200,000 men are estimated to be diagnosed with the disease. While prostate cancer can be an aggressive cancer, currently most men are diagnosed at an early and curable stage.
Since prostate cancer is usually diagnosed at an early stage, since it is a relatively slow-growing tumor, and since the treatment options for most men are excellent, men should utilize a “team approach” to understanding and treating their disease. While a urologist will make the diagnosis of prostate cancer – after performing a prostate biopsy – other physicians and caregivers are equally important in helping you decide what treatment option is best for you.
Rarely does a treatment decision need to be made immediately; most men can take some time (up to three months safely) to research their diagnosis and treatment options. Currently, multiple effective treatment options for prostate cancer are available, including surgery (performed through an open incision or robotically-assisted laparoscopy); radiation therapy (delivered through implanted seeds or external beams); hormonal therapy (usually reserved for men whose tumor is more advanced); cryotherapy to freeze the prostate; or in selected cases, simply observing the tumor (also known as active surveillance or watchful waiting).
Most major cancer centers have at least one qualified person who is able to provide counseling for people with cancer.
Your urologist can discuss with you the typically expected outcomes of surgery and what risks and side effects you may experience. Radiation oncologists can provide information about different treatment protocols for radiation, depending upon your risk factors. Medical oncologists can provide valuable information about potential clinical trials that you may be eligible for. It is also important for you to consult with your primary care physician, who often knows you best.
While older men (70 years old or older) have historically been thought not to be candidates for surgery, newer data suggest that healthy, motivated men with at least a 10-year life expectancy may benefit from surgery or definitive treatment. Even though most men become anxious over their newly diagnosed prostate cancer, it is important to put your cancer in perspective with your overall health and work with your doctor to assess any other medical problems you may have. Because prostate cancer tends to be a slow-growing cancer, some men with other serious medical conditions may not need to be overly concerned about their cancer diagnosis.
Another important component in making a treatment decision is talking with other men who have been similarly diagnosed. Since prostate cancer is so ubiquitous, most men know at least one other person with the disease. Often, speaking with these people will allow you to put your cancer in perspective, allay your concerns and anxieties, and help you understand what to expect from treatment. Thankfully, many men who undergo treatment for prostate cancer are completely cured of their disease. Speaking to one of these prostate cancer survivors can provide strong encouragement to the newly diagnosed.
Psychologists, social workers, and nurses who specialize in treating men with prostate cancer also are available to help you through this process. Most major cancer centers have at least one qualified person who is able to provide counseling for people with cancer. Some men also find great comfort in prostate cancer support groups. Meeting regularly with other men who have similar concerns and have experienced similar problems often provides great reassurance.
Lastly, it is critical that you discuss your prostate cancer with your spouse, family, and loved ones. Often, men’s concerns about prostate cancer diagnosis and treatment are based on what they fear their partner’s reactions will be. In fact, most close family members are extremely supportive and can (and should) be integral in helping their loved one make treatment decisions. Having close family or friends accompany you to doctors’ appointments can be quite comforting and helpful as well.
While prostate cancer can be a daunting disease, it can be managed well. Men should take the time to consult with appropriate physicians, caregivers, and friends prior to making a definitive treatment plan. No one should have to go through diagnosis and treatment alone.
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Dr. Alan Nieder is an assistant professor of Urology at Columbia University, Division of Urology, at Mount Sinai Medical Center in Miami Beach, FL. He specializes in Urologic Oncology, specifically the treatment of prostate, bladder, and kidney cancers.
This article was published in Coping® with Cancer magazine, May/June 2009.
Coping® does not endorse or recommend any particular treatment protocol for readers, and this article does not necessarily include information on all available treatments. Articles are written to enlighten and motivate readers to discuss the issues with their physicians. Coping believes readers should determine the best treatment protocol based on physicians’ recommendations and their own needs, assessments and desires.