A Team Approach to Treating Prostate Cancer
by Alan M. Nieder, MD, and Rafael Yanes, MD
Prostate cancer is the most common non-skin-related cancer for American men. The American Cancer Society estimates that nearly 240,000 men will be diagnosed with prostate cancer this year. While prostate cancer can be aggressive, most men are diagnosed at an early and curable stage. Additionally, most newly diagnosed men have no signs or symptoms of prostate cancer and feel perfectly well. They are typically only diagnosed because they have had a PSA blood test that prompted a prostate biopsy.
Most cases of prostate cancer that are diagnosed at an early stage are relatively slow growing, and most men have excellent treatment options. Therefore, it is critical that men utilize a team approach to understanding and treating their disease. While a urologist can 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 to research their diagnosis and treatment options. Currently, there are multiple effective treatment options for prostate cancer, including surgery (often performed robotically); radiation therapy (delivered through implanted seeds or external beams); hormonal therapy (usually reserved for men whose tumors are more advanced); cryotherapy to freeze the prostate; or in selected cases, simply observing the tumor (also known as active surveillance or watchful waiting).
Your urologist can discuss with you the expected outcomes following surgery, as well as what risks and side effects you may experience. A radiation oncologist can provide information regarding different treatment protocols for radiation, depending on your risk factors. A medical oncologist can inform you of clinical trials that you may be eligible for, especially if your cancer is more aggressive. It’s also important to consult with your primary physician, who often knows you best.
Dr. Rafael Yanes
While men who are 70 years old or older historically have been thought not to be candidates for surgery, newer data suggests that healthy, motivated men with at least a 10-year life expectancy may benefit from surgery. Even though you may become anxious over your newly diagnosed prostate cancer, it’s important to put your cancer in perspective with your overall health and assess your other medical problems. 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 diagnosis.
Another important component for many men in making a treatment decision is talking with other men who have been diagnosed with prostate cancer. Since prostate cancer is so ubiquitous, it’s likely that you know at least one other person with the disease. Thankfully, many men who undergo treatment for prostate cancer are completely cured of their disease. Often, speaking with these men will allow you to put your cancer in perspective; allay your concerns and anxieties; provide reassurance; and help you understand what to expect from treatment.
It can also be helpful to talk with psychologists, social workers, and nurses who specialize in treating men with prostate cancer. Most major cancer centers have at least one qualified person who is able to provide counseling for people with cancer. In addition, some men find great comfort in prostate cancer support groups. Meeting regularly with other men who have similar concerns and who have experienced similar problems can provide great reassurance.
Lastly, it is critical that you discuss your prostate cancer with your partner, family, and loved ones. Often, a man’s fears concerning his prostate cancer diagnosis and treatment are based on what he expects his partner’s reactions to be. On the contrary, most close family members are extremely supportive and can (and should) be integral in helping you make treatment decisions. Having close family or friends go with you to your doctors’ appointments can be comforting and helpful as well.
While prostate cancer can be a daunting disease, it can be managed well. You should take the time to consult with as many physicians, caregivers, and survivors as possible prior to making a definitive treatment plan. No one should have to go through diagnosis and treatment alone or without support.
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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 is the co-chief of urology at Mount Sinai, as well as the program director for the urology residency. He specializes in urologic oncology, specifically the treatment of prostate, bladder, and kidney cancers. Dr. Rafael Yanes is a first-year urology resident at Mount Sinai Medical Center.
This article was originally published in Coping® with Cancer magazine, May/June 2013.
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.