When you think about it there are only about two things you can do to treat prostate cancer.
- You can take the prostate and the cancer within out
- You can treat the prostate with some form of energy
If you take it out you can do it by hand (open) or use laparoscopic instruments with or without the aid of a robot. (End result about the same-yep that’s right!)
If you treat it with energy you can choose your poison (so to speak) between the FDA approved ones or the Non FDA approved ones:
- You can treat it with external beam radiation shot into you like an X-Ray (usually 42 treatments over 6-7 weeks)
- Proton therapy is radiation therapy…so in the decision process the big decision is radiation or not then get specific.
- You can freeze it (cryosurgery)
- You can use radioactive seeds alone or in combo with external beam (think of 80 pellets put around in an apple)
- You can use radio frequency to kill the cancer HIFU
- You can use electricity (so to speak) IRE-The nanoknife
- You can shake it up and fry it in a pan—-just kidding.
- You can do nothing ….is that a treatment…some would say yes.
So even though there are all these forms of therapy and combinations of therapy (and if you elect not to do surveillance) the most common choices are between removal or radiation.
So is ya fer or against surgery? This is the best place to start you decision-making process…this is how it goes:
- The first thing to do if you are newly diagnosed is do you want to treat it or watch it?
- Then if you want to treat it do you want it out or do something else.
- If it is to have it out then you decide on who and how it is removed.
- If you don’t want surgery then what form of radiation (i.e. radiation consult – speak to someone who does it every day…not your buddy at church.
- If you don’t like radiation then you can go to the Bahama’s for HIFU or find a pilot program for the nano knife (ps…there is no knife…it just sounds good) There is one in Atlanta.
- Yes yes you can just hormones and yes the PSA will go down and the cancer will be in “remission” but hormones don’t cure anything and usually not used as a “treatment for cure”
So the answer to the question in the title…there ain’t that much new in the treatment of prostate cancer in the newly diagnosed patient. More variations on a theme.
There is however a lot being done in the realm of hormone refractory prostate cancer and there are many new forms of therapy in this regard. The Prostate Cancer Info Link site does a very nice job of discussing all the activity in this area and is linked to the right of this post.