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Prostate cancer is the most common type of cancer in men in the
United States other than skin cancer. Of all the men who are diagnosed with cancer each year, more than one-fourth have prostate
cancer.
Research is increasing our understanding of prostate cancer. Scientists are
learning more about the possible causes of prostate cancer and are looking for new ways to prevent, detect, diagnose, and treat this disease. Because of this research, men with prostate cancer now
have a lower chance of dying from the disease.
The prostate
The prostate is a gland in a man's reproductive system. It makes and stores
seminal fluid, a milky fluid that nourishes sperm. This fluid is released
to form part of semen.
The prostate is about the size of a walnut. It is located below the bladder and in
front of the rectum. It surrounds the upper part of the urethra, the tube that empties urine from the bladder. If the prostate grows too large, the flow of urine can be
slowed or stopped.
To work properly, the prostate needs male hormones (androgens). Male hormones
are responsible for male sex characteristics. The main male hormone is testosterone, which is made mainly by the testicles. Some male
hormones are produced in small amounts by the adrenal glands.
Diagram of the prostate and nearby organs
Understanding the cancer process
Cancer is a group of many related diseases. These diseases begin in cells, the body's basic unit of life. Cells have many
important functions throughout the body.
Normally, cells grow and divide to form new cells in an orderly way. They perform their functions for a while, and then they
die. This process helps keep the body healthy.
Sometimes, however, cells do not die. Instead, they keep dividing and creating new cells that the body does not need. They
form a mass of tissue, called a growth or tumor.
Tumors can be benign or malignant:
- Benign tumors are not cancer. They can usually be removed, and in most cases, they do not come back. Cells from benign tumors
do not spread to other parts of the body. Most important, benign tumors of the prostate are not a threat to life. Benign prostatic hyperplasia (BPH) is the abnormal
growth of benign prostate cells. In BPH, the prostate grows larger and presses against the urethra and bladder, interfering with
the normal flow of urine. More than half of the men in the United States between the ages of 60 and 70 and as many as 90 percent
between the ages of 70 and 90 have symptoms of BPH. For some men, the symptoms may be severe enough to require treatment.
- Malignant tumors are cancer. Cells in these tumors are abnormal. They divide without control or order, and they do not die.
They can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the
bloodstream and lymphatic system. This is how cancer spreads from the original (primary) cancer site to form new (secondary)
tumors in other organs. The spread of cancer is called metastasis.
When prostate cancer spreads (metastasizes) outside the prostate, cancer cells are often found in nearby lymph nodes. If the
cancer has reached these nodes, it means that cancer cells may have spread to other parts of the body -- other lymph nodes and
other organs, such as the bones, bladder, or rectum. When cancer spreads from its original location to another part of the body,
the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads
to the bones, the cancer cells in the new tumor are prostate cancer cells. The disease is metastatic prostate cancer; it is not
bone cancer.
This article deals with prostate cancer. For information about prostate changes that are not cancer, read NCI's booklet,
Understanding Prostate Changes: A Health Guide for All Men.
Prostate cancer: who's at risk
The causes of prostate cancer are not well understood. Doctors cannot explain why one man gets prostate cancer and another
does not.
Researchers are studying factors that may increase the risk of this disease. Studies have found that the following risk
factors are associated with prostate cancer:
- Age. In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of
diagnosis is 70.
- Family history of prostate cancer. A man's risk for developing prostate cancer is higher if his father or brother has had the
disease.
- Race. This disease is much more common in African American men than in white men. It is less common in Asian and American
Indian men.
- Diet and dietary factors. Some evidence suggests that a diet high in animal fat may increase the risk of prostate cancer and
a diet high in fruits and vegetables may decrease the risk. Studies are in progress to learn whether men can reduce their risk of
prostate cancer by taking certain dietary supplements.
Although a few studies suggested that having a vasectomy might increase a
man's risk for prostate cancer, most studies do not support this finding. Scientists have studied whether benign prostatic
hyperplasia, obesity, lack of exercise, smoking, radiation exposure, or a sexually transmitted virus might increase the risk for
prostate cancer. At this time, there is little evidence that these factors contribute to an increased risk.
Detecting prostate cancer
A man who has any of the risk factors described in the "Prostate Cancer: Who's at Risk" section may want to ask a doctor
whether to begin screening for prostate cancer (even though he does not have any symptoms), what tests to have, and how often to
have them. The doctor may suggest either of the tests described below. These tests are used to detect prostate abnormalities, but
they cannot show whether abnormalities are cancer or another, less serious condition. The doctor will take the results into
account in deciding whether to check the patient further for signs of cancer. The doctor can explain more about each test.
- Digital rectal examination -- the doctor
inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy
areas.
- Blood test for prostate-specific antigen(PSA)
-- a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, BPH, or
infection in the prostate.
Recognizing symptoms
Early prostate cancer often does not cause symptoms. But prostate cancer can cause any of these problems:
- A need to urinate frequently, especially at night;
- Difficulty starting urination or holding back urine;
- Inability to urinate;
- Weak or interrupted flow of urine;
- Painful or burning urination;
- Difficulty in having an erection;
- Painful ejaculation;
- Blood in urine or semen; or
- Frequent pain or stiffness in the lower back, hips, or upper thighs.
Any of these symptoms may be caused by cancer or by other, less serious health problems, such as BPH or an infection. A man
who has symptoms like these should see his doctor or a urologist (a doctor who specializes in treating diseases of the
genitourinary system).
Diagnosing prostate cancer
If a man has symptoms or test results that suggest prostate cancer, his doctor asks about his personal and family medical
history, performs a physical exam, and may order laboratory tests. The exams and tests may include a digital rectal exam, a urine
test to check for blood or infection, and a blood test to measure PSA. In some cases, the doctor also may check the level of
prostatic acid phosphatase (PAP) in the blood, especially if the results of the PSA indicate there might be a problem.
The doctor may order exams to learn more about the cause of the symptoms. These may include:
- Transrectal ultrasonography -- sound waves that cannot be heard by humans (ultrasound) are sent
out by a probe inserted into the rectum. The waves bounce off the prostate, and a computer uses the echoes to create a picture
called a sonogram.
- Intravenous pyelogram -- a series of x-rays of the
organs of the urinary tract.
- Cystoscopy -- a procedure in which a doctor looks into the urethra and
bladder through a thin, lighted tube.
Biopsy
If test results suggest that cancer may be present, the man will need to have a biopsy. During a biopsy, the doctor removes tissue samples from the prostate, usually with a needle. A pathologist
looks at the tissue under a microscope to check for cancer cells. If cancer is present, the pathologist usually reports the grade
of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue and suggests how fast the tumor is
likely to grow. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1
through G4. Tumors with higher scores or grades are more likely to grow and spread than tumors with lower scores.
If the physical exam and test results do not suggest cancer, the doctor may recommend medicine to reduce the symptoms caused
by an enlarged prostate. Surgery is another way to relieve these symptoms. The surgery most often used in such cases is called
transurethral resection of the prostate (TURP or TUR). In TURP, an instrument is inserted through the urethra to remove prostate
tissue that is pressing against the upper part of the urethra and restricting the flow of urine. (Patients may want to ask
whether other procedures might be appropriate.)
Stages of prostate cancer
If cancer is found in the prostate, the doctor needs to know the stage, or extent, of the disease. Staging is a careful
attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The doctor may use various
blood and imaging tests to learn the stage of the disease. Treatment decisions depend on these findings.
Prostate cancer staging is a complex process. The doctor may describe the stage using a Roman number (I-IV) or a capital
letter (A-D). These are the main features of each stage:
- Stage I or Stage A -- The cancer cannot be felt during a rectal exam. It may be found by accident when surgery is done for
another reason, usually for BPH. There is no evidence that the cancer has spread outside the prostate.
- Stage II or Stage B -- The tumor involves more tissue within the prostate, it can be felt during a rectal exam, or it is
found with a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the
prostate.
- Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues.
- Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body.
Treatment for prostate cancer
Getting a second opinion
Decisions about prostate cancer treatment involve many factors. Before making a decision, a man may want to get a second
opinion by asking another doctor to review the diagnosis and treatment options. A short delay will not reduce the chance that
treatment will be successful. Some health insurance companies require a second opinion; many others will cover a second opinion
if the patient requests it. There are a number of ways to find a doctor who can give a second opinion:
- The patient's doctor may be able to recommend a specialist or team of specialists to consult. Doctors who treat prostate
cancer are urologists, radiation oncologists, and medical oncologists. Patients may find it helpful to talk to a specialist in
each of these areas. Different types of specialists may have different thoughts about how best to manage prostate cancer.
- The Cancer Information Service, at 1-800-4-CANCER, can tell callers about treatment facilities, including cancer centers and
other programs supported by the National Cancer Institute.
- People can get the names of doctors from their local medical society, a nearby hospital, or a medical school.
- The Official ABMS Directory of Board Certified Medical Specialists lists doctors' names along with their speciality and their
educational background. This resource, produced by the American Board of Medical Specialities (ABMS), is available in most public
libraries. The ABMS also has an online service that lists many board-certified physicians (http://www.certifieddoctor.org).
Preparing for treatment
The doctor develops a treatment plan to fit each man's needs. Treatment for prostate cancer depends on the stage of the
disease and the grade of the tumor (which indicates how abnormal the cells look, and how likely they are to grow or spread).
Other important factors in planning treatment are the man's age and general health and his feelings about the treatments and
their possible side effects.
Many men with prostate cancer want to learn all they can about their disease, their treatment choices, and the possible side
effects of treatment, so they can take an active part in decisions about their medical care. Prostate cancer can be managed in a
number of ways (with watchful waiting, surgery, radiation therapy, and hormonal therapy). If the doctor recommends watchful
waiting, the man's health will be monitored closely, and he will be treated only if symptoms occur or worsen. Patients
considering surgery, radiation therapy, or hormonal therapy may want to consult doctors who specialize in these types of
treatment.
The patient and his doctor may want to consider both the benefits and possible side effects of each option, especially the
effects on sexual activity and urination, and other concerns about quality of life. Men with prostate cancer may find helpful
information in the sections "Methods of Treatment," "Side Effects of Treatment," and "Support for Men with Prostate Cancer."
Also, the patient may want to talk with his doctor about taking part in a research study to help determine the best approach or
to study new kinds of treatment. "The Promise of Prostate Cancer Research" section has more information about such studies,
called clinical trials.
Methods of treatment
Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some patients
receive a combination of therapies. In addition, doctors are studying other methods of treatment to find out whether they are
effective against this disease. (The "Promise of Cancer Research" section has information about research studies.)
Watchful waiting may be suggested for some men who have prostate cancer that is found at an early stage and appears to be slow
growing. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks
and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Men with early
stage prostate cancer are taking part in a study to determine when or whether treatment may be necessary and effective. (See "The
Promise of Prostate Cancer Research" section for information about this study.)
Surgery is a common treatment for early stage prostate cancer. The doctor may remove all of the prostate (a type of surgery
called radical prostatectomy) or only part of it. In some cases, the doctor can use a new technique known as nerve-sparing
surgery. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very
close to the nerves may not be able to have this surgery.
The doctor can describe the types of surgery and can discuss and compare their benefits and risks.
- In radical retropubic prostatectomy, the doctor removes the entire prostate and nearby lymph nodes through an incision in the
abdomen.
- In radical perineal prostatectomy, the doctor removes the entire prostate through an incision between the scrotum and the anus. Nearby lymph nodes are sometimes
removed through a separate incision in the abdomen.
- In transurethral resection of the prostate (TURP), the doctor removes part of the prostate with an instrument that is
inserted through the urethra. The cancer is cut from the prostate by electricity passing through a small wire loop on the end of
the instrument. This method is used mainly to remove tissue that blocks urine flow.
If the pathologist finds cancer cells in the lymph nodes, it is likely that the disease has spread to other parts of the body.
Sometimes, the doctor removes the lymph nodes before doing a prostatectomy. If the prostate cancer has not spread to the lymph
nodes, the doctor then removes the prostate. But if cancer has spread to the nodes, the doctor usually does not remove the
prostate, but may suggest other treatment.
Radiation therapy (also called radiotherapy) uses high-energy x-rays to kill cancer cells. Like surgery, radiation therapy is local
therapy; it can affect cancer cells only in the treated area. In early stage prostate cancer, radiation can be used instead of
surgery, or it may be used after surgery to destroy any cancer cells that may remain in the area. In advanced stages, it may be
given to relieve pain or other problems.
Radiation may be directed at the body by a linear
accelerator, or it may come from tiny radioactive seeds placed inside or near the tumor (internal or implant radiation, or
brachytherapy). Men who receive radioactive seeds alone usually have small tumors. Some men with prostate cancer receive both
kinds of radiation therapy.
For external radiation therapy, patients go to the hospital or clinic, usually 5 days a week for several weeks. Patients may
stay in the hospital for a short time for implant radiation.
Hormonal therapy keeps cancer cells from getting the male hormones
they need to grow. It is called systemic therapy because it can affect cancer cells throughout the body. Systemic therapy is used
to treat cancer that has spread. Sometimes this type of therapy is used to try to prevent the cancer from coming back after
surgery or radiation treatment.
There are several forms of hormonal therapy:
- Orchiectomy is surgery to remove the testicles, which are the main source
of male hormones.
- Drugs known as luteinizing hormone-releasing hormone (LH-RH) agonists can prevent the testicles from producing testosterone.
Examples are leuprolide, goserelin, and buserelin.
- Drugs known as antiandrogens can block the action of androgens. Two
examples are flutamide and bicalutamide.
- Drugs that can prevent the adrenal glands from making androgens include ketoconazole and aminoglutethimide.
After orchiectomy or treatment with an LH-RH agonist, the body no longer gets testosterone from the testicles. However, the
adrenal glands still produce small amounts of male hormones. Sometimes, the patient is also given an antiandrogen, which blocks
the effect of any remaining male hormones. This combination of treatments is known as total androgen blockade (TAB), combined
hormonal therapy (CHT), combined androgen blockade (CAB), or maximal androgen deprivation (MAD). Doctors do not know for sure
whether total androgen blockade is more effective than orchiectomy or LH-RH agonist alone.
Prostate cancer that has spread to other parts of the body usually can be controlled with hormonal therapy for a period of
time, often several years. Eventually, however, most prostate cancers are able to grow with very little or no male hormones. When
this happens, hormonal therapy is no longer effective, and the doctor may suggest other forms of treatment that are under
study.
Side effects of treatment
It is hard to limit the effects of treatment so that only cancer cells are removed or destroyed. Because healthy cells and
tissues may be damaged, treatment often causes unwanted side effects. Doctors and nurses will explain the possible side effects
of treatment.
The side effects of cancer treatment depend mainly on the type and extent of the treatment. Also, each patient reacts
differently. The NCI provides helpful, informative booklets about cancer treatments and coping with side effects, such as
Understanding Treatment Choices for Prostate Cancer: Know Your Options and Radiation Therapy and You. Patients also may want to
read Eating Hints for Cancer Patients. See "National Cancer Institute Information Resources" and "Other Information Resources"
for additional sources of information about side effects.
Watchful waiting
Although men who choose watchful waiting avoid the side effects of surgery and radiation, there can be some negative aspects
to this choice. Watchful waiting may reduce the chance of controlling the disease before it spreads. Also, older men should keep
in mind that it may be harder to manage surgery and radiation therapy as they age.
Some men may decide against watchful waiting because they feel they would be uncomfortable living with an untreated cancer, even
one that appears to be growing slowly or not at all. A man who chooses watchful waiting but later becomes concerned or anxious
should discuss his feelings with his doctor. A different treatment approach is nearly always available.
Surgery
Patients are often uncomfortable for the first few days after surgery. Their pain usually can be controlled with medicine, and
patients should discuss pain relief with the doctor or nurse. The patient will wear a catheter (a tube inserted into the urethra)
to drain urine for 10 days to 3 weeks. The nurse or doctor will show the man how to care for the catheter.
It is also common for patients to feel extremely tired or weak for a while. The length of time it takes to recover from an
operation varies. Surgery to remove the prostate may cause long-term problems, including rectal injury or urinary incontinence.
Some men may have permanent impotence. Nerve-sparing surgery is an attempt to avoid the problem of impotence. When the doctor can
use nerve-sparing surgery and the operation is fully successful, impotence may be only temporary. Still, some men who have this
procedure may be permanently impotent.
Men who have a prostatectomy no longer produce semen, so they have dry orgasms. Men who wish to father children may consider
sperm banking or a sperm retrieval procedure.
Radiation therapy
Radiation therapy may cause patients to become extremely
tired, especially in the later weeks of treatment. Resting is important, but doctors usually encourage men to try to stay as
active as they can. Some men may have diarrhea or frequent and uncomfortable urination.
When men with prostate cancer receive external radiation therapy, it is uncommon for the skin in the treated area to become
red, dry, or tender, however there may be hair loss in the treated area. The loss is usually temporary.
Both types of radiation therapy may cause impotence in some men. While internal radiation therapy may cause temporary urinary
incontinence, external radiation therapy causes temporary bowel inflammation. Long-term side effects from internal radiation
therapy are uncommon.
Hormonal therapy
The side effects of hormonal therapy depend largely on the type of treatment. Orchiectomy and LH-RH agonists often cause side
effects such as impotence, hot flashes, and loss of sexual desire. When first taken, an LH-RH agonist may make a patient's
symptoms worse for a short time. This temporary problem is called "flare." Gradually, however, the treatment causes a man's
testosterone level to fall. Without testosterone, tumor growth slows down and the patient's condition improves. (To prevent
flare, the doctor may give the man an antiandrogen for a while along with the LH-RH agonist.)
Antiandrogens can cause nausea, vomiting, diarrhea, or breast growth or tenderness. If used a long time, ketoconazole may
cause liver problems, and aminoglutethimide can cause skin rashes. Men who receive total androgen blockade may experience more
side effects than men who receive a single method of hormonal therapy. Any method of hormonal therapy that lowers androgen levels
can contribute to weakening of the bones in older men.
Followup care
During and after treatment, the doctor will continue to follow the patient. The doctor will examine the man regularly to be
sure that the disease has not returned or progressed, and will decide what other medical care may be needed. Followup exams may
include x-rays, scans, and lab tests, such as the PSA blood test.
Support for men with prostate cancer
Living with a serious disease such as cancer is not easy. Some people find they need help coping with the emotional as well as
the practical aspects of their disease. Patients often get together in support groups, where they can share what they have
learned about coping with their disease and the effects of treatment. Patients may want to talk with a member of their health
care team about finding a support group.
People living with cancer may worry about caring for their families, keeping their jobs, or continuing daily activities.
Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses,
dietitians and other members of the health care team can answer questions about treatment, working, or other activities. Meeting
with a social worker, counselor, or member of the clergy can be helpful to those who want to talk about their feelings or discuss
their concerns. Often, a social worker can suggest resources for help with rehabilitation, emotional support, financial aid,
transportation, or home care.
It is natural for a man and his partner to be concerned about the effects of prostate cancer and its treatment on their sexual
relationship. They may want to talk with the doctor about possible side effects and whether these are likely to be temporary or
permanent. Whatever the outlook, it is usually helpful for patients and their partners to talk about their concerns and help one
another find ways to be intimate during and after treatment.
Booklets and other useful materials are available from the Cancer Information Service and through other sources listed in the
"National Cancer Institute Information Resources" section.
The Cancer Information Service can also provide information to help patients and their families locate programs and
services.
Internet sources:
- news://alt.support.cancer.prostate is a newsgroup quite active with men currently
dealing with the disease.
- http://www.phoenix5.org
The promise of prostate cancer research
Doctors all over the country are conducting many types of clinical trials (research studies) in which people take part
voluntarily. These include studies of ways to prevent, detect, diagnose, and treat prostate cancer; studies of the psychological
effects of the disease; and studies of ways to improve comfort and quality of life. Research already has led to advances in these
areas, and researchers continue to search for more effective approaches.
People who take part in clinical trials have the first chance to benefit from new approaches. They also make important
contributions to medical science. Although clinical trials may pose some risks, researchers take very careful steps to protect
people who take part.
A man who is interested in being part of a clinical trial should talk with his doctor. He may want to read Taking Part in
Clinical Trials: What Cancer Patients Need To Know and Taking Part in Clinical Trials: Cancer Prevention Studies. These NCI
booklets describe how research studies are carried out and explain their possible benefits and risks. NCI's Web site at http://cancer.gov provides general information about clinical
trials. It also offers detailed information about specific ongoing studies of prostate cancer by linking to PDQ®, a cancer
information database developed by the NCI. Causes
Although researchers know several risk factors for prostate cancer, they still are not sure why one man develops the disease
and another doesn't. (Known risk factors, which include aging, are listed in the "Prostate Cancer: Who's at Risk?" section.)
Some aspects of a man's lifestyle may affect his chances of developing prostate cancer. For example, some evidence suggests a
link between diet and this disease. These studies show that prostate cancer is more common in populations that consume a high-fat
diet (particularly animal fat), and in populations that have diets lacking certain nutrients. Although it is not known whether a
diet low in fat will prevent prostate cancer, a low-fat diet may have many other health benefits.
Some research suggests that high levels of testosterone may increase a man's risk of prostate cancer. The difference between
racial groups in prostate cancer risk could be related to high testosterone levels, but it also could result from diet or other
lifestyle factors.
Researchers also are looking for changes in genes that may increase the risk for developing prostate cancer. They are studying
the genes of men who were diagnosed with prostate cancer at a relatively young age (less than 55 years old) and the genes of
families who have several members with the disease. Much more work is needed, however, before scientists can say exactly how
changes in these genes are related to prostate cancer. Men with a family history of prostate cancer who are concerned about an
inherited risk for this disease should talk with their doctor. The doctor may suggest seeing a health professional trained in
genetics.
Prevention
Several studies are under way to explore how prostate cancer might be prevented. These include the use of dietary supplements,
such as vitamin E and selenium. In addition, recent studies suggest that a diet that regularly includes tomato-based foods may
help protect men from prostate cancer.
The drug finasteride is being studied in the Prostate Cancer Prevention Trial, which involves thousands of men across the
country who are participating for 7 years, until 2004.
Scientists are also looking at ways to prevent recurrence among men who have been treated for prostate cancer. These
approaches involve the use of drugs such as finasteride, flutamide, and LH-RH agonists. Studies have shown that hormonal therapy
after radiation therapy or after radical prostatectomy can benefit certain men whose cancer has spread to nearby tissues.
Researchers also are investigating whether diets that are low in fat and high in soy, fruits, vegetables, and other food
products might prevent a recurrence. The Cancer Information Service can provide information about these studies.
In July, 2003, an Australian research team lead Graham Giles of The Cancer Council released a report of a medical study that
concluded that frequent masturbation by males may be an effective
preventative measure. It was speculated by the researchers that the resulting ejaculations helps remove carcinogens from the gland area. [1] A
subsequent study from the Health Professionals Study found no link between the two [2] .
Screening/Early detection
Researchers are studying ways to screen men for prostate cancer (check for the disease in men who have no symptoms). At this
time, it is not known whether screening for prostate cancer actually saves lives, even if the disease is found at an earlier
stage. The NCI-supported Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial is designed to show whether certain
detection tests can reduce the number of deaths from these cancers. This trial is looking at the usefulness of prostate cancer
screening by performing a digital rectal exam and checking the PSA level in the blood in men ages 55 to 74. The results of this
trial may change the way men are screened for prostate cancer. The Cancer Information Service can provide information about this
trial.
Treatment
Through research, doctors try to find new, more effective ways to treat prostate cancer. Many studies of new approaches for
men with prostate cancer are under way. When laboratory research shows that a new treatment method has promise, cancer patients
receive the new approach in treatment clinical trials. These studies are designed to answer important questions and to find out
whether the new approach is safe and effective. Often, clinical trials compare a new treatment with a standard approach.
Cryosurgery is under study as an alternative to surgery and radiation therapy. The doctor tries to avoid damaging healthy
tissue by placing an instrument known as a cryoprobe in direct contact with the tumor to freeze it. The extreme cold destroys the
cancer cells.
Doctors are studying new ways of using radiation therapy and hormonal therapy. They also are testing the effectiveness of
chemotherapy and biological therapy for men whose cancer does not respond or stops responding to hormonal therapy. In addition,
scientists are exploring new treatment schedules and new ways of combining various types of treatment. For example, they are
studying the usefulness of hormonal therapy before primary therapy (surgery or radiation) to shrink the tumor.
For men with early stage prostate cancer, researchers also are comparing treatment with watchful waiting. The results of this
work will help doctors know whether to treat early stage prostate cancer immediately or only later on, if symptoms occur or
worsen.
External links
The original text of this article was taken from the public domain
document NIH Publication No. 00-1576, which can be found at http://www.cancer.gov/cancerinfo/wyntk/prostate
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