Various ways to treat prostate cancer

Prostate cancer is one of the most common causes of death in men. Based on 2018 Globocan data, there are around 11,361 new cases of prostate cancer in Indonesia. As many as 5,007 people died from this disease. To prevent prostate cancer from getting worse, early treatment needs to be done. So, how to treat and cure prostate cancer?

Various ways to treat prostate cancer

Cancer cells don't just attack one tissue. These abnormal cells can spread and invade surrounding healthy tissue. In prostate cancer, cancer cells can attack the bladder and even the bones. The patient will have difficulty urinating, pain around the pelvis, difficulty getting an erection, or other symptoms of prostate cancer.

So that cancer does not spread and reduces the patient's quality of life, doctor care is needed. Not just one, there are many different types of treatment for prostate cancer. The treatment will be adjusted to the stage of prostate cancer and the patient's overall condition.

Here are some ways to treat prostate cancer that are generally recommended by doctors:

1. Doctor's active supervision

Not all men who have prostate cancer need medication and medication. For men who are diagnosed with low-risk prostate cancer, generally only active supervision from a doctor is required. This is because prostate cancer tends to grow slowly.

The category of people who generally only need active surveillance is prostate cancer patients who do not have any symptoms, who have other serious medical conditions, or who are elderly, making prostate cancer treatment more difficult.

On active supervision, the doctor will monitor the development of cancer cells in the prostate by performing several tests, namely tests Prostate specific antigen (PSA), Digital Rectal Exam (DRE), or prostate biopsy. Further cancer treatment is needed if cancer cells are found to be continuing to grow through these tests or causing symptoms.

Even though it is carried out actively and regularly, supervision from a doctor may also pose risks, such as the possibility of growing and spreading cancer cells between routine examinations, making cancer difficult to cure.

2. Surgical removal of the prostate gland (radical prostatectomy)

Surgical removal of the prostate gland or radical prostatectomy is the main way to treat prostate cancer. This treatment is done by removing the prostate gland which has abnormal cells. Usually this operation is done before the cancer cells have spread beyond the prostate gland or have not spread too far.

Although quite effective, this treatment sometimes does not completely remove cancer cells, so patients are asked to undergo further treatment. Prostatectomy can cause side effects, such as injury to nearby tissues or urinary incontinence (unable to control the urge to urinate).

3. Radiotherapy

Radiotherapy is a way of treating prostate cancer by using radiation to kill cancer cells. This type of treatment works by slowing the development and spread of cancer cells to relieve symptoms.

Radiotherapy can be given as the first treatment for patients with early stage prostate cancer or as a follow-up treatment after surgery, especially if doctors still suspect that cancer cells are not completely removed. There are two types or ways of radiotherapy to cure prostate cancer, namely external and internal.

Although it can kill cancer cells, radiotherapy also has side effects. In the short term, the patient will experience diarrhea, hair loss, or inflammation of the urinary lining.

4. Brachytherapy

This way of treating prostate cancer is another form of radiotherapy. Brachytherapy or internal radiation is done by implanting a small amount of radioactive seeds into the tumor area in the prostate gland or placing a catheter tube in the prostate gland to give radiation substances through the catheter.

This type of treatment minimizes the risk of damage to other surrounding tissues. However, this treatment is more prone to causing bladder problems than radiotherapy.

5. Hormone therapy

This method of treating prostate cancer aims to reduce the levels of androgens (male hormones) in the body, namely testosterone and dihydrotestosterone (DHT). By lowering androgen levels, prostate cancer can shrink or grow more slowly for a while.

Generally, hormone therapy is given to patients with advanced prostate cancer or if the cancer cells come back after treatment. If it is still in its early stages, hormone therapy can be done before radiation therapy for maximum results.

Prostate cancer hormone therapy is usually done by giving drugs to stop androgen production or block the work of androgens from reaching cancer cells (antiandrogen drugs). Drugs that are usually given, namely leuprolide (Lupron, Eligard), goserelin (Zoladex), triptorelin (Trelstar), histrelin (Vantas), bicalutamide (Casodex), nilutamide (Nilandron), and flutamide.

Other hormone therapy drugs may be given by the doctor. Talk to your doctor about the right type of medication.

Apart from drugs, hormone therapy can also be done by surgical removal of the testicles (orchiectomy) to reduce androgen levels in the body.

Side effects of hormone therapy that may occur, namely erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive, and weight gain.

In addition, hormone therapy alone generally cannot cure prostate cancer, this method is usually accompanied by other treatments, such as radiotherapy or surgery. In fact, in some patients, cancer cells can become resistant to hormone therapy. Consult with your doctor about this possibility.

6. Cryotherapy (freezing of prostate tissue)

In addition to surgical removal, killing cancer cells in the prostate tissue can be done by freezing these cells. How to treat prostate cancer is known by the name cryosurgery or cryoablation.

During this treatment, you will be inserted a small needle into the prostate, which is called a cryoneedle. Then, a very cold gas will be placed on the needle so that the surrounding tissue freezes.

A second gas is then placed in the needle to reheat the tissue. This cycle of freezing and thawing can kill cancer cells and some of the surrounding healthy tissue.

This treatment method is usually used to treat cancer cells that have not spread outside the prostate gland, especially for patients who have never had radiation therapy. However, this type of prostate cancer treatment can also cause side effects, such as erectile dysfunction or urinary incontinence.

7. Chemotherapy

Chemotherapy is a way of treating prostate cancer by relying on drugs, whether it is taken by mouth or injected through a vein. Chemotherapy drugs commonly given to prostate cancer patients are docetaxel (Taxotere), cabazitaxel (Jevtana), mitoxantrone (Novantrone), or estramustine (Emcyt).

This treatment is an option for patients with cancer cells that have spread to other parts of the body (stage 4 or metastatic prostate cancer). Not only that, this treatment is also often given to patients who do not respond to hormone therapy.

Apart from killing cancer cells, chemotherapy also aims to relieve symptoms. Unfortunately, this treatment can attack healthy body cells causing side effects, such as fatigue, hair loss, nausea and vomiting, and decreased appetite.

8. Biological therapy

This method of treating prostate cancer is also called immunotherapy or cancer vaccine. The goal of treatment is to increase the body's immune system so that it is stronger against cancer cells. One type of treatment is called sipuleucel-T (Provenge) which is used to treat advanced prostate cancer.

Treatment is done by taking some of the patient's immune cells. Then, the immune cells will be taken to the laboratory and genetically engineered to fight prostate cancer. These engineered immune cells are then re-injected into the patient.

This type of treatment can also cause side effects, such as fever, chills, fatigue, nausea and vomiting, headaches, and back and joint pain.

Each of the methods of treating prostate cancer above has advantages and disadvantages, including side effects. You can use other remedies, such as herbal remedies for prostate cancer or other natural remedies, to help alleviate these side effects.

But keep in mind, it is important to always consult with your doctor to find out the type of prostate cancer treatment, including the most appropriate alternative according to your condition.