Prostate cancer the most commonly diagnosed non-skin cancer in the United States today. It is estimated that each year, over 200,000 new cases will be diagnosed. In many cases, the cancer is caught early and can be treated or even cured. However, sometimes the cancer returns or is not caught until it has spread to distant areas of the body. With advanced prostate cancer, the goal of palliative care is to reduce symptoms and maintain as much quality of life as possible.
The symptoms of advanced prostate cancer may include anemia, weight loss, bone fractures, spinal cord compression, pain, bloody urine, urinary retention, kidney failure, and urinary incontinence. These symptoms, as well as others that can occur, are all related to the growth of the tumor in the prostate itself, or the spread to lymphatic and bone tissues. Most approaches in palliative care are aimed at reducing the growth and spread to reduce the symptoms, if possible.
One of the hallmarks of palliative care for advanced prostate cancer is hormone therapy. There are different types of hormone therapy, but all aim to reduce or eliminate the production of testosterone, which acts to encourage growth in the cancerous cells. Orchiectomy is the surgical removal of the testes, the organs which produce the majority of testosterone in the body. This is a relatively simple procedure, but the effects are permanent and result in, amongst other things, impotence.
Other palliative care hormone treatments involve the administration of drugs that prevent the production or inhibit the action of the androgen hormones. Drug therapy has the same efficacy as orchiectomy, but the effects are not permanent. Therefore, many men choose drug therapy during hormonal palliative care. All methods of hormonal palliative care for prostate cancer have been shown to slow progression for up to 18 to 20 months, and result in an overall survival of 24 to 36 months.
Another palliative care option is chemotherapy. In chemotherapy, prostate cancer cells, along with other healthy cells of the body, are attacked and killed by harsh chemicals. Because chemotherapy affects both cancerous and non-cancerous cells, it is usually reserved for more advanced stages of prostate cancer. With chemotherapy, prostate cancer tumor growth can be slowed, which can help alleviate some of the symptoms associated with advanced stages of the disease.
While hormonal and chemotherapy palliative care programs can help to reduce the effects of advanced prostate cancer, they both come with their own side effects. Furthermore, there is little evidence to suggest that they play much of a role in extending survival. Therefore, many patients choose pain management as a palliative care option, since there are often fewer side effects. In fact, some pain management techniques, such as acupuncture, have no unpleasant side effects.
If you have been diagnosed with advanced prostate cancer, be sure to discuss all of your treatment options with your physician. Above all, remember to find out if a treatment is solely palliative, or if it has the potential to prolong your life. This may help you in determining whether the side effects are worth the outcome.