Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. Over 200,000 new cases are diagnosed in the United States each year. Most diagnoses are for prostate adenocarcinoma. Therefore, most treatments for prostate cancer aim to treat adenocarcinoma.
What is adenocarcinoma? Essentially, an adenocarcinoma is a cancer that starts in the cells that line the inside of the prostate. What is adenocarcinoma treatment? Adenocarcinoma treatment is standard prostate cancer treatment - watchful waiting, radical prostatectomy and radiotherapy.
Watchful waiting is the simplest method of treatment for prostate cancer adenocarcinoma, as it essentially no treatment. With watchful waiting, you and your physician agree to monitor the adenocarcinoma for growth or changes. This is used in early cases of prostate cancer, where the tumor is small, has not spread and appears to be slow-growing from the pathological tests done on the cancer cells. Regular digital rectal exams and PSA tests are performed, and if no growth or change is seen, then there is little concern and watchful waiting can continue. However, if growth or changes are seen, then more aggressive treatment is often warranted.
One of the standard, more aggressive treatments is radical prostatectomy, or removal of the prostate. There are different techniques used with radical prostatectomy surgeries, but all aim to remove the cancerous tissue and cure the prostate cancer, if possible. Radical prostatectomy has the highest success rates in earlier stages of prostate cancer, seeing less success if the cancer has spread beyond the prostate.
Of note in terms of radical prostatectomy surgery is newer nerve-sparing surgeries that reduce the incidence of impotence and incontinence seen with traditional surgeries. Impotence is greatly targeted with these nerve-sparing techniques. For example, while traditional radical prostatectomy surgical techniques saw an impotence rate of 80 to 90% after one year, these nerve-sparing techniques are seeing only 20 to 30% impotence after one year. These techniques are especially successful in younger men who had full erectile function at the time the surgery was performed. It will not bring erectile function back to older men who had already experience difficulty, it only increases the likelihood that whatever function a man has, he will be able to keep.
Another aggressive form of therapy for prostate cancer adenocarcinoma is radiotherapy. The two main types of radiotherapy are external beam radiation and brachytherapy (internal seed radiation). Both techniques aim to kill the cancerous cells and prostate tissue, but are less invasive than surgery. Radiotherapy has the same level of side effects as traditional radical prostatectomy surgeries and at this time, there are no radiation therapies in place to reduce those symptoms. Therefore, if erectile function is a real concern, nerve-sparing surgery may be the better option, as long as the patient is healthy enough to undergo major surgery.
Regardless of what type of prostate cancer you have been diagnosed with, the treatment options are likely to include at least watchful waiting, radical prostatectomy or radiotherapy. Remember, only you and your physician can make the final decision as to which treatment option is best for you.