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Treatment Options Are Many for Prostate Cancer
Date:12/5/2008

rm incontinence while he recovers from surgery.

Radiation treatment can cause both bladder and bowel incontinence. It can also lead to impotence, although that effect does not take place immediately.

"Men may start out being sexually active, and then as the radiation scarring and damage develops over the next two to three years, there's a gradual decrease in the levels of potency," Brooks said. "With surgery, it's the opposite. There is some initial difficulty, and then things improve over time."

Within each type of treatment, there's also a menu of options with an array of pluses and minuses.

For example, surgical patients can opt for a "nerve-sparing" procedure less likely to interfere with sexual function. And radiation patients can choose between external beam treatment and brachytherapy, in which radioactive "seeds" are implanted in the tumor, according to the American Cancer Society.

"There is no proven best treatment," Brooks said. "They need to investigate all the treatment options, and understand all the up sides and potential complications from each option."

A patient also might decide that it's just not worth getting treated, particularly if the tumor is slow-growing.

In a tactic called "watchful waiting," the patient does not receive treatment. Instead, regular checkups monitor the progress of the cancer.

If the man's life expectancy is low due to old age or other factors, surgery or radiation for prostate cancer might actually do more harm than good, some doctors feel.

"I have that conversation a lot with the older gentlemen, particularly those guys over 75 years old," Mason said. "Those are the guys who really have to weigh whether it's worth it."

New vaccine therapies to attack prostate cancer could be on the horizon, Brooks said. There are two or three vaccines under development that would prompt a patient's immune system to target cancer cells.


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