Once diagnosed and staged, prostate cancer treatments generally rely on radiation, hormone therapy, and chemotherapy. Staging is the term used when doctors “rank” (i.e., calibrate the severity of) individual prostate cancers.
Staging Prostate Cancer via the AJCC TNM
The acronym AJCC stands for the American Joint Committee on Cancer, while TNM stands for the first three criteria in determining how severe a case of prostate cancer is. The TNM uses five essential diagnostic measures. These are:
• The size of the primary prostate tumor (T category)
• The spread of prostate cancer to nearby lymph nodes (N category)
• The presence or absence of distant tumors, called metastasis (M category)
• The PSA level at the time of diagnosis
• The Gleason score, based on the prostate biopsy or surgical prostate cancer intervention
Prostate Cancer Treatments Rely on Radiation and Hormone Therapy
When prostate cancer reaches a certain dimension, physicians will recommend radiation therapy. This can be in one of two forms: external irradiation (beam therapy), or internal irradiation (brachytherapy) via small implants. This second option has become increasingly preferable in treating prostate cancer because of its ability to target the growing prostate tumor with extreme precision.
Physicians will also block the production of the hormone testosterone via antiandrogen compounds called LHRH agonists. If that doesn’t work, they will find a way to keep testosterone from reaching cells, because prostate cancer growth depends on testosterone. Some doctors also favor Vitamin D supplements, largely because studies have shown that men who develop prostate cancer have low Vitamin D levels. Unfortunately, 2015 studies show otherwise.
Prostate Cancer Treatments List
A physician or oncologist has a number of tools at his/her disposal to shrink and remove prostate cancer tumors. Based on staging, the patient’s general health and age, they may choose to monitor tumors at intervals, or actively catalog prostate tumor growth. When the tumor is at a certain stage, medical professionals can resort to the following methods, either singly or in combination:
• Radiation therapy
• Hormone therapy
• Cryosurgery (cryotherapy)
• Vaccine treatments, i.e., sipuleucel-T (Provenge) or PROSTVAC
• Immune checkpoint inhibitors like ipilimumab (Yervoy)
• Bone-directed treatment for painful cancer spread, via radiofrequency ablation (RFA)
There are 2.8 million men in the United States who are either living with prostate cancer or in recovery. Because prostate cancer is such a complicated disease, survivors will require long-term care to manage the ravages of prostate cancer. The American Cancer Society has updated “healthy behavior” guidelines. These include weight control, exercise, diet management, limiting alcohol intake and avoiding tobacco. Survivors are also advised to have regular follow-up testing to insure that prostate cancer has not returned, and immediate treatment in those instances where it has.
SOURCES: Bruce Hollis, Ph.D., professor, pediatrics, biochemistry and molecular biology, Medical University of South Carolina, Charleston, S.C.; Anthony D’Amico, M.D., Ph.D., chief, radiation oncology, Brigham and Women’s Hospital, Boston; March 22, 2015, presentation, American Chemical Society meeting, Denver