But fear gradually gives way to furious thinking; thinking about what happens next and where to go. Usually this is in the form of treatment options, a myriad of them, and the many, many characteristics of each that must be weighed carefully. Watchful waiting? Surgery? Radiation? Hormones? Cryosurgery? Perhaps even proton beam? And so on. Along with the careful advice of your doctor, you may begin to narrow it down, or you may begin to feel overwhelmed. What exactly ARE some of these treatments and which one is the best?
As you've probably already guessed, the "best" is different for everyone. Watchful waiting is "best" for you if you're cancer is slower and less aggressive and you are old. That's right, I called you "old." Seriously, though, if your doctor thinks you are no spring chicken, he may recommend that any treatment would be harder on you than the cancer itself, and that you both should take a wait and see approach. If not, he may decide that you are ready for surgery.
This is the most drastic treatment choice, and is seen by some as the "best" of the "best." What's so great about it is that the surgeon manually removes the entire prostate gland, including the cancer. It's gone. Completely. And he can poke around in there to see if there's more. The problem is that there can be side effects that can seriously mess up your comfort level. Effects like the inability to hold in your pee (incontinence), and the inability to have an erection (impotence). Tempering these problems are two small facts: incontinence is very, very rare, and the chance of becoming impotent can be reduced by having something called "nerve sparing surgery," where the surgeon is careful not to snip any "erection" nerves. Still, with surgery you would have to face long hospital stays and long recovery times, which brings us to one of the other common treatments: radiation.
Scary-sounding as it is, radiation is much less invasive than most forms of therapy. Hospital time is less, and recovery time is quicker. Not to say it's perfect. Radiation side effects can be severe, and include such nasties as diarrhea and bleeding from the rectum. In addition, there is some controversy as to whether radiation can zap cancer as effectively as surgery.
In fact, the effectiveness of many treatments are often compared to surgery. Does this mean surgery is the gold standard, and hence the "best" treatment?
It's just too complicated to answer. Certainly, a study performed by the Johns Hopkins Medical Center in 1998 came to the conclusion that only surgery can successfully remove all cancer, and that surgery patients may have short term decrease in their quality of life in exchange for long-term freedom from cancer. Other treatments have been improved since then, however, and this answer is less certain. For some individuals, surgery is simply too drastic and the cancer too slow to demand it. For others, previous health problems or your own personal reasons may make radiation a more reasonable choice.
Only your doctor and you can make a decision like this together. Treatment for prostate cancer is one of the most personal decisions you can make, and the "best" is different for everybody.
About the Author
James Culp is a prostate cancer survivor and runs a free newsletter tracking the latest developments in disease of the prostate. His newsletter can be subscribed to at http://www.prostaide.org