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Advanced Treatment Options For Prostate Cancer

The prostate is a small gland that is located in the lower abdomen in men, just under the bladder and surrounding the urethra. The hormone testosterone is responsible for regulating the prostate. The prostate gland is also responsible for producing semen. When there is an abnormal and malignant growth of cells, known as a tumor, in the prostate, it leads to prostate cancer. Prostate cancer is one of the most commonly diagnosed forms of cancer in the world in males. If left untreated, prostate cancer can also spread to other parts of the body.

Advanced Treatment Options For Prostate Cancer

There are many different ways of treating prostate cancer, and the treatment is determined by factors like how advanced the cancer is, whether it has spread outside of the prostate, your age, as well as your overall health. Here are some of the new advances in the treatment of prostate cancer.

What is Prostate Cancer?

Prostate cancer is one of the most common types of cancer in males worldwide.(1) According to estimates by the American Cancer Society (ACS), in the United States alone, there are 268,490 men diagnosed with this condition in the first half of 2022 alone.(2)

The prostate is a small gland that is located in the lower abdomen, just under the bladder and surrounding the urethra. The prostate gland has many functions in the body, primarily being responsible for producing the fluid that helps nourish and transport sperm, known as seminal fluid. The prostate gland is regulated by the hormone testosterone. It is believed that one in every eight males will be diagnosed with prostate cancer at some point in their life. However, only 1 in 41 males die as a result of prostate cancer. This is because treatment for prostate cancer is very effective, especially if the cancer is caught in the early stages. This is why routine screening is very important, and it helps doctors detect many cases of prostate cancer before it reaches an advanced stage and spreads beyond the prostate.(3)

Various Types of Prostate Cancer

Nearly all cases of prostate cancer belong to a type of cancer known as adenocarcinoma, which develops in the tissue of a gland, just like the prostate gland. However, there are some other rare types of cancer as well that can originate in the prostate, such as:(4)

  • Small cell carcinoma
  • Neuroendocrine tumors
  • Sarcomas
  • Transitional cell carcinomas

Prostate cancer is also segregated by how quickly it grows. There are two types of growth in prostate cancer, including:

  • Fast-growing or aggressive
  • Slow-growing or Non-aggressive

The tumor grows slowly in non-aggressive prostate cancer. However, in aggressive cancer, the tumor grows rapidly, and it can also overgrow and spread to other parts of the body, including the bones, and become metastatic cancer.(5, 6)

Symptoms of Prostate Cancer

As mentioned, some forms of prostate cancer are non-aggressive. This means they may not have any symptoms. However, advanced stage prostate cancer or aggressive prostate cancer usually always causes symptoms. At the same time, some of the symptoms of prostate cancer can also be caused by other conditions such as benign prostatic hyperplasia.(7) This is why you must visit a doctor to get a proper diagnosis.

You are also unlikely to experience any symptoms during the early stages of prostate cancer. Some of the symptoms you may notice are as follows:

  • A week urine stream
  • Difficulty starting and maintaining urination
  • A frequent urge to urinate, especially at night
  • Pain in the hips, pelvis, or the back
  • Painful urination
  • Painful ejaculation
  • Blood in the urine or in the semen

People with advanced prostate cancer may also not show any symptoms. Potential signs and symptoms will depend on the size of the tumor and where it has spread in the body. In addition to the above symptoms, advanced prostate cancer can also cause the following symptoms:

Treatment for Prostate Cancer

There are many different treatment options for prostate cancer. The exact treatment depends on a variety of factors, including whether cancer has spread outside the prostate, how advanced the cancer is, how aggressively the cancer is growing, your age, and your overall health. At the same time, research has been continuously going on into the various causes, prevention, detection, testing, and treatment of prostate cancer throughout the world.

There have been many advances in the treatment of prostate cancer in recent years. No one treatment is suitable for any man, but there are usually several treatments that are used simultaneously to treat prostate cancer. Here are some of the treatment options for prostate cancer.

Wait and Watch

For early-stage prostate cancer, that is, if the cancer is small and localized, a doctor is likely to recommend watchful waiting and monitoring. Your doctor will check the levels of prostate-specific antigen (PSA) in the blood, which is a protein that helps semen retain its liquid state. PSA blood levels will be tested regularly, but your doctor will not take any immediate action. Since most prostate cancer grows slowly, the risk of treatment side effects is likely to outweigh the need for seeking treatment immediately.

Radical Prostatectomy

Even in early-stage prostate cancer, a surgeon may recommend surgery. They may carry out a radical prostatectomy to remove the tumor. Apart from removing the prostate, this surgical procedure also involves removing the surrounding tissue, seminal vesicles, and even the nearby lymph nodes. A surgeon may perform this procedure using either laparoscopic, open, or robot-assisted laparoscopic surgery. Radical prostatectomy is usually only used when cancer is limited to the prostate. The various options for performing this surgery are as follows:

  • Open surgery: The surgeon will make a big incision in the lower abdomen or in the perineum to get access to the prostate. The perineum is the area located between the scrotum and the rectum.(8)
  • Laparoscopic surgery: In this format of radical prostatectomy, the surgeon uses numerous specialized cameras and tools to look inside the body. They remove the prostate gland by making tiny incisions.(9)
  • Robotic-assisted Laparoscopic Surgery: In this form of surgery, the surgeon uses very precise robotic arms from a computerized control panel to carry out laparoscopic surgery and remove the prostate.

Either open surgery or laparoscopic surgery will allow doctors to also look at the lymph nodes nearby and other tissues to search for evidence of cancer.

It is important to keep in mind that loss of the prostate gland will reduce the amount of fluid in male ejaculate.(10, 11)

Radiation therapy is another common option for the treatment of prostate cancer. This treatment method uses radiation to kill the cancer cells or to prevent them from growing further. External radiation therapy and internal radiation therapy are the two main options for treating early-stage prostate cancer.(12)

Advanced Treatment Options For Prostate Cancer

There are many advanced treatment options also available for prostate cancer. These include:

  1. Cryosurgery

    In this treatment procedure, the doctor inserts probes into the prostate. These probes are filled with super cold gases to freeze and kill cancerous tissue. Both cryosurgery and radical prostatectomy are carried out under general anesthesia or regional anesthesia, either spinal or epidural. Some of the possible side effects of cryosurgery may include impotence and urinary incontinence. This happens because the nerves that affect your ability to control urination and get an erection are located close to the prostate, and cryosurgery causes damage to these nerves.(13, 14)

  2. Transurethral Resection of the Prostate (TURP)

    This is also a surgical procedure that is used to alleviate the symptoms of prostate cancer. During the procedure, the doctor will insert a thin, long scope that has a cutting tool mounted on one end. This scope is inserted into the penis through the urethra, and the tool is used to cut away at the prostate tissue that is blocking the flow of urine. TURP, though, cannot remove the entire prostate gland. This is why it is only used to relieve the urinary symptoms in people with prostate cancer, but this procedure will not cure the cancer.(15, 16)

  3. Treatment Through Genetics

    There has been a lot of interest in new research on genetic changes that are linked with prostate cancer. This research is helping researchers better understand how prostate cancer develops, making it possible to design medications and other treatments to specifically target these changes.

    Tests for abnormal prostate cancer genes may also help identify those men who are at a higher risk of prostate cancer and who may benefit from screening or chemoprevention clinical trials that make use of drugs to prevent the men from getting cancer in the first place.

    In men who have already been diagnosed with prostate cancer, tests are being developed to look for gene changes that can provide a better idea of how likely the cancer is to grow and spread. This may influence the treatment options.(17, 18)


If prostate cancer is diagnosed at an early stage and it has not spread from the original location, the outlook is usually good. Early detection and treatment are absolutely critical to a positive outcome in men with prostate cancer. This is why if you suspect you may have prostate cancer or you are experiencing any type of abnormal symptoms while urinating or ejaculating, you should see your doctor at the earliest.


  1. Leslie, S., Soon-Sutton, T., Sajjad, H. and Siref, L., 2022. Prostate Cancer. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK470550/> [Accessed 10 July 2022].
  2. Cancer.org. 2022. Key Statistics for Prostate Cancer | Prostate Cancer Facts. [online] Available at: <https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html> [Accessed 10 July 2022].
  3. Auanet.org. 2022. Prostate Cancer: Early Detection Guideline – American Urological Association. [online] Available at: <https://www.auanet.org/guidelines/guidelines/prostate-cancer-early-detection-guideline> [Accessed 10 July 2022].
  4. van der Toom, E.E., Axelrod, H.D., de la Rosette, J.J., de Reijke, T.M., Pienta, K.J. and Valkenburg, K.C., 2019. Prostate-specific markers to identify rare prostate cancer cells in liquid biopsies. Nature Reviews Urology, 16(1), pp.7-22.
  5. Msaouel, P., Pissimissis, N., Halapas, A. and Koutsilieris, M., 2008. Mechanisms of bone metastasis in prostate cancer: clinical implications. Best practice & research Clinical endocrinology & metabolism, 22(2), pp.341-355.
  6. Parra, S.A.A., González-Estrada, O.A. and Quiroga Mendez, J.E., 2018. Damage assessment of spinal bones due to prostate cancer. In Key Engineering Materials (Vol. 774, pp. 149-154). Trans Tech Publications Ltd.
  7. Guess, H.A., 2001. Benign prostatic hyperplasia and prostate cancer. Epidemiologic reviews, 23(1), pp.152-158.
  8. Hu, J.C., Gu, X., Lipsitz, S.R., Barry, M.J., D’Amico, A.V., Weinberg, A.C. and Keating, N.L., 2009. Comparative effectiveness of minimally invasive vs open radical prostatectomy. Jama, 302(14), pp.1557-1564.
  9. Türk, I., Deger, S., Winkelmann, B., Schönberger, B. and Loening, S.A., 2001. Laparoscopic radical prostatectomy. European urology, 40(1), pp.46-53.
  10. Koeman, M., Van Driel, M.F., Weijmar Schultz, W.C.M. and Mensink, H.J.A., 1996. Orgasm after radical prostatectomy. British Journal of Urology, 77(6), pp.861-864.
  11. Barnas, J.L., Pierpaoli, S., Ladd, P., Valenzuela, R., Aviv, N., Parker, M., Waters, W.B., Flanigan, R.C. and Mulhall, J.P., 2004. The prevalence and nature of orgasmic dysfunction after radical prostatectomy. BJU international, 94(4), pp.603-605.
  12. Cancer.org. 2022. Radiation Therapy for Prostate Cancer. [online] Available at: <https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html> [Accessed 10 July 2022].
  13. Fahmy, W.E. and Bissada, N.K., 2003. Cryosurgery for prostate cancer. Archives of andrology, 49(5), pp.397-407.
  14. Langenhuijsen, J.F., Broers, E.M. and Vergunst, H., 2009. Cryosurgery for prostate cancer: an update on clinical results of modern cryotechnology. european urology, 55(1), pp.76-86.
  15. Mansfield, J.T. and Stephenson, R.A., 1996, August. Does transurethral resection of the prostate compromise the radical treatment of prostate cancer?. In Seminars in urologic oncology (Vol. 14, No. 3, pp. 174-177).
  16. Merrill, R.M., Feuer, E.J., Warren, J.L., Schussler, N. and Stephenson, R.A., 1999. Role of transurethral resection of the prostate in population-based prostate cancer incidence rates. American journal of epidemiology, 150(8), pp.848-860.
  17. Abate-Shen, C. and Shen, M.M., 2000. Molecular genetics of prostate cancer. Genes & development, 14(19), pp.2410-2434.
  18. Choudhury, A.D., Eeles, R., Freedland, S.J., Isaacs, W.B., Pomerantz, M.M., Schalken, J.A., Tammela, T.L. and Visakorpi, T., 2012. The role of genetic markers in the management of prostate cancer. European urology, 62(4), pp.577-587.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 3, 2022

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