Navigating Prostate Cancer Treatment: 5 Key Questions to Ask Your Doctor

By Dr. David Samadi

A prostate cancer diagnosis can feel overwhelming, leaving you with many questions and concerns. With a 98% survival rate, this disease is highly treatable, especially when caught early. By asking the right questions, you can better understand your options and make informed decisions for the best possible outcome.

One of the most critical steps in managing prostate cancer is discussing treatment options with your urologist. Advances in medical science have introduced numerous therapies, many offering excellent results with fewer side effects. Your recommended treatment will depend on your cancer’s stage, type, and location. Here are five essential questions to guide you:

1. Is Active Surveillance Right for Me?

Hearing the word “cancer” often sparks an instinct to act quickly, but not all prostate cancers require immediate treatment. Some grow so slowly that they pose little risk to your health. In such cases, active surveillance might be the best approach.

Active surveillance involves closely monitoring the cancer with periodic prostate-specific antigen (PSA) tests, digital rectal exams, and sometimes imaging or biopsies. This approach may be appropriate if:

  • The tumor is small and confined to the prostate.
  • The cancer is slow-growing.
  • The risk of spreading is low.

A similar approach, “watchful waiting,” may focus on managing symptoms rather than frequent testing, particularly for older men or those with other health concerns. Discussing these strategies with your doctor can help you avoid unnecessary procedures while keeping the disease in check.

2. Am I a Candidate for Surgery?

For many men, surgery—typically a prostatectomy—is a key treatment option. This procedure removes the prostate gland and is most effective for:

  • Men with a life expectancy of more than ten years.
  • Cancer that is localized within the prostate.
  • Patients under 70 are in good overall health.

Surgical options include:

  • Open Prostatectomy: A traditional method involving a single abdominal incision. It’s effective but requires a more extended recovery period.
  • Laparoscopic Prostatectomy: A minimally invasive technique using small incisions, helping result in a quicker recovery and less pain.
  • Robotic-Assisted Prostatectomy: This method combines robotic precision with minimal invasiveness, often preserving urinary and sexual function better.

In order to determine the best and most suitable approach for you, conversations with doctor is essential. 

3. Is Radiation Therapy an Option?

Radiation therapy is another common treatment, either alone or combined with other therapies like hormone therapy. It’s particularly effective for cancer that hasn’t spread beyond the prostate or as a follow-up to surgery to eliminate remaining cancer cells.

Radiation therapy specifically targets cancer cells with high-energy rays to damage their DNA and prevent growth. While nearby healthy tissues may be affected, they typically recover over time. Candidates for radiation include:

  • Men under 70 with localized cancer.
  • Patients experiencing pain from advanced cancer.
  • Those with recurring cancer after surgery.

It’s worth noting that undergoing surgery after radiation can be challenging due to changes in tissue structure, so careful consideration is needed when choosing this option.

4. Is Hormone Therapy a Good Option?

Prostate cancer often depends on male hormones like testosterone to grow. Hormone therapy which is also called androgen deprivation therapy (ADT), reduces androgen levels to slow or stop cancer growth. It’s typically recommended when:

  • The cancer has spread beyond the prostate.
  • Hormonal therapy can enhance the effectiveness of radiation therapy.
  • Cancer has recurred, as indicated by rising PSA levels.

Side effects of hormone therapy may include hot flashes, reduced libido, erectile dysfunction, and changes in weight or bone density. Understanding these potential impacts can help you prepare and plan supportive care.

5. Could Chemotherapy Be Beneficial?

Chemotherapy is not typically a first-line treatment for localized prostate cancer but may be used for advanced cases when other therapies are less effective. It’s designed to target rapidly dividing cancer cells and can:

  • Relieve symptoms in metastatic cancer.
  • Improve outcomes after surgery.
  • Extend survival for men resistant to hormone therapy.

While chemotherapy may not cure prostate cancer, your quality of life can be enhanced and help prolong survivability. Always have a thorough discussion about chemotherapy’s potential risks and benefits with your healthcare provider. 

Final Thoughts

Every prostate cancer journey is unique. The best treatment plan considers your specific circumstances, including the cancer stage and overall health. Open communication with your urologist is key to understanding your options and making confident decisions. Don’t hesitate to ask questions, seek second opinions, or explore additional resources—empowered patients achieve better outcomes.

 

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911. 

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