Treatment of Prostate Cancer

Prostate cancer treatment is planned according to the stage of the disease, whether the cancer is limited to the prostate, PSA level, biopsy result, the patient’s age, general health status and factors that may affect quality of life. During the treatment process, active surveillance, surgery, radiotherapy, hormone therapy, chemotherapy and drug therapies for advanced-stage disease may be evaluated under different conditions. Therefore, prostate cancer treatment cannot be explained with a single method; the risk level of the disease and the expected benefit from treatment are evaluated together for each person.

The main purpose of treatment is to control the cancer, reduce the risk of spread and preserve the person’s quality of life as much as possible. In prostate cancers detected at an early stage, the disease may be limited to the prostate, and in this case, local treatments such as surgery or radiotherapy may be considered. In some low-risk patients, active surveillance may be preferred instead of starting treatment immediately. In advanced-stage or metastatic disease, the treatment approach is different; hormone therapy, chemotherapy and different systemic treatments may be used according to the course of the disease. Current guidelines state that treatment planning for localized disease and advanced-stage disease should be evaluated separately.

How Is Prostate Cancer Treatment Planned?

When symptoms related to the prostate occur, it is not enough to evaluate only prostate symptoms; PSA level, examination, imaging and biopsy results are reviewed together for treatment planning. Whether the cancer is only inside the prostate, whether it has extended to surrounding tissues, or whether it has spread to lymph nodes or distant areas such as bones is decisive in the treatment decision. For this reason, PSA level, prostate MRI, biopsy result, Gleason score, imaging methods and the person’s general condition are evaluated together.

The treatment plan does not only target the cancer. Urinary control, sexual functions, age, accompanying diseases, the person’s expectations and compliance with the follow-up process are also part of the decision process. For example, low-risk prostate cancer and high-risk or metastatic prostate cancer are not managed in the same way. Therefore, prostate cancer treatment methods are determined individually.

There may be patients who need to start treatment in a short time, as well as patients who can be monitored with regular follow-up. The important point here is to correctly determine the risk level of the disease and evaluate treatment options together with their advantages, limitations and possible side effects.

Searches such as how does the prostate go away are generally made by people who are curious about the treatment of prostate diseases; however, in prostate cancer, the treatment method is determined according to the stage of the disease, spread status and the person’s general health condition.

Who gets prostate cancer?

What Are the Factors Affecting Treatment Selection?

The main factors affecting treatment selection are the stage of the disease, PSA level, biopsy grade of the tumor, spread status of the cancer, the person’s age and general health status. While surgery or radiotherapy may stand out in localized prostate cancer, active surveillance may be appropriate in some low-risk patients. In advanced stages, hormone therapy, chemotherapy or different drug treatments are evaluated.

Life expectancy is also important in the treatment decision. Some prostate cancers may progress slowly. Therefore, it may not be necessary to start aggressive treatment immediately in every patient. However, in patients with high-risk disease, a tendency for rapid progression or signs of spread, the timing of treatment is planned differently.

The person’s expectations after treatment should also be included in the process. Urinary incontinence or erectile problems after surgery, bowel and urinary tract effects after radiotherapy, hot flashes after hormone therapy, decreased sexual desire or effects on bone health are topics that should be evaluated before treatment.

If a rapid increase in PSA level, suspicious progression on MRI or increased risk in the biopsy result is detected during follow-up, active treatment options are re-evaluated.

Active surveillance does not mean “leaving the disease untreated.” It requires regular and planned control. Therefore, it is important that the person can comply with follow-up appointments, that results are evaluated regularly and that decisions are made without delay when changes occur.

What Is Radical Prostatectomy?

The surgical procedure commonly known as prostate surgery is generally performed under the name radical prostatectomy in prostate cancer and aims to remove the entire prostate gland. It is usually considered in cases where the disease is thought to be limited to the prostate or can be controlled surgically. During the procedure, surrounding tissues and lymph nodes may also be removed together with the prostate gland when necessary.

Radical prostatectomy can be performed with open, laparoscopic or robotic methods. The choice of surgical method is determined according to the condition of the disease, the surgeon’s experience, the patient’s anatomical characteristics and the treatment plan. The purpose of the surgery is to remove the cancerous tissue from the body. However, preservation of nerves and tissues that may affect urinary continence and sexual functions is also evaluated during this process.

Follow-up after prostate cancer surgery is performed with PSA testing. Since prostate tissue is removed, PSA value is expected to decrease to very low levels. If an increase is detected during PSA follow-up after surgery, additional treatment options may be considered.

How Is Robotic Prostate Cancer Surgery Performed?

The answer to the question of how prostate surgery is performed varies according to the surgical method to be applied; the procedure can be performed with open, laparoscopic or robotic surgical techniques. Robotic surgery is a surgical approach that allows prostate cancer surgery to be performed with a closed method and with the assistance of a robotic system. In this method, the surgeon controls robotic arms through a console. The robotic system does not perform the operation on its own; all stages of the surgery are managed by the surgeon.

Robotic prostate cancer surgery is one of the methods that may be preferred in prostate surgery because it provides precise movement capability in a narrow surgical field. Since there are structures around the prostate that may affect urinary control and erectile function, surgical precision is important. In suitable patients, a nerve-sparing surgical approach may be evaluated.

Whether robotic surgery is suitable for every patient is determined according to the stage of the disease, the location of the tumor, previous surgeries the person has undergone and general health status. When making a treatment decision, not only the technology used but also oncological control of the disease and possible effects on quality of life should be evaluated together.

Prostate Cancer Treatment With Radiotherapy

Radiotherapy is a treatment method that uses high-energy beams to target prostate cancer cells. It may be applied as an alternative to surgery in localized prostate cancer or, in some cases, as an additional treatment after surgery. The treatment plan is prepared according to the risk level of the disease, PSA value, biopsy result and spread status.

The aim of prostate cancer radiotherapy treatment is to control cancer cells in the prostate region. In some patients, only the prostate is targeted, while in some cases surrounding lymph regions may also be included in the treatment area. AUA/ASTRO sources emphasize the use of modern techniques such as IMRT when pelvic lymph nodes are irradiated.

Radiotherapy may be applied alone or may be planned together with hormone therapy in intermediate- or high-risk patients. During treatment, increased frequency of urination, changes in bowel habits, fatigue or effects on sexual functions may occur. These effects vary from person to person and are taken into account when planning treatment.

In Which Situations Is Hormone Therapy Applied?

Prostate cancer cells may often be affected by the testosterone hormone. Hormone therapy aims to slow the growth of cancer cells by reducing the effect of testosterone. It may be used together with radiotherapy in locally advanced disease and as an important part of systemic treatment in metastatic disease.

Prostate cancer hormone therapy may be planned alone or together with other treatments. In which patient and for how long it will be applied varies according to the stage of the disease, spread status and response to treatment. In some patients, short-term hormone suppression treatments may be needed, while in some patients longer-term treatments may be required.

Hormone therapy may have side effects such as hot flashes, decreased sexual desire, weight changes, loss of muscle mass, decreased bone density and metabolic effects. Therefore, general health status, bone health and quality of life should be closely monitored during treatment.

When Does Chemotherapy Come Into Consideration?

Chemotherapy is one of the systemic treatment options generally evaluated in advanced-stage, metastatic or hormone therapy-resistant prostate cancer. Chemotherapy is not required for every early-stage prostate cancer patient. The aim of treatment is to control disease progression, reduce complaints and contribute to survival.

Prostate cancer chemotherapy treatment is planned according to the person’s general health status, blood values, disease spread and response to previous treatments. Chemotherapy may be applied together with hormone therapy or after it in some patients. The frequency and duration of application vary according to the drug used and the response to treatment.

During chemotherapy, side effects such as fatigue, nausea, hair loss, susceptibility to infection or decreased blood values may occur. Therefore, the person’s general condition is evaluated before treatment and the process is monitored with regular controls.

How Is Advanced-Stage Prostate Cancer Treatment Planned?

Advanced-stage prostate cancer may be defined as the disease extending beyond the prostate, spreading to lymph nodes or showing distant organ involvement. In this case, treatment may not be directed only at the prostate region; systemic treatments targeting cancer cells in the body are also planned.

Within the scope of advanced-stage prostate cancer treatment, hormone therapy, chemotherapy, radiotherapy, new-generation hormone-suppressing drugs and different drug options according to the characteristics of the disease may be used. In some patients, regional radiotherapy may be applied to reduce pain related to bone involvement. In some cases, treatments directed at the prostate region may also be part of the general treatment plan.

In advanced stages, the aim is to keep the disease under control, reduce the speed of spread, relieve pain and similar complaints, and support quality of life. Response to treatment is monitored with PSA follow-up, imaging methods and general health evaluations.

How Is Metastatic Prostate Cancer Treated?

Metastatic prostate cancer is a condition in which the disease spreads beyond the prostate to bones, lymph nodes or different organs. At this stage, the treatment plan is generally based on systemic treatments. Hormone therapy, chemotherapy, new-generation drugs and radiotherapy in some patients may be evaluated together or sequentially.

Metastatic prostate cancer treatment is planned according to the person’s disease burden, spread areas, PSA value, previous treatments, general health status and possible response to treatment. Supportive treatments to protect bone health may also come into consideration in patients with bone metastasis.

In metastatic disease, the aim of treatment is not so much to completely eliminate the disease, but to keep it under control, slow progression, reduce pain and preserve quality of life. Therefore, regular follow-up and evaluation of treatment response are very important.

Why Is PSA Follow-Up Important After Treatment?

PSA follow-up is one of the main monitoring methods used to evaluate disease control after prostate cancer treatment. After surgery, PSA value is expected to decrease to very low levels. After radiotherapy, PSA may decrease more slowly and is followed at certain intervals.

Prostate cancer PSA follow-up is important to evaluate response to treatment and detect possible recurrence suspicion early. An increase in PSA value does not always mean the same thing; it should be evaluated together with the treatment method, timing, previous values and imaging results.

During follow-up, in addition to PSA, examination, imaging methods and the person’s complaints are also taken into account. The frequency of controls is planned according to the risk level of the disease and the treatment applied. Regular follow-up helps make new decisions in a timely manner after treatment.

In the post-treatment period, pelvic floor exercises, lifestyle adjustments, regular controls and necessary supportive treatments may help improve quality of life. In this process, not only cancer follow-up but also functional conditions affecting daily life should be evaluated.

Evaluation Process For Prostate Cancer Treatment In Ankara

The evaluation process for prostate cancer treatment in Ankara begins with determining the stage of the disease and planning the treatment method suitable for the person. PSA value, biopsy result, prostate MRI, imaging findings and general health status are evaluated together, and the appropriate option is selected among active surveillance, surgery, radiotherapy, hormone therapy or other methods.

For people searching for Ankara prostate cancer treatment, the important issue is not only the name of the treatment method. At which stage the treatment is recommended, how the follow-up process after surgery or radiotherapy will proceed, and how urinary control and sexual functions will be evaluated are also part of the decision process.

People diagnosed with prostate cancer or those who want an evaluation about different treatment options can plan their treatment options according to their personal condition with the support of an Ankara urology specialist. The aim in this process is to determine the correct treatment approach by evaluating the biological characteristics of the disease together with the person’s general health condition.

Prostate cancer treatment is not planned through a single procedure or standard method. The stage of the disease, risk level, PSA follow-up, biopsy result, spread status and factors that may affect the person’s quality of life are evaluated together. While active surveillance, surgery or radiotherapy options may be considered in the early stage, hormone therapy, chemotherapy and systemic treatment options may be planned in advanced stages. Regular follow-up is important for the safe and controlled progress of the post-treatment process.

Frequently Asked Questions About Prostate Cancer Treatment

How Long Does Prostate Cancer Treatment Take?
The duration of prostate cancer treatment varies depending on the method applied. While surgery is a single procedure, radiotherapy and drug treatments may be planned in specific sessions or periods.

Can Prostate Cancer Be Treated Without Surgery?
In some patients, active surveillance, radiotherapy, hormone therapy or drug treatments may be considered as non-surgical options. Which method is suitable is determined according to the stage and risk level of the disease.

What Should PSA Be After Prostate Cancer Treatment?
After surgery, PSA value is expected to decrease to very low levels. After radiotherapy, PSA may decrease more slowly, and results are interpreted according to the type of treatment.

Can Prostate Cancer Recur After Treatment?
Prostate cancer may recur in some patients after treatment. Therefore, PSA follow-up and regular control should not be neglected.

Can Urinary Incontinence Occur After Prostate Cancer Surgery?
Temporary urinary incontinence may occur in some people after surgery. The recovery process varies depending on the surgical method, age and condition of the pelvic floor muscles.

Is Sexuality Affected After Prostate Cancer Treatment?
Surgery, radiotherapy and hormone therapy may affect sexual functions. The degree of effect varies depending on the treatment method, age and whether a nerve-sparing approach is applied.

Who Is Robotic Surgery Suitable For In Prostate Cancer Treatment?
Robotic surgery may generally be considered in prostate cancer patients whose disease is limited to the prostate or who are considered suitable for surgery. Suitability is determined according to the stage of the disease, tumor location and general health status.

How Is Follow-Up Performed After Prostate Cancer Treatment?
Follow-up after treatment is usually performed with PSA testing, examination and imaging methods when necessary. Control intervals are determined according to the risk level of the disease and the treatment applied.