Over the years, a wide array of treatments for prostate cancer have been developed including surgery, radiation, hormone deprivation therapy, chemotherapy, dietary changes and the use of various herbal supplements. Deciding which of these treatments to select is a difficult decision. Prostate cancer is a complex heterogeneous disease that acts differently in different men. Fortunately, for most men, most prostate cancer grows very slowly. The slow rate of growth, however, coupled with the widely varied presentation, has made it difficult, if not impossible, to determine scientifically which treatment is best for which man.
Since there is no ?one size fits all? treatment, each man must learn as much as he can about various treatment options and, in conjunction with his physician, make his own decision about what is best for him. It may be reassuring to know that 86% of all prostate cancers are diagnosed in the local and regional stages and that the 5-year relative survival rate for men whose prostate cancer is diagnosed at this early stage is nearly 100%. Additionally, according to the most recent data, the relative 10-year survival rate is 86%, and the 15-year survival rate is 56% (ACS Cancer Facts & Figures, 2004). A variety of factors that must be considered and evaluated before deciding on a treatment plan (or no treatment at all) include the stage of the prostate cancer, age, other health issues and the patient's willingness to undergo certain procedures or therapies ? some of which may have side effects.
At this time, it is virtually impossible to know how rapidly or slowly a particular man's prostate cancer will grow ? because at the time of diagnosis it is not known how long the prostate cancer cells have been developing. If the cancer has been found to be contained within the prostate, it could take years for a tumor to double in size. In fact, the cancer might stay within the confines of the prostate indefinitely and never cause problems. Alternatively, the cancer might be growing very rapidly and might spread to other parts of the body quickly.
The Gleason Grade discussed in the ?Screening & Diagnosis? section of this website, helps to provide some basis for determining how slowly or rapidly the prostate cancer cells might grow. However, it is an imperfect means of predicting the future behavior of the cancer cells. This uncertainty creates challenges for men diagnosed with prostate cancer in deciding how aggressively to treat the cancer.
The key is to collect as much information as possible before making a final decision ? and if you are being encouraged to pursue one particular treatment by your physician, it may be valuable to get a second or third opinion, just to be sure that you have received a balanced view of your particular situation. Keep in mind that second and third opinions can sometimes be confusing because you may receive conflicting advice or opinions. That is why it is important to gather as much information about your particular cancer and the various treatment options as possible, so you can make an informed decision about which treatment is best for you.
Making a decision regarding treatment can be helped by talking with a spouse, friends, family and other men who have prostate cancer. When speaking with other men with prostate cancer, however, it is important to remember that their circumstances (including the grade and stage of their cancer) may be very different from yours. The treatment decisions that they have made may not be appropriate for you.
Because dealing with a prostate cancer diagnosis can be very stressful, attending to your psychological and spiritual well-being is also important. Reaching out and including those close to you may be crucial to helping you deal with this stress. Some people have trouble asking for and accepting support, even from family members, but a diagnosis of prostate cancer may require that you consider reaching out to others, even if you don't normally do so.