Harlem Word: Dr. Carlton McGregor explains the treatment options for men with prostate cancer

Editor November 11th, 2010

New York Presbyterian Hospital's Dr. Carlton McGregor, MD, discovered he had prostate cancer in fall 2009. In October 2009, he had surgery to remove his prostate. In this article, Dr. McGregor breaks down the different types of treatment for prostate cancer. Read more below!

 Q: What are the treatments for prostate cancer?

A: Depending on the stage of the cancer and your age, there are several treatment options for prostate cancer that have been confirmed:

1. Surgery or prostatectomy: the prostate is removed. It is a single treatment method, which means that no additional treatment is expected.

2. Radiation therapy: uses high-power x-rays or other radiation to kill cancer cells. There are different radiation types. There is external beam radiation, which involves daily radiation treatments on the prostate. You can also have radiation implants, or brachytherapy, into the prostate itself to destroy the cancer. The radioactive implants are the size of rice and stay in the prostate, but their radioactivity goes away over time. A man can also get post-surgical radiation treatment to reduce the chances that the cancer will come back after surgery for prostate removal.

3. Cryotherapy: when your doctor freezes the cancer cells in the prostate gland. During this process, the doctor puts metal probes, or rods, into the prostate and freezes all the cancer cells causing them to die.

4. Drug or hormone therapy: usually used when prostate cancer can't be treated through surgery or other options. Hormone therapy uses drugs to stop the body from making male sex hormones or block hormones from getting into cancer cells. By reducing male sex hormones, it keeps the prostate cancer from growing faster and can control the cancer from spreading.

5. Expectant management or "watchful waiting,": involves watching for new signs or symptoms of prostate cancer. This is done through regular blood tests, rectal exams, and biopsies. It may be an option for men over 70, those in poor health, and men whose cancer is small and slow-growing. If you're in your 70s and you don't have symptoms, you may decide you are going to watch it. If you catch the disease early on through screening, you are probably going to want to do more than just watch it. This is because when you do decide to treat it, it may be too late and the cancer may have already spread.

Q: What suggestions do you have for men who need to make a treatment decision?

A: The key thing to consider is your age of diagnosis. The younger you are, the more likely your doctor is going to recommend surgery because it removes the prostate. You also need to think about if you have any other medical issues because they may influence your decision.

Although people have access to a lot of information about the treatment options, when it comes time to make a decision, you need a lot of input. You have to talk to your mate to find out if they agree with you because you can't make a decision by yourself that affects two people-especially if a side effect is sexual dysfunction. Making the choice involves a lot of discussions with your mate, your surgeon, and your urologist. If you have a good urologist, he or she will sit there and discuss the options with you. I think you need to wait until you get to that situation and see what the variables are and go from there.

Q: What kind of treatment did you have?

A: I had robotic surgery. The surgeon removed the prostate through 6 small incisions, or cuts, in my stomach instead of one large incision. The surgical instruments are placed through the incisions and then controlled by a precise robot. With this type of surgery, you have less bleeding and scarring and recover more quickly. Not everybody can have this type of surgery because it depends on the size of the cancer in the prostate. By getting prostate cancer detected earlier, you have more options, such as less invasive robotic surgery.

To read more about prostate cancer, Dr. McGregor recommends visiting the Mayo Clinic Prostate Cancer website.

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