The following questions and answers were provided by Rajat Malhotra, MD, Medical Oncology/Hematology at Illinois Cancer Specialists in Arlington Heights.
1. What determines the stage of my disease?
The stage is typically determined after a biopsy reveals prostate cancer. Certain characteristics about a prostate cancer will require some patients to have testing to learn the extent (stage) of the disease to help decide the best treatment approach. Staging can include bone scans, CT scans and MRI examinations.
2. What is the goal of my treatment?
This is an important question to ask as there are certain stages of this disease that are curable: stages I–III versus stage IV, which is typically not curable.
3. What are my treatment choices?
Treatment choices may include active surveillance in very early stage, nonaggressive prostate cancer. More aggressive or higher stage cancers will require active therapy. These can include surgery and/or radiation therapy, with or without antihormonal therapy.
4. When considering either surgery or radiation therapy, what are the possible lasting side effects from either treatment, and how might they affect my quality of life?
Common side effects from surgery may include some urinary incontinence and impotence. The impotence can come from damage to the nerves around the prostate. Most men regain some bladder control after a few weeks postoperatively. Common side effects from radiation therapy will depend mainly on the dose and type of radiation therapy performed. Both external and internal radiation can cause impotence. Internal radiation therapy may cause incontinence, which typically minimizes and goes away with time. Not every patient will have the same side effects from surgery and/or radiation therapy. Each person will react differently to his treatment.
5. After I have radiation and/or surgery, will additional treatments be needed such as antihormonal therapy?
Sometimes patients will need anti hormonal therapy prior to or after therapy, based on staging and other pathological findings.
6. How should I follow up after I receive surgery and/or radiation therapy?
This may include regular examinations along with blood testing, usually every three to six months for five years. Occasionally, further radiological studies are performed in the follow-up.