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Things to consider about prostate cancer treatment
By Mayo Clinic staffChoosing the treatment that's best for you means weighing all options in relation to your values and situation. As you make the decision about how your prostate cancer should be treated, here are some issues to consider and questions to ask yourself and your doctor.
- How much time should you take to make your decision? Consider the aggressiveness of your prostate cancer — is it likely to grow rapidly or slowly? If it's growing quickly, it's important to make a reasonably quick decision and proceed with treatment. Many prostate cancers grow slowly and don't require immediate or aggressive treatment, so there may be no need to rush your decision.
- How healthy are you? Do you have other diseases or conditions that may change your state of health over the next few years? If you're relatively healthy, you may want to consider aggressive treatment options, which may help you maintain that level of health. However, if you have other conditions affecting your health, you may choose to not treat your prostate cancer as aggressively because you're less likely to experience many of the long-term side effects of prostate cancer.
- How old are you? Prostate cancer in your 40s is different from prostate cancer in your 80s. If you're a man in your later years, aggressive treatment may not extend your life and thus may not be warranted. A younger man may fare better with aggressive treatment, as not only will it extend his life but recovery is usually better in younger men. It's also important to consider how you feel about life. Do you think of yourself as young and active? If so, you may find it worthwhile to consider more-aggressive treatments, regardless of your chronological age.
- How will your treatment choice and its potential side effects affect your lifestyle? How much will your chosen treatment affect your current lifestyle? Does the prospect of side effects — particularly impotence and urinary incontinence — bother you enough to sway your decision? Can your lifestyle accommodate a course of daily external beam radiation therapy?
- Are you willing to commit to follow-up care? Are you willing to undergo routine blood tests, digital rectal exams and perhaps repeat biopsies? Are you willing to schedule follow-up appointments with your doctor as necessary? Are you committed to a close partnership with your doctor, who will likely be your partner in fighting this disease?
- Is your doctor's experience and training having undue influence on your treatment decision? Make sure you and your doctor decide on the treatment that's judged to be best for you, not just the treatment that your doctor is trained in or has the most experience with.
- Once your treatment ends, how much will you continue to worry about recurrent cancer? If you choose watchful waiting, how will you feel knowing that untreated cancerous cells are inside your body? If you choose radiation — either seed implants or external beam radiation — will you feel confident that the cancer is under control? Or, will you feel more secure with surgery to remove the cancer?
- How do you find a doctor who's skilled in the procedure? Before deciding on a procedure, talk with a doctor who can help explain the complexity of the choices you're facing and one who will listen to your concerns and values about health-related quality-of-life issues. You may feel more comfortable with making a decision after you've heard a second opinion. Doctors who treat prostate cancer are urologists, radiation oncologists and medical oncologists. You may want to talk with a specialist in each of these areas because each may have a different opinion on how best to proceed. If you choose a treatment option other than watchful waiting, select a doctor who has extensive experience with it. In many cases, your primary care doctor may refer you to one or more specialists. You can also get the names of specialists from a nearby hospital or medical school, or contact the National Cancer Institute's Cancer Information Service at 800-4-CANCER, or 800-422-6237. Any of these sources can give you information about cancer centers and programs supported by the National Cancer Institute.
- How will your decision affect the relationship with your life partner? If you're married or in a relationship, you may want to think about how your choice will affect your partner. It's your life, but both of you will have to live with the decision. Treatment for prostate cancer can be a life-changing event. An open, honest discussion before making a treatment choice can help you both cope afterward if urinary or sexual dysfunction results. Discuss the trade-offs between short-term and long-term effects. Your partner can help you talk through the value you place on certain benefits and risks. Your decision has biological, psychological and social aspects and may very well affect your sexual relationship and your daily life for years after therapy is complete.
