Many men who are diagnosed with prostate cancer opt not to get treatment. Here are some of the reasons why.
Prostate cancer is, after skin cancer, the second most common cancer in men in the United States. The American Cancer Society estimates that 200,800 men will be diagnosed with prostate cancer in the USA in 2015. One out of six white, Hispanic,and Asian men in the United States and one out five African-American men will be diagnosed with the disease at some time during their lives.
Prostate cancer rates differ by as much 5000 percent from country to country. The disease is most common in northern Europe, Australia, and the United States, and relatively rare in South Asia and North Africa.
How Is Prostate Cancer Treated?
Prostate cancer is most commonly treated with surgery, the removal of the prostate, or radiation, the planting of radioactive "seeds" around the prostate to deliver a continuous dose of radiation. The disease may also be treated with hormone therapy, usually hormones to counteract the production of testosterone, and sometimes by cryosurgery (freezing), high-intensity ultrasound, or focused proton-beam radiation.
Surgical treatments include nerve-sparing techniques, designed to minimize the frequency of impotence or incontinence after the procedure, laparoscopic procedures, which involve smaller incisions, robotically-assisted procedures, which are more precise, and the classic retropubic prostatectomy and perineal prostatectomy, both of which involve large incisions and cutting through considerable tissue.
Complications Of Prostate Cancer Treatment
A study published in the Jan. 31, 2013 issue of the New England Journal of Medicine confirms that there are long-term complications to prostate cancer treatment. Researchers enrolled 1,655 men in the Prostate Cancer Outcomes Study (PCOS). In this group, 1,164 had had surgical removal of the prostate,and 491 had been treated with radiation. Most of the men were in their sixties when the cancer was diagnosed and they were treated.
Two years and five years after treatment, most of the men were still alive.
Men who had radiation treatment instead of surgery were less likely to experience urinary incontinence or erectile dysfunction. However, these problems did not get better with time. Fifteen years after treatment, almost all the men in the study reported having problems getting erections, 87 percent in the radiation treatment group and 93.9 percent in the radiation group.
These are not the only potential complications of prostate cancer treatment. A relatively common complication of treatment is bowel leakage, the inability to control bowel movements. Two and five years after treatment bowel leakage was more common among men who had received radiation treatment than in men who had had their prostates removed. By the time fifteen years had passed, however, both groups were equally likely to have bowel control problems.
Side Effects Of Hormone Treatment
Some men also receive treatment with androgen deprivation therapy, designed to counteract the production of testosterone in the testes, or combined androgen blockade, which is intended to block both the 90 percent of testosterone that is made in the testes and the 10 percent of testosterone that is made by the adrenal glands. These therapies may be continuous, given on a regular basis, or intermittent, given when laboratory results indicate the cancer is active. Continuous therapy elevates the risk of heart disease, while intermittent therapy elevates the risk of cancer progression.