Hormone therapy, radiation, and surgery are valuable tools in the medical arsenal to tackle prostate disease, which according to the American Cancer Society, is the most common cancer in American men next to skin cancer. There are almost 200,000 new cases each year and over 33,000 deaths in 2020, according to ACS estimates.
A new study published in JAMA Network Open found that men with unfavorable intermediate-risk prostate cancer could benefit from having androgen-deprivation therapy, or ADT, and lived eight months longer than men who did not receive the hormone therapy after 15 years. ADT reduces androgen hormones like testosterone and stops them from feeding cancer cells, according to Harvard Health Publishing. The study subjects also received radiation therapy.
Dr. David Samadi, the director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island, and a renowned prostate surgeon, tells Newsmax that the study shows that there are many treatment options available for prostate cancer patients, and offers his advice.
“We need to carefully evaluate the risk versus the reward when deciding on prostate cancer treatment,” he said. Samadi said that, when caught early, prostate cancer has an amazingly high five-year survival rate of almost 100% if found localized or regional. But this high survival percentage drops off sharply to only about 38% survivability if the cancer has already spread beyond the prostate to distant areas such as the bones or liver.
A diagnosis of prostate cancer is like approaching a fork in the road, says the expert, who is a contributor to Newsmax TV.
“There are numerous treatment options available, each with its pros and cons, including side effects,” says Samadi. “How prostate cancer is treated will determine what a man’s life will look like in the future. You need to consult with an experienced doctor who can address your personal needs.”
Samadi says that while ADT, the hormone therapy described in the study may appear favorable, there are side effects that include weight gain, hot flashes, loss of libido, breast enlargement, erectile dysfunction, osteoporosis, reduced muscle mass, mood swings, and depression. A man’s life may be extended by a few more months but his quality of life drops dramatically.
“I also want to address radiation treatment for prostate cancer,” says Samadi. “Some men mistakenly believe trying radiation first before considering surgery is superior for treating their cancerous prostate. They rationalize if their cancer comes back after radiation, then they will consider surgery. But there is a catch: men who choose radiation first over surgery as a treatment method, will wish they hadn’t. Surgery after radiation is almost impossible.”
Prostate tissue that has undergone radiation can become almost like cement attaching to the rectum and surrounding tissue. This unfortunate side effect significantly increases the risk of incontinence and erectile dysfunction. There is also the risk of cystitis, urinary frequency, urethral structures or scar formation, and a possible chance of an increased risk of rectal or bladder cancers.
Surgery may be the best option for some men to treat prostate cancer.
“While surgery may seem scary to some men, the robotic-assisted laparoscopic prostatectomy is an excellent option for men with a long life expectancy and whose cancer is contained within the prostate,” says the expert who specializes in this procedure.” Many advances have been made in surgery keeping side effects minimal – little to no blood loss, less pain, shorter recovery, and better preservation of urinary and sexual functioning.”
Samadi says the biggest reason for choosing surgery over radiation first if that is an option, is that there is no risk of a secondary prostate cancer recurring.
“That should put any man’s mind at ease,” he says. “When it comes to cancer treatment, making decisions can be tough. That is why my advice for men with prostate cancer is this: choose wisely, look at all options, research the experts in this field, and get a second opinion. Men who make good prostate cancer treatment decisions will also likely have good outcomes. And my job as a prostate cancer surgeon is to work with patients helping them achieve the outcomes most important to them.”
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