Prostate cancer options vary from 'watchful waiting' to radiation therapy

Prostate cancer is the most common cancer diagnosed in men in the nation.

Nearly 181,000 new cases will be detected in the United States in 2016, according to the American Cancer Society. Prostate cancer is also second only to lung cancer as a cause of cancer deaths in men.

The most appropriate treatment for prostate cancer should be based on the man's age, life expectancy and other medical problems, as well as the stage and aggressive nature of the cancer.

Treatment options for localized prostate cancer include:

Observation (watchful waiting).

Radical prostatectomy.

External beam radiation therapy.

Stereotactic body radiation therapy.

Brachytherapy ? the implanting of radioactive seeds into the prostate.

Watchful waiting is unique to prostate cancer. In most cases, prostate cancer is a slow-growing cancer that can be monitored closely instead of pursuing treatment right away. In this situation, a man is seen by his physician regularly for digital rectal exams, PSAs and, if needed, a repeat prostate biopsy. If necessary, the physician might recommend moving to a more aggressive treatment plan.

Prostate cancer can be treated often with surgery or radiation therapy. Surgeons can perform a radical prostatectomy to remove the prostate. Some men might be candidates for minimally invasive surgery, which involves smaller incisions, less pain and a speedier recovery.

Radiation oncologists treat prostate cancer using IMRT or intensity modulated radiotherapy. With IMRT, we are able to deliver radiation directly to the prostate, minimizing harm to the surrounding organs, including the bladder, the rectum, the femoral heads and the small bowel. IMRT also has been shown to be beneficial in reducing long-term side effects of prostate cancer.

When we treat men for prostate cancer using radiation, the radiation beams are only passing through the pelvis. As a result, the side effects of treatment impact the organs that are in the pelvis and not elsewhere in the body.

Men undergoing prostate cancer treatment with radiation might notice an increase in urination and experience some burning when urinating. Men also might have trouble starting their stream.

There could be an increase in bowel movements or loose bowel movements as the end of treatment nears. Usually, these side effects go away when radiation ends. However, approximately 20 percent of men will require a medication like Flomax to help them with their urination long-term.

McLeod recently installed its second TrueBeam linear accelerator. Not only does this treatment machine allow for improved images of the tumors and normal organs, but it also allows for faster treatment times. For example, using traditional radiation machines, treatment can take 15 to 20 minutes to treat men with prostate cancer, while the TrueBeam provides the capability to treat men within five minutes.

There is no one treatment option that is better for all men. If you are diagnosed with prostate cancer, have a thorough discussion with your physician of all treatment options so you can decide together which one is best suited for you.

McLeod offers men in the region an active prostate cancer program, which includes urology, oncology and radiation oncology physicians all working together to provide the best treatment plans and outcomes.

Dr. Virginia Clyburn-Ipock is a board-certified radiation oncologist with the McLeod Center for Cancer Treatment and Research. She received her medical degree from the Medical University of South Carolina in Charleston. She completed a residency in radiation oncology at the University of Texas Health Science Center at San Antonio, where she served as chief resident. Clyburn-Ipock also has special training in Stereotactic Body Radiation Therapy and IMRT. For more information or to ask a cancer specialist questions, visit McLeodCancer.org.