You have learned that it is “HIM” and your life has been broken into a million tiny pieces. While a prostate cancer diagnosis is always a shock, it doesn’t mean the end. This is the beginning of treatment and the fight for health. Thanks to modern medicine, the chances of recovery and long-term survival are high, even in the case of advanced prostate cancer.
Not only you…
It is quiet – it can remain silent for years. It is cunning – its first symptoms may resemble benign prostatic hyperplasia (BPH). It is common – it is estimated that about 300-400 Polish men are measured each week with the diagnosis of prostate cancer. [1]
You may have learned that you are one of them under various circumstances. Perhaps you routinely performed a Prostate Specific Antigen (PSA) test and the result was abnormal. Or maybe it was different, and the disturbing symptoms, ranging from lower urinary tract symptoms (LUTS), to erectile dysfunction, to bone pain, prompted you to visit your GP who referred you to the clinic. urological.
However, the rest was similar … During the rectal examination, the doctor found abnormalities in the structure of the prostate gland. The next step was a biopsy, the result of which you waited for several days. Those were the longest days of your life. You’ve been struggling all the time with your thoughts: What if it’s cancer …? May it not be cancer …
And it happened … – you heard the diagnosis. As the first shock passed, other emotions started to arise: anger, anger, denial, guilt, and a boomerang-like question: why me? The truth is, statistically, prostate cancer affects one in seven men in our country. [1] It is the most frequently diagnosed malignant neoplasm among Polish men.
However, there is good news: prostate cancer detected early is completely curable. Moreover, as experts argue, new treatment options, including innovative drugs, have made advanced prostate cancer a chronic disease. You wonder what awaits you now and what the treatment looks like. We already explain …
Three treatment options
Treatment options for prostate cancer depend primarily on the stage of the disease, but also on your age and health, especially the presence of comorbidities such as: hypertension, heart disease, diabetes and obesity.
According to the current guidelines for the therapeutic management of patients with low-risk cancer meeting certain criteria, active surveillance is proposed. In practice, the man is subject to special observation, including repeated PSA determinations (usually every 3 months) and repeated biopsies. It is estimated that half of men under active surveillance will never require any form of radical treatment and thus avoid complications associated with it. [2]
The treatment of a more advanced stage of gland cancer includes: surgery to remove the prostate, the so-called Radical prostatectomy or radical radiotherapy, i.e. irradiating the prostate with ionizing rays. The recommendation regarding the choice of therapy should be made by a council of doctors of various specialties: urologists, oncologists, radiologists and radiotherapists, and then discussed with the patient, who is responsible for the final decision.
Radical prostatectomy is usually performed in patients whose cancer is confined to the prostate gland and whose life expectancy is longer than 10 years. It is also a method recommended for patients with cancer that infiltrates periosteal tissues. During the procedure, the cancerous area (including, in some cases, the pelvic lymph nodes) is carefully removed. All removed structures are sent for histopathological examination, which allows to finally determine the malignancy and stage of the neoplasm. The result of this examination also determines the scheme of further management – termination of treatment or undertaking further, complementary therapeutic steps.
There are currently three surgical techniques in use: open, laparoscopic and robotic laparoscopic. The last two allow you to shorten the hospitalization time, reduce the level of blood loss, and reduce the risk of the most common side effects of radical prostatectomy: urinary incontinence and erectile dysfunction. Unfortunately, not all centers in Poland have the same experience in conducting minimally invasive surgical methods. While in developed countries the percentage of robotic operations reaches even 98%, in Poland it is only about 22%. all radical operations. [3]
The third treatment option for prostate cancer is radical radiotherapy. Like radical prostatectomy, it is a method that can have complications, mainly due to the response of surrounding healthy tissues to radiation. The most common of these include: urinary incontinence, inflammation of the urinary bladder and rectum, swelling of the lower limbs or lack of erection.
The good news for patients is that innovative technologies (cybernetic knife, gamma knife, tomotherapy) are used more and more, which significantly shorten the duration of therapy, save healthy tissues and reduce the number and intensity of side effects, with high treatment effectiveness at the same time.
Also, in the case of advanced metastatic prostate cancer, when radical treatment is not possible, patients have a chance of a long life. Then, hormone therapy, chemotherapy, new targeted drugs, radiotherapy and analgesic treatment are used. Importantly, the use of effective treatment of advanced prostate cancer allows to inhibit the progress of the neoplastic process, and even reduce the size and number of metastases and reduce negative symptoms, including pain.
Although the last 3 years have brought an improvement in the access to innovative treatment of Polish patients with prostate cancer, clinical experts emphasize the need for further evolution of the drug program, including providing access to innovative pharmacotherapy. Clinical guidelines more and more often recommend treatment regimens that recommend the use of effective treatment as early as possible in the development of the disease, without waiting for its progression, which translates into better results.
Advice for you
Prostate cancer today is not a sentence but a challenge that can be overcome. The success of treatment depends to a large extent on you and your active participation in this process and adherence to doctors’ recommendations.
Therefore, never be afraid to ask – if you have trouble understanding what specialists say to you, ask for an explanation or come to an appointment with someone close to you who will help you during the consultation. Getting as much knowledge as possible about the disease that you have suffered will reduce the fear of the unknown and will allow you to better find yourself in the new situation.
Finally, remember that you are not alone! Think about what you need now and clearly tell your family and friends about it. Your loved ones can become an important source of emotional support and practical knowledge related to the management of the disease.
You can always ask the coordinating physician for information about the psychologists or psycho-oncologists working at the facility and about the possibility of using their advice. Many hospitals also hold special workshops where people dealing with cancer meet.