Dr. Patrick Walsh's Guide to Surviving Prostate Cancer summary

Thinking about prostate cancer isn’t fun. Nobody wants the hassle of going to the doctor and having an uncomfortable rectal exam. But the consequences of not finding it early can be much worse.

The thing about prostate cancer is that, in its early stages, it is silent. No symptoms, no warning signs, nothing. Until it grows outside of the prostate, in which case it is rarely curable.

You may be asking yourself: “What’s the best treatment for prostate cancer?” Unfortunately, there is no answer to this question. A better question is: “What is the best treatment for me?”

You see, everybody’s experience is different. It’s not just the severity and grade of the tumor that can influence treatment decisions – there are also things like age and general health to consider.

Picture, if you will, the many-headed hydra from Greek mythology. You battle this fearsome beast, cutting off its heads, only to have more grow back in their place. This is not too different from prostate cancer – on average, three to seven tumors will be growing in the prostate at once. So, instead of chopping off the heads, why not target the whole thing?

Radical prostatectomy is the most effective cure if the cancer is confined to the prostate. It’s considered the gold standard in treatment, and if done by an experienced surgeon, negative side effects like impotence and incontinence can be rare.

For some men, surgery can be much too invasive, and the associated risks and recovery time are not worth the trouble. Luckily, several less-invasive treatments are considered nearly as effective.

One such option is radiation therapy. This basically involves shooting radiation at the prostate, causing the targeted cells to die. The right amount of radiation must be used so the cancer is killed, but not the surrounding healthy tissue. Luckily the method has been finetuned over the years, and it is now extremely accurate and precise. The patient wears a custom-made body suit so they remain completely still, and the same position can be reproduced for each dose of radiation.

There is one remaining avenue to explore when looking at treatment options: Hormone therapy.

The treatments you’ve seen up until now are most effective for treating lower-grade, localized prostate cancer, which is still contained to the prostate. Because hormone therapy does not actually cure the cancer, it should not be used as the primary treatment in these situations. However, hormone therapy becomes essential when the disease is metastatic, meaning it has spread to other parts of the body.

You’ve consulted your doctor, chosen the right treatment for your unique situation, and undergone whatever procedure was deemed best. You may be asking yourself: Will my cancer be cured forever?

For prostate cancer to be cured, two things must be true. Firstly, the cancer needs to be diagnosed at a stage where it is curable – meaning it hasn’t established itself outside of the prostate. Secondly, the treatment has to work. If these conditions are met, a complete cure is possible.

The story of prostate cancer is constantly changing and being retold. Only a few decades ago your options would have been limited and extremely brutal. Now we know enough to be able to confidently monitor a confirmed cancer using active surveillance if it isn’t an immediate threat.

And more aggressive treatments such as radical prostatectomy and radiation therapy are tested and reliable enough to let us face the disease head-on. Even the less preferable option of hormone therapy offers promising results in the later stages of cancer.