I have prostate cancer. Which treatment has good recovery?

Question

Hello doctor,

I am a 62-year-old man recently diagnosed with prostate cancer. My doctor said it is in an early stage, but I am still very anxious. They mentioned options like surgery, radiation, or just monitoring it for now.

I am worried about side effects such as incontinence and erectile problems after treatment. How do I decide which option is best for me?

I also want to know if diet or exercise can help slow the cancer. My wife and I are concerned about how this will affect our relationship and daily life.

Please explain what recovery looks like after treatment and what warning signs I should watch for if it comes back.

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I hope you are doing well. I truly understand and appreciate the amount of fear and anxiety you are experiencing after being diagnosed with prostate cancer. I also know that your wife and life partner must be feeling worried as well.

However, I would like to reassure you that we have many different treatment modalities for prostate cancer. The choice of treatment mainly depends on the PSA (prostate-specific antigen) level, the Gleason score, and whether the tumor is metastatic or not.

Since the cancer is non-metastatic, we will focus primarily on the PSA level and the Gleason score. If the PSA is less than 10 and the Gleason score is less than seven, in this case, we can consider an approach called active surveillance or watchful waiting.

This means that every three months, we will check your PSA level, monitor your condition closely, and make sure everything is stable. If at any point we notice any changes, we can intervene with appropriate treatment modalities.

If, however, the PSA level and Gleason score are high, then we have other options such as radiotherapy or surgery.

We usually prefer radiotherapy over surgery because surgery has many side effects, including permanent urinary incontinence and permanent erectile dysfunction. In general, side effects from surgery tend to be permanent, whereas the side effects of radiotherapy are usually reversible.

For example, if you experience mild urinary tract symptoms or some gastrointestinal upset, these usually resolve once the radiotherapy sessions are completed.

Nowadays, radiotherapy has become much more precise. It targets the tumor cells themselves rather than the surrounding healthy cells, which significantly reduces side effects compared to surgery.

Regarding your sexual relationship with your wife, it is not affected unless we use hormonal therapy. Hormonal therapy is usually required if, after radiotherapy or surgery, the PSA level remains high.

In that situation, we may prescribe hormonal therapy for a period such as six months, and then stop it once the PSA returns to normal.

Hormonal therapy is what can reversibly affect sexual function, meaning that after we stop hormonal therapy, everything will be okay. Otherwise, there is no effect on the relationship, and everything should be fine.

The treatment plan for you is active surveillance and radiotherapy.

Throughout all stages of treatment, it is very important to pay attention to nutrition, eat plenty of vegetables and fruits, and make sure you are well hydrated. This will support the treatment and help achieve better outcomes.

You can schedule a follow-up appointment after seven days to monitor your progress and address any concerns.

I wish you a speedy recovery, and I hope this explanation is clear and helps you make the right decision. If you have any questions at any time, we are always here to support you.

I hope this helps.

Thank you.