Cancer cure is the goal of radical prostatectomy surgery. Unfortunately, despite earlier detection and treatment of Prostate Cancer today, recurrence following surgery is experienced in about 30% of cases. For many men, due to age or the nature of their cancer, treatment may not be required for many years, or ever. When it is determined that further treatment should be undertaken, hormonal therapy is typically the first treatment used. It will kill some cancer cells and will slow the cancer’s progress. But before agreeing to start hormonal therapy “a man should always question his doctor:

• What exactly are you planning to accomplish with hormonal therapy?
• Will the cancer-fighting benefits offset the quality-of-life negatives?
• Will I live longer?

If you are not satisfied with what you hear from your physician, seek a second opinion.” – Jacek Mostwin, M.D., D. Phil., The Johns Hopkins Prostate Library.

How Does This Work?

Based on my readings, I’ll attempt to describe the process. To grow and develop most cancerous prostate cells need a hormone called testosterone. The body produces testosterone. The goal of hormone therapy is to block production of testosterone. When the supply of testosterone is shut off by drugs, tumours generally shrink or regress. Absent testosterone, the prostate cancer may stay in remission for years. Men need to understand, however, that there is no known cure for recurring prostate cancer. Unfortunately the cancer cells that may eventually prove fatal are the hormone-insensitive cells. They continue to grow when testosterone is not present. Current research is making significant advances in developing secondary and even tertiary treatments that do extend patient survival periods. These developments are very positive and give rise to the expectation that a cure will be found.

Nobody said it would be easy.

Hormone therapy can cause significant side effects after several months of treatment. Following the removal of the prostate gland, men with no prostate cancer symptoms should give careful consideration to possible quality of life issues associated with hormone therapy before agreeing to go ahead with the treatment. In other words, if there are no symptoms evident, the anticipated benefits of hormone therapy may not match the negative quality of life issues that result from hormonal therapy. Long-term side effects may include one or as many as all the following:

• Decrease in mental acuity
• Loss of muscle mass
• Decreased energy
• Loss of sexual function
• Osteoporosis
• Depression
• Anemia
• Hot flushing episodes

If you undergo hormonal therapy your treatment team will give advice on how to cope with the side effects.

Radiation Therapy Following Radical Prostatectomy

Is radiation therapy a valid treatment if cancer recurs following prostate removal? According to my readings, and discussion with my oncologist, this question is not easily answered. “The problem is that a rising PSA doesn’t distinguish between incurable systemic disease versus curable, local-only disease.” – H. Ballentine Carter, M.D., The Johns Hopkins Prostate Library.

Using radiation therapy following prostate removal is subject to many considerations. Whether or not to go ahead with this treatment will depend on conclusions agreed to by the medical team and the patient.

Wrapping Up

The purposes of this three-part blog include: generating increased awareness of prostate cancer; promotion of  patient proactivity with respect to testing and treatment; and increasing the general level of the understanding of prostate cancer by laymen. It is not the purpose of this blog to replace your doctor or your treatment team. A great deal of expertise is available from the medical community. The task of the patient is to take full advantage of this expertise.

Status Report

I’ll conclude with a quick status report. I am being treated as though my cancer has recurred. The post-surgery biopsy of my prostate gland and of lymph nodes, removed during surgery, indicated that the cancer has escaped the prostate capsule, but is localized. I am in hormone therapy and will undergo radiation therapy soon. The hormone therapy will continue during and following radiation. At this point I feel great. I exercise regularly and have resumed running following three months away from the paths and trails. I follow the diet recommended by my treatment team and generally have a very positive outlook with respect to the future.

Good luck to all of you men with or without prostate cancer. And a big group hug to all the current and future caregivers whether helping a prostate cancer patient or providing a service too any person requiring your help.

Qigong – The art and science of Chinese energy healing

One further note about my personal approach to life and cancer. I am a self-taught Qigong practitioner. My reference material for almost 15 years has been the book “The Way of Qigong” by Professor Kenneth S. Cohen. Professor Cohen’s website is available to introduce you to the benefits available from the practice of Qigong, including its potential in the prevention and treatment of cancer.

Comments: If you have a prostate related story you wish to share or have information to pass on, please comment away.

Read Part One – “Testing For Prostate Cancer” – Category: Health Matters

Read Part Two – “You’ve Got Prostate Cancer” – Category: – Health Matters