Watchful Waiting

Watchful waiting, or active surveillance as it is sometimes called, involves the active monitoring of an individual’s untreated prostate cancer. This includes periodic PSA blood tests, digital rectal exams and repeated prostate biopsies. Older men with small, slow growing tumors or those not able to tolerate treatment may choose this option. Current studies suggest, however, that for most men choosing this strategy have a less than optimal cancer control outcome.

Cryotherapy

Cryotherapy, or cryoablation, involves the use of liquid nitrogen or argon gas to destroy the cancerous cells of the prostate. This is accomplished by inserting probes through the perineum, the area between the scrotum and the anus, into the prostate. The preponderance of current literature deems the therapuetic effectiveness of cryotherapy to be lower than those of surgery and radiation. Additionally, the ability of cryotherapy to adequately preserve the surrounding neurovascular structures around the prostate, namely the nerves that control continence and potency, have not been well established.

Radiation Therapy

Radiation therapy involves the use of radioactive energy to kill the cancerous cells of the prostate. Radiation generally involves two different modalities, external beam radiation and brachytherapy, both of which may be combined for patients who are deemed to require it. In external beam radiation, the prostate anatomy is mapped out using one of various radiological techniques and a beam of radiation is then used to destroy the area where cancerous tissue is thought to be. In this type of therapy all of the prostate tissue is destroyed. In brachytherapy, radioactive pellets, or seeds, are implanted into the prostate via needles that enter the perineum (the section of skin between the scrotum and the anus). Radiation from these seeds then destroys prostate tissue including cancerous areas.