What are the methods of treatment of prostate cancer? What are their side effects? What to expect after a method of treatment? Read in this article.
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Pressure Cancer Treatment Methods
Decide on the most appropriate method of treatment of prostate cancer is not always simple, for this it is necessary to take into account a number of factors. The most important of these includes the age of the patient, the overall state of his health and the stage of development of cancer, on the basis of which can be judged by the probability of its distribution to other organs.
Since in many cases the growth of the cancer tumor of the prostate gland is slowly, then in the initial stage, there is often no need for treatment; Instead, a regular examination should be carried out in order to make sure that cancer does not apply to other organs. Many older men, despite their illness, have chances of a normal life for quite a long time. Many find that it is very difficult to adopt a life approach «Observations and expectations», But, as a rule, still go, t.To. Side effects of treatment can sometimes be worse than the manifestation of the disease itself.
There are quite a lot of opportunities to choose the treatment of prostate cancer treatment: surgical operation, radiotherapy, hormone therapy, less often — chemotherapy. Sometimes the best results give a combination of several methods. But in some cases, and relatively often, it is advisable to abandon any interference and restrict ourselves to a regular examination of the patient. Since the cancer of this type is developing slowly, then for the study required for many years; However, tests and inspections do not stop in order to establish the most effective method of treatment.
Perhaps in the hospital you pay attention to the fact that other patients are appointed not such treatment as you. Often this may be due to the fact that their disease is manifested in a different form, but also because each doctor has its own point of view regarding the most appropriate treatment. If you have any questions regarding the treatment appointed to you, do not be afraid to contact them to your doctor or care for your nurse. To not forget about anything, make a list of questions you are interested in and take with you for a conversation with a doctor close or relative.
Some patients believe that the decision proposed by the method of treatment could help the opinion of this other physician could help. Most doctors will be happy to direct you to another specialist if you feel that it will benefit you.
Operational treatment of prostate cancer
Your doctor will discuss with you the most suitable type of operation depending on type, sizes and distribution of cancer. Before any operation, make sure that you have comprehensively discussed with your doctor all the questions related to it, so you understand well what it represents and what effects have. Remember that no operation or procedure will be performed without your consent.
Transuretral resection (tour)
Often there is a need for operational intervention to remove a part of the tumor, which clogs the urethra (urethra), through which the urine is derived from the bladder. In this case, most often resort to an operation called «Transuretral prostate rescue».
This operation is usually done under general anesthesia, but sometimes spinal anesthesia is also applied. In this case, there is an anesthesia of the corresponding site by injection anesthetic to the vertebral pillar, so that the patient does not feel anything during the operation.
As it follows from the very name of this operation, it is that the urethra (urethra) is injected through the penis; Inside the tube, a special tool is attached, which allows you to eliminate the blockage when promoting the tubule on the urethra.
After translateral resection surgery
At the end of the operation you will be recommended to start moving as soon as possible. Probably during the day you will be on your feet.
After the operation, the tour you may make an intravenous infusion (with a dropper) to ensure normal fluid content in the body. The dropper will remove as soon as you can drink yourself. In the bladder you will be introduced a small tube (catheter) to remove urine in the urinary. To prevent the clogging of the catheter with blood clots of blood can be washed by bladder. For this purpose, liquid is introduced into the bladder, which is then displayed through the catheter. Gradually rocked, and the catheter can be removed. At first, perhaps it will be difficult for you to do without a catheter when urinating, but soon everything will work out.
Sometimes there is a need to leave the catheter for a while after discharge from the hospital. Before you go home, the nurse will explain to you how they turn to the catheter; In addition, you can agree with the precinct sister, which will visit you to the PA home and help in solving any problems that are included in its competence.
Although within a few days after surgery, you can experience painful or unpleasant sensations, they can always be removed due to the availability of various types of very effective painkillers. If you do not stop pain, it is necessary to raise your doctor about it if possible, in order for them to replace the drugs assigned to you.
Most patients can go home in 3-6 days after surgery. If you assume that at home you can meet with those or other difficulties after surgery, inform your nurse or social worker, so that they organize you timely help.
Many social workers are able not only to give practical advice, but also have special training as consultants who can provide greater support for both the patient and its family, both in hospital and at home. If you want to talk with a social worker, ask your doctor or nurse to organize such a conversation for you
Before you leave the hospital, you will be appointed a day of visits to the clinic as an outpatient patient, T.To. During a certain postoperative period, you will be under observation. So you can discuss all the problems with which you will encounter after the operation.
Radical prostatectomy (complete removal of prostate gland)
The second type of operation applied over the prostate cancer is called radical prostatectomy. In this case, we are talking about the removal of the prostate gland surgically by the abdominal cavity. It is resorted only when the prostate cancer has not yet given metastases, as well as if patients — Pretty young men with high malignant tumors. The consequence of such a transaction can sometimes be sexual impotence (no erection) and urinary incontinence, but thanks to the use of modern techniques, these complications are now less common. Since doctors can not predict, who from the patients the operation gives such a complication, it is important that each patient will give a report in advance, which risk is associated with such an operation. Your doctor will discuss in detail the question of the operation, and will also tell about other forms of treatment.
After the operation of radical prostatectomy
After prostatectomy, you will be made intravenous infusion and the catheter is introduced, possibly with washing the bladder (see. Above section Transuretral resection). You will have a wound from the operational cut. Probably, a drainage tube for removing the resulting excess fluid will be introduced into the wound. Most likely within a few days after the operation, you will experience painful sensations, especially when walking. Regular reception of painkillers will help to weaken these pains, if the drugs assigned to you do not give the right effect, report this to medical personnel so that you replace them.
After 7-10 days after surgery, you are likely to go home. If you have trouble with urination, you will be released home with the intrated catheter. You can also organize visiting you at home by a precinct nurse, and if any problems arise, you should contact your doctor as soon as possible.
Orchidectomy
To slow down the growth of the cancerous tumor, it is possible to make an operation called orchidectomy, which consists in removing the testicles, which leads to a decrease in the level of maintenance of the male hormone, testosterone. This is not a difficult operation, and most patients can go home 3 days after its execution. Make only a small incision in the groin area or in the scrotum. However, many men consider huge misfortune to undergo such an operation, especially due to possible side effects — Challenges in heat and sexlessness. Sometimes the operation may be accompanied by the insertion (attachment) of the plastic prosthesis, imitating the form and appearance of the testicles. Often do not so radical operation and remove only the inner part of the testicles (subcapsule orchidectomy), so the need for a prosthesis disappears.
Currently, newer methods of hormone therapy have been developed that can be applied instead of orchidomy, unfortunately, they give the same side effects as the operation. Hormone therapy method is described below in the relevant section.
Radiotherapy
The method of radiotherapy in the treatment of cancer is based on the use of high-energy radiation, which destroys cancer cells, causing the minimum damage to normal cells. In the case of prostate cancer, outdoor irradiation is usually produced, but some patients receive intra-freed irradiation.
There are two different forms of radiotherapy in the event of prostate cancer: therapeutic and palliative. As the name itself speaks, the first one implies an impact on the sink tumor itself and, when possible, allows you to achieve healing. The second is prescribed for the weakening of symptoms, especially to reduce the pain in the bones, and to improve the subjective well-being of the patient. Palliamental treatment is described in more detail below in the relevant section.
Treatment by radiotherapy is carried out in hospital conditions in the radiotherapeutic office, as a rule, from 5 sessions per week (from Monday to Friday) with a break for weekends. The duration of the entire course can be several weeks. This duration in each case will depend on the type, size and distribution of cancer. Your doctor will discuss with you the treatment selected for you in advance.
Radiotherapy treatment planning
To ensure that the rate of radiotherapy brings the patient maximum benefit, it is necessary to carefully prepare. With your first visit to the radiotherapy Cabinet you will be asked for a large car, which is called the simulated device. With it, X-ray pictures are obtained by the zone to be treated. Sometimes for the preparation of treatment produce computed tomography. Treatment Planning Plays a very important role, it may sometimes be necessary to several preliminary visits to the radiotherapeutic office before the doctor planning your treatment will be satisfied with the result obtained.
Tags are applied to the skin of the patient, in order to help a radiotherapist, which will carry out the radiotherapy procedure, put the patient exactly in the right position and show where the rays should be sent. These labels should be maintained throughout the entire treatment period, but they can be washed immediately upon completion. Before you start a course of radiotherapy, you will be explained how to follow the skin on the site to be rapidly.
Before each radiotherapy session, X-ray beast will help you take the right position on the couch and make sure that you are comfortable. During the procedure that lasts only a few minutes, you will be indoors alone, but you can talk to a X-ray-bearable, which will watch you from the adjacent room.
Radiotherapy — Painless procedure, but during its holding it is necessary to lie completely fixed for a few minutes.
Side effects of radiotherapy
Radiotherapy can cause such side effects such as nausea and fatigue. These side effects can be either weak or rather painful depending on the dose of irradiation and duration of treatment.
Nausea is usually removed by antiemetic drugs that your doctor may prescribe. If you do not want to eat, you can replace the usual food with high-calorie nutritional drinks that are sold in many pharmacies.
Exposure of the prostate gland area can have a harmful effect of Pa Bubble and intestines. This may lead to more frequent, compared with the usual, urination and the appearance of burning sensation. During this period of time, it is necessary to drink as much liquid as possible. Often observed when the irradiation of this zone and such a side effect like diarrhea. In this case, opposed anti-diabetes. A positive result can be achieved and by making changes to the diet: Eating with small portions, more frequent food intakes, if possible, refusal of products with high fiber content, such as raw fruits and vegetables. These side effects usually affect the end of the course of treatment and continue approximately for three weeks.
When conducting a course of radiotherapy, the skin in the irradiation zone can redden and inflamed. Various skin care methods are recommended in different hospitals. In one department, they can advise not to wash this site at all during the course of the course, in others — use only heat-drying water and for drying slightly patted the corresponding plot with a soft towel. From creams and lotions containing aromatic substances, it is advisable to refuse. Before choosing any skin care tool, you must consult with radiation therapy specialists. If necessary, your doctor will moderate you a special cream to care for the inflamed area of the skin.
Since radiotherapy can cause severe fatigue, you should rest as much as possible, especially if you have to get up at night or daily go through a big way for getting another radiotherapeutic session.
The passage of the course of radiotherapy over the prostate cancer can cause sexual impotence (no erection), as well as urinary incontinence, but this risk is much smaller than in the case of a surgical operation.
Before you assign one or another method of treatment, your doctor will discuss with you all the possible side effects of the treatment, with which there is a chance of facing you. Make a list of questions you are interested in that you would like to ask a doctor, and take with you to consult if you consider it a useful, relative or friend.
Most of the side effects of the radiotherapeutic course after its completion, gradually disappears, although some are about to know about themselves for several weeks, while others may remain forever. If in the process of treatment you will have any problems, talk to the staff of the radiological department, they have extensive experience in monitoring patients who are found or were in the same situation as you.
The radiotherapy rate does not make you radioactive, you can not imagine any danger to other people, including children during the entire treatment period.
Internal radiotherapy
Currently, this form of radiotherapy is used very rarely. Under general anesthesia, small radioactive granules are injected inside the tumor, thereby ensuring a slow process of activity of activity for a certain period of time. These granules are not far from the tumor, but the activity gradually fades, and for other people it does not represent any danger.
Radiotherapy for removing pain in the bones (palliative treatment)
If the prostate cancer has spread to the bone (metastases), then radiotherapy can be assigned to loosening (removal) of pain. Irradiation is subjected to either affected bone or the corresponding zone. Many patients feel some decrease in pain already two after the start of treatment, in other cases it takes 3-4 weeks to achieve a positive effect. If necessary, you can continue regular reception of painful drugs.
To remove pain in the bones, radiotherapy is often assigned in the form of a single session, but sometimes the course is divided into several less long sessions. The radiotherapist will explain in advance the principle of treatment with you and all possible associated with it, side effects.
If the spread of prostate cancer is not limited to one zone, then you may be appointed irradiation of half of the body. As follows from the very name of the method, the extensive zone is exposed: either the top, or the lower half of the body. As a rule, this form of radiotherapy provides a fairly effective removal of pain in a few days. However, such treatment gives more unpleasant side effects than local exposure. Your doctor will write you any antiwheat pills and, probably, you will have to stay in a hospital for some time. If necessary, it will later be possible to subjected to irradiation and the second half of the body, after your condition returns to normal.
Hormone therapy in the treatment of prostate cancer
Hormones — produced in the body of substances that regulate the growth and functioning of normal cells.
The growth of the prostate tumor of the prostate gland is depending on the male hormone of Testosterone. By reducing the testosterone content in the body, you can slow down the growth of the tumor or reduce its dimensions, and the symptoms often disappear completely.
Two main ways to reduce testosterone content — This is a surgical operation or appointment of special drugs.
Testosterone is generated mainly in the testicles, and the operational removal of testicles (orchidectomy) leads to a decrease in the content of this hormone in the body. Currently, instead of orchidectomy, hormone therapy is often used.
One of the commonly consulting types of therapy is to use drugs that «Turn off» Production of men's hormones in the testicles. They are known as hypostic regulators of reducing hormone content and are introduced by subcutaneous injection. They are usually prescribed in combination with tablets of any antandrogen (which delay the production of hormones in the testicles), for example, cinroteron acetate (cyprostat) or flutamide (drogenyl), or a new preparation bicalutamide (CASTEX). As it is believed that these funds are most effective when used in combination. In addition, antiyidrogen hinder «The exacerbation of cancer», T.E. Such a situation when, after receiving the first dose of the hypographic regulator, the symptoms alone are temporarily intensified.
Injection is usually done once a month, but currently a new injection solution has been developed, which can be administered in 12 weeks, and this procedure can be performed as your attending physician, and a landed sister.
The results of some recent studies are talking about the appropriateness to continue the reception of antidrogenic tablets throughout the course of treatment along with a hypospray regulator reduction of hormone content. This type of treatment received the name of the full androgenic blockade.
Unfortunately, the side effect of almost all methods of hormone therapy is sexual impotence (no erection), which is usually observed during the entire treatment period. Upon completion of the course, this problem usually completely disappears. The operation can also cause impotence, although thanks to modern operating methods, this takes place not so often. Any course of treatment may be so tired of the patient that he never ceases to be interested in sexual relations. This phenomenon is called loss of libido (t.E. sexual entry), it can accompany many diseases, not only cancer. Other frequently occurring side effects of hormone therapy include random headache and less often — nausea.
Nonteroidal antandrogenic drugs, such as flutamide, which are prescribed in the form of tablets without simultaneously use of other methods of treatment, allow preserved libido and potency in most patients. These drugs are not suitable for all patients, but you can discuss this option with your doctor.
For the treatment of prostate cancer tried to use female sex hormones (estrogens), but now they are rarely resorted to this method due to its side effects.
Subsequent medical observation
After completing the course of treatment, you will be under regular observation as an outpatient patient; Check will probably consist of blood test, determining the level of a specific antigen of prostate and x-ray examination. If you have any problems between the designated inspections of any problems, or you will notice new symptoms, you should like a doctor as soon as possible.
Possible side effects of treatment
Unfortunately, treatment for prostate cancer can be accompanied by unpleasant and long-term nature by side effects, therefore, before agreeing to any treatment, it is important that you will give yourself a complete report in its possible consequences. Obviously, the doctor can not accurately predict who exactly the patients threaten this or that side effect of treatment, so it is very important that you discussed the degree of risk to which you are exposed to.
Sexlessness
Paul powerlessness, which is that a man is deprived of an erection ability, extremely painful for the patient, can affect the course of hormone therapy. It is usually temporary and disappears at the end of the course. The same side effect can give operational intervention, less — Course of radiotherapy.
Many men, regardless of age, believe that it is very difficult to discuss such purely personal questions with anyone, in particular, with doctors or with other medical personnel. Paul powerlessness may not be constant, and sometimes it is due to a not so much applied method of treatment, how much concern and uncertainty. In some hospitals, specially trained consultants or sexology therapists, which can give you useful tips and assist. Some men are also difficult to speak this topic with their partners without fear to be rejected; These fears are usually unreasonable. The basis of sexual relations are many circumstances: love, trust, general experiences. Talk to your partner about your fears and anxieties. You may benefit you a joint visit of a consultant or a sexologist to discuss any questions you are interested in.
There are practical ways to overcome impotence, and your doctor will be able to give you more detailed information about them. Sometimes in this case, injection can benefit, you can also resort to the implant implantation in a penis or to the use of vacuum pumps. Remember that your doctor, most likely, had a chance to treat not one patient with the same problem as you, so try not to be embarrassed and without constraint to contact him for help.
Infertility
It is very likely that the treatment of prostate cancer can cause infertility, in other words, the patient after treatment loses the ability to become a father. With such a consequence it is very hard to reconcile, especially if you hoped to have children in the future. So for you and your partner it is important to discuss this unpleasant perspective with your doctor before you start treatment.
Urinary incontinence
The loss of control over the bladder may be due to the very cancer tumor and operation or radiotherapy for prostate cancer. In recent years, great progress has been achieved in relation to the elimination or prevention of this side effect, and to solve the name of the problem there are various ways. Feel free to discuss any question that you causing you with your doctor or nurse. Some hospitals have medical personnel who have received special preparation for consulting on urine incontinence.
It is important to emphasize that these problems arise far from all men. Ask your doctor all the questions you are interested in regarding your treatment and its side effects, so you will be prepared for solving problems that may be in front of you.
