| When you first find out you have | | | | incontinence is very, very rare, and the |
| prostate cancer, that voice inside your | | | | chance of becoming impotent can be |
| head screams. Loudly. And the fear | | | | reduced by having something called |
| begins. | | | | "nerve sparing surgery," where the |
| But fear gradually gives way to furious | | | | surgeon is careful not to snip any |
| thinking; thinking about what happens | | | | "erection" nerves. Still, with surgery |
| next and where to go. Usually this is in | | | | you would have to face long hospital |
| the form of treatment options, a myriad | | | | stays and long recovery times, which |
| of them, and the many, many | | | | brings us to one of the other common |
| characteristics of each that must be | | | | treatments: radiation. |
| weighed carefully. Watchful waiting? | | | | Scary-sounding as it is, radiation is |
| Surgery? Radiation? Hormones? | | | | much less invasive than most forms of |
| Cryosurgery? Perhaps even proton beam? | | | | therapy. Hospital time is less, and |
| And so on. Along with the careful advice | | | | recovery time is quicker. Not to say |
| of your doctor, you may begin to narrow | | | | it's perfect. Radiation side effects can |
| it down, or you may begin to feel | | | | be severe, and include such nasties as |
| overwhelmed. What exactly ARE some of | | | | diarrhea and bleeding from the rectum. |
| these treatments and which one is the | | | | In addition, there is some controversy |
| best? | | | | as to whether radiation can zap cancer |
| As you've probably already guessed, the | | | | as effectively as surgery. |
| "best" is different for everyone. | | | | In fact, the effectiveness of many |
| Watchful waiting is "best" for you if | | | | treatments are often compared to |
| you're cancer is slower and less | | | | surgery. Does this mean surgery is the |
| aggressive and you are old. That's | | | | gold standard, and hence the "best" |
| right, I called you "old." Seriously, | | | | treatment? |
| though, if your doctor thinks you are no | | | | It's just too complicated to answer. |
| spring chicken, he may recommend that | | | | Certainly, a study performed by the |
| any treatment would be harder on you | | | | Johns Hopkins Medical Center in 1998 |
| than the cancer itself, and that you | | | | came to the conclusion that only surgery |
| both should take a wait and see | | | | can successfully remove all cancer, and |
| approach. If not, he may decide that you | | | | that surgery patients may have short |
| are ready for surgery. | | | | term decrease in their quality of life |
| This is the most drastic treatment | | | | in exchange for long-term freedom from |
| choice, and is seen by some as the | | | | cancer. Other treatments have been |
| "best" of the "best." What's so great | | | | improved since then, however, and this |
| about it is that the surgeon manually | | | | answer is less certain. For some |
| removes the entire prostate gland, | | | | individuals, surgery is simply too |
| including the cancer. It's gone. | | | | drastic and the cancer too slow to |
| Completely. And he can poke around in | | | | demand it. For others, previous health |
| there to see if there's more. The | | | | problems or your own personal reasons |
| problem is that there can be side | | | | may make radiation a more reasonable |
| effects that can seriously mess up your | | | | choice. |
| comfort level. Effects like the | | | | Only your doctor and you can make a |
| inability to hold in your pee | | | | decision like this together. Treatment |
| (incontinence), and the inability to | | | | for prostate cancer is one of the most |
| have an erection (impotence). Tempering | | | | personal decisions you can make, and the |
| these problems are two small facts: | | | | "best" is different for everybody. |