Watchful waiting is observing a patient while no treatment is given. Such a patient usually has an organ-confined tumor and no symptoms. Understand, however, that although watchful waiting involves no actual treatment, the patient still needs close follow-up and monitoring. The follow-up involves frequent visits to the doctor, perhaps every three to six months. The visits include questions about new or worsening symptoms and digital rectal examinations for any change in the prostate gland. In addition, blood tests are done to watch for a rising PSA and imaging studies can be conducted to detect the spread of the cancer. If the history, examinations, or any of the tests signal the possibility of an advancing cancer, the watchful waiting usually is discontinued and treatment is recommended.
» Read more: What is watchful waiting?

Alternative medicine, also called integrative or complementary medicine, includes such non-traditional treatments as herbs, dietary supplements, and acupuncture. A major problem with most herbal treatments is that their composition is not standardized. Moreover, the way herbal treatments work and their long-term side effects usually are not known.
» Read more: What about herbal or other alternative medicine treatments for prostate cancer?

Chemotherapeutic agents, or chemotherapy, are anti-cancer drugs. They are used (for hormone resistant prostate cancer) as a palliative treatment (palliation to relieve symptoms) in patients with advanced cancer for whom a cure is unattainable. Recall that the goal of palliation is simply to slow the tumor’s growth and relieve the patient’s symptoms. Chemotherapy is not ordinarily used for organ-confined or locally advanced prostate cancers because a cure in these cases is possible with other treatments. Currently, chemotherapy is used only for advanced metastatic prostate cancers that have failed to respond to other treatments.
» Read more: What is chemotherapy for prostate cancer?

Cryotherapy is one of the newer treatments that is being evaluated for use in the early stage of prostate cancer. This treatment kills the cancer cells by freezing them. The freezing is accomplished by inserting a freezing liquid (for example, liquid nitrogen or argon) through needles directly into the prostate gland. The procedure is accomplished under the guidance of ultrasound images. Actually, cryotherapy is not a new technique. Rather, it is a modification of a procedure that was tried previously, but had an unacceptably high rate of complications. Thus, cryotherapy was used in the 1960s to freeze the lining of the stomach to treat ulcers, but was discontinued because it also severely damaged the lining of the stomach.
» Read more: What is cryotherapy for prostate cancer?

The male (androgenic) hormone is called testosterone. It stimulates the growth of cancerous prostatic cells and, therefore, is the primary fuel for the growth of prostate cancer. The idea of all of the hormonal treatments (medical and surgical), in short, is to decrease the stimulation by testosterone of the cancerous prostatic cells. Testosterone normally is produced by the testes in response to stimulation from a hormonal signal called LH-RH. The LH-RH stands for luteinizing hormone-releasing hormone and is also called gonadotropin-releasing hormone. This hormone comes from a control station in the brain and travels in the blood stream to the testes. Once there, the LH-RH stimulates the testes to produce and release testosterone.
» Read more: What about hormonal treatment for prostate cancer?

The goal of radiation therapy is to damage the cancer cells and stop their growth or kill them. This works because the rapidly dividing (reproducing) cancer cells are more vulnerable to destruction by the radiation than are the neighboring normal cells. Clinical trials have been conducted using radiation therapy for patients with organ-confined (localized) prostate cancer. These trials have shown that radiation therapy resulted in a rate of survival (being alive) at 10 years after treatment that is comparable to that for radical prostatectomy. Incontinence and impotence can occur as complications of radiation therapy, as with surgery, although perhaps less often than with surgery. More data are needed, however, on the risks and benefits of radiation therapy beyond 10 years, especially because late recurrences (reappearances) of the cancer can sometimes occur after radiation.
» Read more: What about radiation therapy for prostate cancer?

The surgical treatment for prostate cancer is commonly referred to as a radical or total prostatectomy, which is the removal of the entire prostate gland. Since 1990, the radical prostatectomy has been the most common treatment for prostate cancer in the United States. This operation is done in about 36% of patients with organ-confined (localized) prostate cancer. The American Cancer Society estimates a 90% cure rate nationwide when the disease is confined to the prostate and the entire gland is removed. The potential complications of a radical prostatectomy include the risks of anesthesia, local bleeding, impotence (loss of sexual function) in 30%-70% of patients, and incontinence (loss of control of urination) in 3%-10% of patients.
» Read more: What about surgical treatment for prostate cancer?

Hormonal therapy is the mainstay of treatment for symptomatic advanced prostate cancer. Patients without symptoms, but with advanced disease, do not appear to have improved survival with treatment when compared with untreated patients. Therefore, treatment of patients with asymptomatic advanced disease is not essential. The treatments available for hormonal therapy are:

1. Orchiectomy is the surgical removal of the testicles.
» Read more: What are the differences between hormonal treatment and chemotherapy?

The staging of a cancer refers to determining the extent of the disease. Once a prostate cancer is diagnosed on a biopsy, additional tests are done to assess whether the cancer has spread beyond the gland. For this assessment, biopsies of the surrounding organs, such as the rectum or urinary bladder, or of the nearby (pelvic) lymph nodes might be done. In addition, imaging tests are usually performed. For example, radionuclide bone scans can determine if there is a spread of the tumor to the bones. Additionally, CAT scans (coaxial tomography) and MRIs (magnetic resonance imaging) can determine if the cancer has spread to adjacent tissues or organs such as the bladder or rectum or to other parts of the body such as the liver or lungs. Newer scanning using a method called PET scan can sometimes help to detect hidden locations of cancer that has spread to various areas of the body.
» Read more: How is the staging of prostate cancer done?