TREATMENTS, RISKS, AND SIDE EFFECTS
Treatments for prostate cancer are effective in most men, but they can cause both short- and long-term side effects that may be difficult to accept. The patient, his partner, and the urologist should discuss treatment options in detail. A second opinion may be sought. The patient should make sure he understands which treatments are available, how effective each is likely to be, and what side effects can be expected. In addition, the patient should understand the option of accepting no treatment based upon statistical data and patient outcomes. All of the treatment choices should be weighed carefully before making a decision about which course to pursue.
All active treatments for prostate cancer have costs as well as benefits. Because the prostate is an integral part of the genitourinary tract, physical treatments tend to cause genitourinary problems. In addition, radiation will damage neighboring tissues, the most sensitive of which is the rectum, so radiation often gives bowel as well as genitourinary problems. In contrast, androgen-deprivation therapy is a systemic treatment, and its side effects can be whole-body problems, either metabolic, physiologic, or psychological.