Dr. Krista Noonan
Medical Oncologist, BC Cancer Agency & Clinical Assistant Professor, University of British Columbia
Prostate cancer patients face a challenging journey, but the good news is that they have options when it comes to treatment.
Prostate cancer significantly impacts Canadians. It’s the most common cancer among Canadian men (excluding non-melanoma skin cancers) and the third leading cause of death for Canadian men with cancer. However, prostate cancer patients have various treatment options available at different stages of the disease, which is both encouraging and empowering.
A range of treatment options
Different treatments are available for patients at each stage or state of prostate cancer. “The disease states of prostate cancer are critical because we have different clinical trials based on different disease settings,” explains Dr. Krista Noonan, a medical oncologist at the BC Cancer Agency and Clinical Assistant Professor at the University of British Columbia. “I often discuss the evolution of prostate cancer along a timeline with my patients and chat with them about what we call the localized and advanced settings.”
In early-stage prostate cancer, the tumour is localized, meaning it’s only in the prostate. In more advanced stages, the cancer spreads to varying degrees. There are also different types of prostate cancer. The most common type is adenocarcinoma, and rarer subtypes include urothelial (transitional cell) carcinoma, squamous cell carcinoma, and small cell (neuroendocrine) carcinoma. Regardless of the type of prostate cancer, your specialist will discuss the appropriate treatment for you.
For early-stage prostate cancers, the recommended treatments include surgical removal of the cancer with radical prostatectomy, radiation therapy, or active surveillance without immediate treatment (monitoring frequently). For advanced stages, treatments may include androgen deprivation therapy (also known as novel hormone therapy), chemotherapy, radiopharmaceuticals (drugs that contain radioactive elements), and targeted therapy (drugs that zero in on cancer cells).
Early-Stage Prostate Cancer
- surgical removal of the cancer with radical prostatectomy
- radiation therapy
- active surveillance
Advanced Prostate Cancer
Treatments may include:
- androgen deprivation therapy
- novel anti-androgens
- targeted therapy
Understanding patients’ priorities
These treatment options — including new medications and personalized treatments— give more hope to prostate cancer patients for a longer and better-quality life. Doctors work with patients to select the best course of treatment based on the stage of the disease and the patient’s unique priorities.
Dr. Noonan stresses the importance of maintaining open dialogue and shared decision-making. “Whenever I meet a patient, I like to hear what their goals of care are,” she says. “Oftentimes, as oncologists, we look at the data and determine ‘obvious’ goals, such as eradicating the cancer for localized disease or, in cases of advanced disease, extending length or quality of life. But everyone is different, and we should never assume.”
Patients can work with their health-care practitioner, caregivers, and loved ones to determine the course of treatment that’s best for them. When making a decision, they’ll want to consider their desired lifestyle and goals, including activity level, energy level, and sexual function, as well as potential drug interactions and side effects.
For Charlie Taylor, who was diagnosed with prostate cancer at age 50, what mattered most was being able to be there for his family. “Our daughter told us we were expecting our first grandchild,” he says. “My doctors were all very open and easy to talk to. They explained the treatment options, and I opted for surgery.”
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