Prostate cancer is the most common type of cancer diagnosis in men, with more than 248,000 new cases in the United States in 2021, according to the American Cancer Society.

While some people choose to manage their prostate cancer with monitoring or active surveillance, others may opt for treatment to remove the cancer or reduce its size. However, some routine medical operations can trigger aggressive prostate cancer and have potentially harmful side effects.

Biopsies

Prostate biopsies are a common way to diagnose prostate cancer. During a biopsy, a needle is inserted into the prostate gland to remove a sample of tissue that is then analyzed for cancer cells.

While biopsies are generally safe, they can also have some side effects, such as infection, pain, and bleeding. Additionally, biopsies can promote the spread of prostate cancer cells. The needle can dislodge cancer cells from the prostate gland that can then travel to other parts of the body, such as the lymph nodes or bones, and anchor there to form new tumors.

Radical Prostatectomy

Radical prostatectomy is a surgical procedure to remove the entire prostate gland and some surrounding tissues. While this operation can cure prostate cancer if it is caught early, it can also have some drawbacks, such as incontinence and impotence.

Additionally, some studies have suggested that men who undergo radical prostatectomy may be at a higher risk for developing aggressive prostate cancer after surgery. The reasons for this are not entirely clear, but one theory is that the operation may release dormant cancer cells from the prostate that then become more aggressive over time.

Radiation Therapy

Radiation therapy is another commonly used treatment for prostate cancer. It involves using high-energy radiation to kill cancer cells and shrink tumors.

While radiation therapy can be effective, it can also have some side effects, such as urinary problems, diarrhea, and fatigue. Additionally, some studies have found that radiation therapy can increase the risk of aggressive prostate cancer in some men.

For instance, a study published in the Journal of Clinical Oncology found that men who received radiation therapy for localized prostate cancer had a higher risk of developing aggressive cancer within 15 years of treatment than men who did not undergo radiation therapy.

Hormone Therapy

Hormone therapy, also known as androgen deprivation therapy, is a treatment that reduces the levels of male hormones in the body, such as testosterone, that fuel the growth of prostate cancer cells.

Hormone therapy can be given as a pill or injection or by surgically removing the testicles. While hormone therapy can slow the growth of prostate cancer, it can also have some side effects, such as hot flashes, decreased sex drive, and weakened bones.

Additionally, some studies have suggested that hormone therapy may increase the risk of aggressive prostate cancer in some men. For example, a study published in the Journal of the National Cancer Institute found that men who received hormone therapy for prostate cancer were more likely to die of aggressive prostate cancer than men who did not receive hormone therapy.

Cryotherapy

Cryotherapy is a procedure that uses freezing temperatures to kill cancer cells. It involves inserting a probe into the prostate gland and circulating a gas that cools the tissue to very low temperatures.

While cryotherapy is generally safe, it can also have some side effects, such as urinary problems, pain, and swelling. Additionally, some studies have suggested that cryotherapy may promote the growth of aggressive prostate cancer in some men by damaging the prostate gland and releasing cancer cells into the bloodstream.

High-intensity Focused Ultrasound (HIFU)

High-intensity focused ultrasound (HIFU) is a non-invasive treatment that uses high-energy sound waves to kill cancer cells. It involves using a probe to deliver ultrasound waves to the prostate gland to heat and destroy cancer cells.

While HIFU is generally safe, it can also have some side effects, such as urinary problems, rectal bleeding, and pain. Additionally, some studies have suggested that HIFU may increase the risk of aggressive prostate cancer in some men.

The reasons for this are not entirely clear, but one theory is that HIFU may cause tissue damage that promotes the growth of cancer cells.

Active Surveillance

Active surveillance is a management strategy for prostate cancer that involves monitoring the cancer with regular check-ups, such as physical exams, prostate-specific antigen (PSA) tests, and biopsies, to evaluate its growth and aggressiveness.

While active surveillance is generally safe, it can also have some drawbacks, such as anxiety and uncertainty about the cancer’s progression. Additionally, some studies have suggested that active surveillance may miss the early signs of aggressive prostate cancer in some men, leading to delayed treatment and poorer outcomes.

Bone Density Tests

Bone density tests are a routine way to screen for osteoporosis, a condition that weakens bones and makes them more prone to fractures.

However, some studies have suggested that bone density tests, which use low-dose radiation, may increase the risk of aggressive prostate cancer in some men. For example, a study published in JAMA Internal Medicine found that men who received repeated bone density tests over a 10-year period were at a higher risk of developing aggressive prostate cancer than men who did not receive bone density tests.

The reasons for this association are not entirely clear, but some researchers suggest that the radiation exposure may damage DNA and increase the risk of cancer.

Genetic Testing

Genetic testing is a way to screen for inherited mutations in genes, such as BRCA1 and BRCA2, that increase the risk of breast and ovarian cancer in women and prostate and other cancers in men.

However, some studies have suggested that genetic testing may also increase the risk of aggressive prostate cancer in some men. For instance, a study published in the Journal of Clinical Oncology found that men with a BRCA2 mutation who received a diagnosis of prostate cancer were at a higher risk of developing aggressive cancer than men without the mutation.

The reasons for this association are not entirely clear, but some researchers suggest that the mutation may make cancer cells more resistant to treatment.

Conclusion

Prostate cancer is a complex disease that requires individualized treatment based on numerous factors, such as age, overall health, and the cancer’s stage and aggressiveness.

While many medical operations can be effective in treating prostate cancer, they can also have potentially harmful side effects, such as promoting the growth of aggressive cancer cells. Therefore, it is essential for men with prostate cancer to work closely with their healthcare providers to choose the best treatment option for their individual needs, taking into consideration the potential risks and benefits of each approach.