What are my treatment options?

The results of your tests will give you and your doctor a good idea of how your cancer is behaving. A number of things such as the stage of your cancer, your Gleason Score and PSA level will affect which treatments you can have. If you have been diagnosed with localised prostate cancer, there may be several treatments available to you. If you have locally advanced or advanced prostate cancer, there may be fewer suitable treatments.

Localised prostate cancer

Prostate cancer that has not spread outside the prostate gland (localised cancer) can behave in different ways. Many localised cancers are not aggressive and grow so slowly that they do not cause any problems during your lifetime. However, some cancers may be aggressive and spread to other parts of the body. The results of biopsy tests and scans may give some clue as to how your cancer will behave.

There is not an overall best treatment for localised prostate cancer, and each treatment has its own advantages and disadvantages. You will need to think about these when deciding on a treatment.

Locally advanced prostate cancer

Locally advanced prostate cancer is cancer that has spread to the area just outside the prostate gland. Your treatment options will depend on how far the cancer has spread.

Advanced prostate cancer

Advanced prostate cancer is cancer that has spread from the prostate to other parts of the body. It is also called metastatic prostate cancer. Prostate cancer can spread to any part of the body, but most commonly to the bones. Advanced prostate cancer can cause symptoms, such as bone pain and problems passing urine. It is not possible to cure advanced prostate cancer, but treatments can often keep it under control for several years.

Choosing a treatment

Your doctor or Clincical Nurse Specialist will explain all your treatment options and help you choose the right treatment for you. Ask your doctor or Clincical Nurse Specialist to tick the options that may be suitable for you. You may not be able to have all of the treatments mentioned.

Your personal preference will be an important factor in deciding which treatment to have. Hearing about your different treatment options can be a lot to take in, especially when you have just been diagnosed. Your doctor may suggest you take time to think things through before coming to a decision.

Make sure you have all the information you need. It can be a good idea to write down any questions you might want to ask at your next appointment. You might find it useful to have someone with you at the consultation, or to make notes that you can read in your own time.

Each treatment has side effects, and will affect each man differently. You may not get all of the side effects. It is important that you think about the side effects and how you would cope with them when deciding on a treatment.

The first treatment you have may affect which treatments you can have in the future, if you need further treatment. Speak to your doctor or Clincical Nurse Specialist about this.

Treatment options

Table highlighting treatment options
Localised prostate cancer Active surveillance
Watchful waiting
Surgery (radical prostatectomy)
External beam radiotherapy
Brachytherapy (either permanent seed or high dose rate)
Cryotherapy (as part of a clinical trial)
High intensity focused ultrasound (as part of a clinical trial)
Locally advanced prostate cancer Hormone therapy
Watchful waiting
External beam radiotherapy with hormone therapy (and sometimes with high dose rate brachytherapy)
Surgery (radical prostatectomy) with hormone therapy and/or external beam radiotherapy. This is less common and you may be offered it as part of a clinical trial.
Advanced prostate cancer Hormone therapy
Pain-relieving drugs to treat pain
Palliative radiotherapy to treat symptoms
Bisphosphonates to treat symptoms
Chemotherapy to treat symptoms