PSA test for prostate cancer

Choosing a treatment if cancer is diagnosed

If prostate cancer is diagnosed, and if the cancer is localised (only affecting the prostate gland), men have a number of options. These include:

  • Watchful waiting - treatment started only when, or if, necessary.
  • Active surveillance - where the state of the cancer is closely observed and treatment started only when, or if, necessary
  • Surgery - (radical prostatectomy - removal of the prostate gland)
  • External beam radiotherapy - where radiation is used to kill cancer cells
  • Brachytherapy - where radioactive seeds are implanted into the prostate 
  • Hormone therapy - (may be used in combination with other therapies)
  • Cryosurgery - freezing the prostate (a fairly new treatment, not available everywhere and usually only as part of a trial)
  • New treatments - such as High Intensity Focused Ultrasound (HIFU usually only as part of a trial)

There is a shift by health professionals just to monitor men with localised cancer with one of the  monitoring regimes;  Active surveillance and Watchful waiting.

If the cancer has spread to other parts of the body (e.g. the bones), hormone therapy can be effective for many months or years. Radiotherapy and Chemotherapy may be given if hormone therapy is no longer effective. 

One man we talked to said that his surgeon had told him that there is no real evidence to prove that any treatment is better than 'doing nothing'. However, this man was convinced that doctors wouldn't treat patients unless they were confident that treatments were beneficial.

Men who had been diagnosed with early prostate cancer often said that their doctors had taken great trouble to explain the various treatment options. Some said that it was helpful having a wife or partner with them during consultations. Taking a cassette recorder to record the conversation can also be helpful since it is often hard to remember what has been said.

A man in his early 70's was invited to take part in a trial of an experimental treatment, high intensity focused ultrasound (HIFU).

Some men would have liked their doctors to tell them much more, and searched elsewhere for help and advice. One man, for example, who got information from the Internet and from Prostate Cancer UK, explained why he chose to have radiotherapy for his 'advanced prostate cancer'. He said that the consultant insisted that he make the final decision about treatment.

Men may have fewer treatment options because their cancer is more advanced or because of co-morbidity or because of age. Some men said that options were limited and that their doctors had recommended hormone therapy.

(For much more about prostate cancer; e.g. symptoms, scans, treatments (including active surveilance or watchful waiting), side effects of treatments, catheters, support groups, finding information, and “living with it” see the prostate cancer section.)

Last reviewed Last reviewed May 2016.
Last updated May 2016.

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