There are several different types of prostate cancer treatment, and your doctor will recommend what is best for you based on your diagnosis. Some of these treatments are standard of care and others may be available through clinical trials.
Your risk of having prostate cancer is determined by a combination of factors including age and your overall health, as well as the Gleason score of the biopsy tissue. This determines your prostate cancer’s risk category, which ranges from low/very low to intermediate to high. The lower the score, the less likely your prostate cancer is to spread.
Surgery is one option for most people with prostate cancer. For those who prefer to avoid surgery or have an advanced disease, radiation therapy is another way to treat prostate cancer and relieve symptoms. Radiation can be delivered by external beam or by brachytherapy. Both treatments use sophisticated technology to minimize the radiation dose to healthy tissue around your prostate.
Your doctor will also consider your specific symptoms and preferences when recommending a treatment. For example, some people with prostate cancer want to retain their erectile function, so drugs or penile implants may be recommended. Your doctor will discuss how these options might affect sexual side effects (see Coping With Treatment for more information).
For those who have a low risk of their cancer spreading, watchful waiting is an option. This means you will have routine PSA tests, digital rectal exam (DRE), and biopsies but won’t get treatment unless your symptoms worsen. This approach is particularly appropriate for older men and those with other serious or life-threatening illnesses who are expected to live at least five more years.
If you and your doctor decide that active surveillance is a good choice, you will be given a schedule for regular follow-up visits. At these visits, your PSA level will be measured and your doctor will examine you for signs of prostate cancer, such as painful urination or blockage of the urinary tract.
Surgical options include a radical prostatectomy, in which all or most of the prostate gland is removed, or a laparoscopic or robotic prostatectomy. In some cases, your doctor might recommend a more conservative procedure, such as a partial prostatectomy or a radioactive seed implant.
Other treatments include hormone therapy to decrease levels of testosterone, which fuels prostate cancer cells; a drug that stops the prostate from making androgens, such as tamoxifen; or sipuleucel-T, an immunotherapy drug that teaches your immune system to recognize and destroy prostate cancer cells.
If you are interested in participating in a clinical trial, your doctor will refer you to specialists in the area of prostate cancer. This includes doctors who specialize in treating prostate cancer, as well as urologists who have special training in treating patients with prostate issues. Visit the Prostate Cancer Treatment Options Overview page for more detailed information about prostate cancer treatment options and links to other resources. A member of your MDT can also answer questions and help you find a clinical trial.
