Summary of Treatment Options

You will have been diagnosed with one of three categories of prostate cancer:

Localised (or early stage) cancer, is where the cancer has been found to be enclosed within the prostate; this will most likely be at Stage T1 or T2. Localised disease has the most options available for a possible cure.

Locally advanced cancer is where the cancer has been found to have begun to spread outside the prostate but not to other organs. The treatment options are more limited, but the disease may still be potentially curable.

Advanced cancer will have spread to other organs of the body (i.e. it will be at an M1 stage – see Staging of Prostate Cancer). In this situation it is only possible to treat the cancer with drugs designed to delay the progression of the disease.

Where options are available, you may not always be informed of all the possible choices, nor will you necessarily be recommended a particular treatment. It is therefore not always easy to make a decision as to which treatment to choose. Some may not be available at your local hospital and you may have to travel to a centre of expertise. Others are not approved by NICE and may only be available privately. Some treatments may effectively be used in combination (e.g. hormone therapy before surgery or radiotherapy in order to shrink the prostate).

You should be aware that all treatments have consequences and side effects, which are listed under each treatment in this section, with more information here. After treatment, regular PSA readings are taken in order to check its success. A cure may not be confirmed for several years.

In the summary below, treatments suitable for Localised prostate cancer are marked (L), Locally advanced (LA) and Advanced (A).

Active Surveillance L pro-active monitoring of early-stage cancer
Watchful Waiting L
LA
A
regular check-ups, leading to hormone treatments or
palliative care where necessary
Surgery L an operation to remove the whole prostate
External Beam Radiotherapy  L
LA
using radiation to destroy the cancer
Low-dose rate Brachytherapy L the implantation of radio-active seeds
High-dose rate Brachytherapy L
LA
the insertion of radiated catheters, removed after
treatment
HIFU L the cancer cells are heated and destroyed by ultrasound
Cryotherapy (or cryosurgery) LA  the freezing of cells in the prostate
Hormone Treatments L
LA
A
drugs used either where the cancer has spread outside
the prostate 
(LA, A) or prior to curative treatments (L)
Chemotherapy A drugs used after hormone therapies have failed

 Click here to view/download a flow chart of treatment options