How is prostate cancer treated?
There are several different types of treatment depending on the stage of cancer, how aggressive (or fast growing) it is and your age.
For some low risk cases it may be most appropriate not to treat the cancer, but instead to monitor the condition until symptoms become worse – also known as watchful waiting.
Watchful waiting is most likely to be recommended for early stage prostate cancers with mild or no symptoms and older men (when the cancer or cancer treatment is unlikely to affect their lifespan).
If the condition deteriorates, hormone therapy may be used to treat symptoms and slow progression.
Active surveillance - this approach is used for slow growing cancer in patients who are otherwise fit and well. The aim here is to delay or avoid unnecessary treatment – and the side effects that go with it – until necessary.
As the name suggests patients are monitored closely, with regular PSA tests and MRI scans for example, so that at the first sign that the cancer may be progressing it can be treated.
For other types, where the cancer has spread beyond the prostate (locally advanced or advanced prostate cancer), different treatments may be more appropriate. These include:
Radiotherapy – where radiation beams are used to kill cancer cells.
Brachytherapy – this is also known as internal radiotherapy as radioactive materials are inserted directly into the tumour or prostate to kill cancerous cells.
High-intensity focused ultrasound (HIFU) – where high frequency sound waves are used to try and kill cancerous cells.
Hormone therapy – used to stop or slow the production of testosterone to stop or slow prostate cancer.
There is some research to show that radiotherapy is more effective when combined with hormone therapy.
Surgery – this could be keyhole surgery or open surgery and could include removing the prostate.
Surgical treatment of prostate cancer
Surgery can treat prostate cancer that’s confined to the prostate (localised prostate cancer) or which has spread only just beyond that (locally advanced prostate cancer). It may be used to remove the cancer, to alleviate symptoms or to slow the growth of the cancer. It isn’t suitable for everyone.
There are three types of surgery for prostate cancer:
Removal of the prostate gland (prostatectomy)
Here, the aim is to cure the cancer by removing the whole prostate and the prostate cancer cells with it. This can be done in one of three ways:
- keyhole (laparoscopic) surgery,
- robot-assisted keyhole surgery (robotic prostatectomy)
- or open surgery.
The three techniques are equally effective in treating the cancer and have the same side effects. However, robotic keyhole surgery has the advantage over the other two in that it generally results in less blood loss, less pain, less time in hospital and a shorter recovery time post-surgery.
Removal of part of the prostate gland (TURP)
Both cancer and benign swellings within the prostate can press on the urethra making it difficult to urinate. The aim of this type of surgery is to remove some of the tissue in the inner prostate – whether it’s cancerous or not – to remove the obstruction and relieve symptoms. It won’t provide a cure for prostate cancer.
Removal of the testicles (orchidectomy)
This type of surgery may be recommended to help slow the growth of the cancer. Again its purpose isn’t to provide a cure for prostate cancer. Instead, removing the testicles removes the source of the male hormone testosterone, which the cancer needs to grow.
After removal the level of testosterone in the blood falls rapidly. This type of treatment is less common than using hormone therapy to manage testosterone levels.
However, it does have the advantage of being one single treatment as opposed to regular hormone injections.
Side effects of prostate cancer treatment
The side-effects of prostate cancer treatment can vary greatly from person-to-person both in terms of the actual side-effects experienced as well as the degree and duration of these side-effects. Side-effects are therefore difficult to predict but can include:
- Incontinence – this often improves after treatment. Medications and pelvic floor exercises can help
- Erectile dysfunction – there are several different treatments for erectile dysfunction which can be effective
- Loss of libido
- Bladder problems
The management of treatment related side-effects is becoming increasingly effective and you should discuss any specific concerns with your treating specialist.
There’s lots of support and information available to you and your family. If you’ve got a health question our Ask the Expert service allows you to ask our team of friendly and experienced nurses, midwives, counsellors and pharmacists about any health topic.
Coping with a cancer diagnosis – AXA Health
How do I tell people I have cancer? – AXA Health
5 cancer myths busted – AXA Health
Useful resources for help and support
Macmillan Cancer Support
Prostate Cancer UK
This information is based on guidance and evidence in men. If you’re a trans woman, male-assigned non-binary or intersex, this information is still relevant to you – but your experience may be slightly different.
For more information, head to Prostate Cancer UK.
- Am I at risk of prostate cancer? - Prostate Cancer UK
- Prostate cancer statistics - Cancer Research UK