While standard protocols have been established for the treatment of virtually all cancers, physicians will often modify them for their individual patients. These modifications are based on many factors including the patient’s age, general health, desired results, and the specific characteristics of his or her cancer. Since the treatments described in this report represent the standard therapeutic approaches, your physician may not strictly adhere to them.

The treatment and management of prostate cancer depends on the location and size of the tumor, the stage of the cancer, your general health, and other factors. Because prostate cancer usually tends to progress very slowly, your age, current level of health, and predicted life expectancy are very important factors in deciding treatment. Often, more than one type of treatment may be used.

The choice among these treatments requires careful discussion with your doctors. It may be appropriate to get input from several types of specialists—a urologist (surgeon), radiation oncologist, and a medical oncologist—to help you make this important decision.

Treatment for Prostate Cancer that has not Spread (Localized Cancer)

If your cancer has not spread, your doctor may recommend watchful waiting, surgery, or radiation therapy. The surgical procedure that is used is called a radical prostatectomy, which is the removal of the prostate gland. Radiation can be given from outside the body (externally) or by implanting small sources of radiation within the prostate gland

Unfortunately, there have been no studies to determine which of these treatments is best for which groups of patients, either in terms of the likelihood of curing the cancer, or in terms of side effects and complications. In general, patients with early stage cancers and relatively low PSA levels and Gleason scores are more likely to have good results with any of these approaches. Conversely, when the cancer is more advanced, the outcomes are worse with any of these types of treatment.

Treatment for Prostate Cancer that has Spread to Other Parts of the Body (Advanced Cancer)

If your cancer has spread outside of your prostate to other parts of the body (called advanced), the treatment approach will be slightly different than that for localized cancer. Treatment for advanced prostate cancer includes hormonal therapy, radiation, and chemotherapy, as well as supportive care to manage the side effects of both the cancer and the treatment.

Select a topic below for a thorough discussion of each prostate cancer treatment option:
Surgery
Radiation therapy
Chemotherapy
Hormonal therapy
Other: watchful waiting
Lifestyle changes
Managing the side effects of cancer and its treatment

Existing treatment protocols have been established and continue to be modified through clinical trials. These research studies are essential to determine whether or not new treatments are both safe and effective. Since highly effective treatments for many cancers remain unknown, numerous clinical trials are always underway around the world. You may wish to ask your doctor if you should consider participating in a clinical trial. You can find out about clinical trials at the government website ClinicalTrials.gov .