Information for patients and families

Treatment options


What are the treatment options for prostate cancer?

There are several ways that prostate cancer can be managed and treated.

These include:1

  • Watchful waiting
  • Active surveillance
  • Radiotherapy
    • External beam radiotherapy (EBRT)
    • Brachytherapy (internal radiotherapy)
  • Surgery
  • Chemotherapy
  • Hormone therapy


The types of treatment you receive will depend on how far the cancer has progressed. You can find out more about the progression and stages of prostate cancer in the introduction section.

The table below provides a broad overview of the different treatments.1 Each treatment has advantages and disadvantages. These should be considered and discussed with your healthcare professional when choosing the most suitable treatment options for you.


Treatment
Grade of prostate cancer
Low risk Medium risk High risk
Watchful waiting
If the cancer is thought to be unlikely to progress during a patient's natural lifespan, treatment is avoided unless the cancer starts to advance. This approach may be offered to older men, or those with other serious illnesses. However, for most other men, active surveillance or a form of treatment (see below) are more common options.    
Active surveillance
If the cancer is also not causing any health problems, immediate treatment may not be required. In these circumstances, you can undergo regular check-ups. If tests start to indicate that the cancer might progress, treatment can start straight away.    
Brachytherapy (internal radiotherapy)
Works by precisely targeting the cancerous tumor. The source of radiation is placed directly next to the tumor.
External beam radiotherapy (EBRT)
The source of radiation is directed at the tumor from outside of the body.
Surgery (prostatectomy)
Removal of the prostate and surrounding tissues.  
Hormone therapy
Oral tablets to shrink the size of the tumor. Treatment usually given in addition to another treatment.  
Chemotherapy
A course of chemotherapy may be recommended in addition to surgery and/or radiotherapy. Several drugs are effective and your doctor will be able to advise of the best one for you.    


Advantages and disadvantages of prostate cancer treatments

Treatment Advantages Disadvantages
Watchful waiting

Avoids unnecessary investigations and treatment if the cancer is unlikely to progress during a patient's natural lifespan.2

If the cancer progresses, the available treatment options may be limited.2
Active surveillance

Regular monitoring means treatments can start immediately, if required.2

Some patients may feel concerned that the cancer will spread if actual treatment is not being received.2
Brachytherapy (internal radiotherapy) Reduced risk of unnecessary damage to surrounding healthy tissues and organs, which reduces the chance of side effects.3
Clinically proven to be highly effective.4
Minimally invasive technique.3
Short treatment times – the procedure can be completed within an hour.5
Short recovery time.5
Can be used in combination with other treatments.2

May require more than one visit to the hospital depending on the procedure.3

External beam radiotherapy (EBRT) Clinically proven to be highly effective.2
Short recovery time.
Can be used in combination with other treatments.
Increased chance of some long-term side effects compared with brachytherapy, as the radiation passes through healthy tissues.2
Longer treatment times than brachytherapy.2
Surgery (prostatectomy)

Clinically proven to be highly effective.2
One-time procedure.

Increased chance of some long-term side effects compared with brachytherapy.2
Invasive technique.
Longer treatment and recovery times than brachytherapy.2
Hormone therapy Can be used in combination with other treatments.2 Does not provide a cure.2
Chemotherapy Can be used in combination with other treatments.
Depending on the drug, outpatient treatment is possible.
Depending on the drug, a stay in hospital may be required.


References
  1. National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/wyntk/prostate/page8. Accessed 2 February 2011
  2. National Cancer Institute. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/prostate/HealthProfessional/page4. Accessed 2 February 2011.
  3. Fatyga M, Williamson JF, Dogan N, et al. Med Phys 2009;36(9):3995-4006.
  4. Grimm P. et al. BJU Int 2012 ;109 (Suppl1): 22-29
  5. Hoskin PJ and Bownes P. Semin Radiat Oncol 2006;16(4):209-17.
Page last updated on 24 April 2014.

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