Treatment choice depends on age, health, tumor risk (PSA, stage, Gleason/Grade Group), and tolerance for side effects. Active surveillance is common for low-risk, localized cancer; surgery or radiation aims for cure in higher-risk cases; systemic therapy treats advanced disease. Use a multidisciplinary team and consider second opinions.
Overview
After a prostate cancer diagnosis and grading, you and your care team should focus on treatment decisions that match your cancer risk, life expectancy, and personal priorities. Take time to understand options, get a second opinion if helpful, and weigh potential benefits against side effects.Key factors to consider
- Age and overall health: comorbidities and life expectancy influence whether treatment aims for cure or symptom control.
- Tumor risk: PSA level, clinical stage (T-stage), and pathology grade (Gleason score and the newer ISUP Grade Group 1-5) determine risk of progression.
- Side effects you can accept: urinary incontinence, bowel changes, and erectile dysfunction vary by treatment.
- Treatment goals: intent can be curative (for localized cancer) or palliative (for advanced disease).
Risk categories and treatment goals
Low-risk, localized cancers (for example, Grade Group 1, low PSA, small tumor burden) are often managed with active surveillance to avoid overtreatment. Intermediate- and high-risk tumors are more likely to be treated with curative intent using surgery or radiation, often combined with androgen-deprivation therapy (ADT) in higher-risk disease. Metastatic prostate cancer is typically managed systemically, with ADT and other targeted or systemic therapies.Main treatment options
Active surveillance
Monitoring with regular PSA tests, repeat prostate MRI and periodic biopsies. It aims to delay or avoid treatment unless the cancer shows signs of progression. This is the standard approach for many men with low-risk disease.Radical prostatectomy
Surgical removal of the prostate can offer cure for localized cancer. Nerve-sparing techniques and improved surgical approaches (including minimally invasive options) can reduce some side effects but do not eliminate risks of urinary and sexual dysfunction.Radiation therapy
External beam radiation or brachytherapy (radioactive seed implants) are curative options for localized disease. Radiation is sometimes combined with short- or long-term ADT for intermediate or high-risk cancers.Systemic therapies
Androgen-deprivation therapy (medical or surgical castration) controls hormone-sensitive disease and is central for metastatic cancers or used with radiation in higher-risk localized disease.Other and emerging approaches
Focal therapies and advanced imaging/genomic tests are increasingly used in select cases to refine risk assessment and personalize care. Discuss availability and evidence with your team.Side effects and quality of life
Side effects vary by treatment and by patient. Urinary control exercises, medications, devices, and rehabilitation can help manage urinary and sexual side effects. Discuss expected outcomes and recovery timelines with your specialists.Making the decision
Use a multidisciplinary team (urology, radiation oncology, medical oncology) and consider a second opinion. Base your choice on tumor risk, life expectancy, and how you weigh possible side effects against the chance of cure. Document your preferences and revisit decisions if your health or the cancer changes.FAQs about Treatment Of Prostate Cancer
What is active surveillance and who is it for?
Active surveillance monitors low-risk prostate cancer with periodic PSA tests, MRI, and biopsies to delay or avoid treatment unless the cancer progresses. It's commonly recommended for men with Grade Group 1 and low PSA who prefer to avoid immediate side effects.
How do surgery and radiation compare?
For many men with low-risk localized prostate cancer, surgery and radiation offer similar cancer control. They differ in side-effect profiles and recovery: surgery may carry higher early urinary issues, while radiation can cause gradual urinary or bowel changes. Discuss specifics with your care team.
Will treatment cause sexual dysfunction or incontinence?
Both surgery and radiation can affect erectile function and urinary continence to varying degrees. Nerve-sparing surgery, rehabilitation, medications, and devices can help. Risks depend on baseline function, age, and the chosen treatment.
What is watchful waiting versus active surveillance?
Active surveillance aims to monitor and treat if the cancer becomes aggressive. Watchful waiting is a less intensive approach for men with limited life expectancy where the focus is on symptom control rather than curative treatment.
Are newer tests like MRI and genomic classifiers useful?
Multiparametric MRI and genomic risk tests can improve risk assessment and help decide between surveillance and active treatment. Discuss their role and costs with your team, as availability and utility vary by case.
News about Treatment Of Prostate Cancer
‘Striking’ new treatment for deadly prostate cancer could increase life expectancy - The Independent [Visit Site | Read More]
New drug combination could delay the progression of advanced prostate cancer - News-Medical [Visit Site | Read More]
Research at Risk: Rooting Out Treatment-Resistant Prostate Cancer - WCM Newsroom [Visit Site | Read More]
Personalization Drives Next Wave of Metastatic Castration-Sensitive Prostate Cancer Treatment - OncLive [Visit Site | Read More]
How Will RLTs Be Integrated Into the Prostate Cancer Treatment Paradigm? - CancerNetwork [Visit Site | Read More]
Men being over-treated for prostate cancer, says charity - BBC [Visit Site | Read More]
Beyond PSMA: theranostic cell surface targets in metastatic prostate cancer - Nature [Visit Site | Read More]