Treatment options for prostate cancer
You and your doctor can decide together on the best treatment plan for you. Your doctor is an expert in the best treatments. But you know your preferences and what is important to you. You can decide how involved you want to be in your treatment plan.
- Your treatment for prostate cancer will depend on:
- your general health
- your age
- the risk group if you have early prostate cancer
- the Gleason score and cancer grade
- the stage of the cancer
- your preferences. Your preferences and how you feel about treatments is a personal choice. What is important to one person might not be to someone else.
Multidisciplinary team (MDT) for prostate cancer
After your test results, you and your doctor start to talk about your treatment. Your doctor usually meets with other specialists to get their opinions too.
A team of specialists meets to talk about the best treatment for you. This is called a multidisciplinary team (MDT). The MDT looks at national treatment guidelines or the latest evidence for the type of cancer. If you have any treatment preferences, your doctor will tell them about this.
The MDT meeting will usually include the following professionals:
Urologist or urological surgeon is a doctor who treats problems with and does surgery on the prostate, kidneys, bladder and male reproductive system.
Clinical oncologist is a doctor who uses radiotherapy, chemotherapy and other anti-cancer drugs to treat people with cancer.
Medical oncologist is a doctor who uses chemotherapy and other anti-cancer drugs to treat people with cancer.
Clinical nurse specialist is a nurse who gives information about cancer, and support during treatment.
Radiologist is a doctor who looks at scans and x-rays to diagnose problems.
Pathologist is a doctor who looks at cells or body tissue under a microscope to diagnose cancer.
The MDT may also include:
Pathway co-ordinator, who can provide information and guidance for other needs, such as financial support.
Advanced nurse practitioners, who are specialist nurses for types of cancer and treatments - for example, surgical advanced nurse practitioners.
Advanced clinical practitioner, who is an expert healthcare professional, such as a nurse, who works with doctors to help assess people with cancer and manage their treatment and care.
Other healthcare professionals – for example, physiotherapists, occupational therapists or pharmacists, who are specialists in cancer and treatments.
Other people will be involved in your care. This includes medical and nursing staff on the wards or in different departments. If you have radiotherapy, you will meet a therapeutic radiographer. They are an expert in radiotherapy and are specially trained to give you treatment. They can also give you support, advice and information.
Treatments for prostate cancer
The main types of treatment for early stage prostate cancer or locally advanced prostate cancer include:
- Surgery to remove the prostate
- External beam radiotherapy
- Internal radiotherapy (brachytherapy)
- Active surveillance
- Hormonal therapy
- Watchful waiting
- High-intensity focused ultrasound (HIFC) or cryotherapy
- Prostate cancer risk groups and treatment
In prostate cancer, doctors offer treatments based on the risk group of the cancer using the Cambridge Prognostic Group system (CPG). Your doctor may still describe your risk as low, moderate or high.
- Low risk prostate cancer (CPG1 or 2)
- Intermediate risk prostate cancer (CPG3)
- High risk prostate cancer (CPG4 or 5)
Making treatment decisions
You and your doctor can decide together on the best treatment plan for you. Your doctor is an expert in the best treatments. But you know your preferences and what is important to you. You can decide how involved you want to be in your treatment plan.
Sometimes doctors need to review a treatment plan. This may be when more information about the cancer becomes available – for example, when the doctor knows the results of surgery to remove the cancer. It may mean making more decisions with your doctor.
When you make treatment decisions, there are different things you may want to think about:
How you feel about different treatments
How you might cope with treatments if you have other health conditions. For example, you may prefer not to have surgery if you have heart problems. Or you may want to avoid radiotherapy if you have a bowel condition – some bowel problems mean that radiotherapy is not suitable.
How much side effects are likely to bother you – for example, erection difficulties. If active surveillance is suitable, you may be able to avoid erectile dysfunction (ED) caused by surgery or radiotherapy. After surgery, you are more likely to get ED straight away.
Whether cancer is very unlikely to cause you problems over your lifetime. If it is unlikely, monitoring the cancer with active surveillance or watchful waiting may be more suitable for you.
What your treatment options would be if the cancer came back. You may be able to have radiotherapy after surgery. But it may not be possible to have surgery if you have already had radiotherapy.
Treatment effects on your sex life
The effects of treatment on your sex life and relationships may be a big concern for you. Your doctor and nurse will explain the likely effects of treatments on your sex life. You may worry about talking about your sex life with your healthcare team. But it is important to ask questions. There are different treatments and support available to improve sexual difficulties.
Fertility
Most treatments for prostate cancer are likely to cause infertility. This means you will no longer be able to make someone pregnant. If fertility is a concern for you, contact your healthcare team before treatment.
Did you know?
Diagnose
About 1 in 8 men will be diagnosed with it during their lifetime.
