Orchid exists to save men's lives from testicular, prostate and penile cancers
through pioneering research and promoting awareness

 

How is prostate cancer treated

If you are diagnosed with prostate cancer, a specialist healthcare team will need to identify the "grade" or aggressiveness of your cancer and the "stage" or progression of your cancer in order to determine the best course of treatment.

The "grade" of cancer is determined through the biopsy and the system used to measure the grade is called the Gleason system. If the cancer is slow growing, only within the prostate gland, and non-aggressive, it will have a low "Gleason score". If it is fast growing, easy to spread to other parts of the body, and aggressive, it will have a high "Gleason score". Most cancers will be scored somewhere between 2 and 10. The "stage" of your cancer determines how far, if at all, it has spread. Tests might include Computerised Tomography (CT) scanning, a bone scan or Magnetic Resonance Imaging (MRI). You may have early prostate cancer where the cancer is only in the prostate gland, locally-advanced prostate cancer where the cancer has spread to nearby lymph nodes in the pelvis, or metastatic disease where the cancer has spread to distant lymph nodes or the bones.

Treatment option When it’s used Drawbacks
Active surveillance and "watchful waiting" Often used for men with low-risk or slow-growing cancers, other medical conditions and those at an early stage. It involves close monitoring with regular check-ups with PSA tests, DREs, scans or sometimes further biopsies. Can lead to anxiety while waiting to see if cancer will progress
Surgery May be used when cancer has not spread too far. May involve removal of the prostate, surrounding tissues and lymph nodes Can cause erection problems or urinary incontinence
Radiotherapy May be used when cancer has not spread too far. Can be either external (where an external beam is directed at the cancer) or internal (where radioactive seeds are placed into or near the cancer – this is known as "brachytherapy") Can cause erection and urinary problems, including urinary incontinence
Hormone therapy Used to slow tumour growth and reduce tumour size. May be used when cancer has spread beyond the prostate. It works by removing or blocking the male hormone, testosterone, which can encourage growth of prostate cancers Can cause hot flushes, loss of sex drive and weakened bones. Eventually, cells become immune and other treatments may be needed
Chemotherapy Most common treatment for cancer and may be beneficial in prostate cancer. Choice of treatment will depend on the grade and severity of the cancer All chemotherapies have side effects

Choice of treatment will depend on a large number of factors, and every individual will be assessed carefully before any treatment decisions are made.

People with hereditary prostate cancer will have exactly the same treatment options as those with other forms of prostate cancer, but because they are often diagnosed at a younger age and may be healthier in general, “watchful waiting” or surgical removal of the cancer may be the preferred options. The key for people at risk of hereditary cancer is prevention, early screening, and early investigation of any prostate symptoms.

ARE THERE ANY NEW TREATMENTS?

There are many new treatments for prostate cancer under development. Your specialist healthcare team can explain these to you and advise if any may be suitable for you. You may read about the following:

  • Cryosurgery or cryotherapy
    Cryosurgery involves freezing and destroying prostate cancer cells.
  • High-intensity focused ultrasound (HIFU)
    HIFU is a treatment that uses ultrasound (high-energy sound waves) to destroy cancer cells.
  • Gene and immunotherapy
    Gene and immunotherapy uses the individual’s own immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defences against cancer.

Some people with prostate cancer may be considered for a clinical trial during their course of their treatment. These trials are an important part of the cancer research process. Individuals who take part in a clinical trial may receive the standard treatment for their cancer or be among the first to receive a new treatment. The “Resources Section” at the back of this leaflet can provide you with further information.

WHY MIGHT YOU BE RECOMMENDED OR REFUSED A SPECIFIC TREATMENT?

No two cases of prostate cancer are the same. The grade and stage of the cancer will vary, as will the medical history and general health of the person being treated. Your specialist healthcare team will consider all these factors before recommending a specific course of treatment. They will also want to consider the side effects of your treatment and how this might affect your quality of life.

 

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