The treatment choices for each man depend on the size and location of the tumor in his prostate, the results of lab tests, and the stage or extent of the disease. A doctor also considers the man's age and general health when making recommendations about a treatment plan for him. A man considers these recommendations based on a range of personal factors as well.
Many men want to learn all they can about their disease and their treatment choices so that they can take an active part in decisions about their care. They are likely to have many questions and concerns about their treatment options. Most patients also want to know how they will function after treatment and whether they will have to change their normal activities. The doctor is the best person to answer a man's questions, such as what the treatment choices are, how successful a treatment is expected to be, what the risks and side effects may be, and how much a treatment is likely to cost.
The doctor may recommend a treatment but may offer more than one and ask the man to decide which one he would like to follow. This can be a hard decision for a man to make. There is often more than one "right answer," with different trade-offs of possible benefit and possible risks. It is important that a man take the time he needs to make a decision that is best for him.
Treatment for prostate cancer is either local or systemic. Local treatments remove, destroy, or control the cancer cells in one certain area. Surgery and radiation therapy are local treatments. Local treatments are usually used when the cancer is confined to the prostate gland and is potentially curable. Sometimes, prostate cancer grows so slowly that local treatment may cause more harm than closely monitoring the cancer will. Doctors refer to this monitoring as "watchful waiting" or "active surveillance." In these cases, treatment will be started only if necessary.
Systemic treatments are used to destroy or control cancer cells throughout the entire body. Systemic therapies are the main treatment when the cancer has spread outside of the prostate gland and when local therapy alone cannot eliminate all cancer from the body. A patient may have just one treatment or a combination of different treatments. Hormone therapy is typically the first type of systemic treatment used, as it often stops or slows the growth of prostate cancer for some time. Chemotherapy or a prostate cancer vaccine may be used if hormone therapy is no longer working.
It is important to understand the goals of therapy for each man with prostate cancer. Some cancers can be cured, while others can't. The stage and grade information helps a doctor make a prediction about the chances of curing the cancer. This is why knowing the stage and grade is so important. Very aggressive treatment, which has more side effects, makes sense when the goal is to cure the cancer. Less aggressive, gentler therapies make sense when the goal is to control or to slow the cancer's growth.
Not all men require treatment for their prostate cancer. For those who do, a number of treatments are available, including surgery, radiation therapy, and hormone therapy. The man and his doctor will want to consider both the benefits and possible side effects of each option. The patient should understand and compare each treatment's effects on his sexual activity and urination, and discuss any other concerns he has, before making a decision. Also, the patient may want to talk with his doctor about taking part in a research study or clinical trial to help study treatments.