Treatment options for prostate cancer part 2

Active surveillance

Many prostate cancers
are diagnosed at an early stage by PSA testing. Prostate cancer is
often very slow-growing and for many men with prostate cancer, the
disease may never progress or cause any symptoms. In other words, many
men with prostate cancer will never need any treatment. Treatments for
prostate cancer can cause side-effects, which can affect your
lifestyle. By monitoring the cancer with active surveillance, you can
avoid or delay the side-effects of treatment.

Active
surveillance aims to find those cancers that are likely to grow and
cause symptoms if they are not treated. These cancers can then be
treated at an early stage.

Active surveillance may be suitable
if you have low to medium risk prostate cancer. It will involve regular
check-ups with PSA tests, rectal examination of the prostate and
possibly repeat prostate biopsies.

Surgery

Removing the prostate (radical
prostatectomy) can be curative if the cancer is in an early stage
(confined to the prostate and not spread). It is a major operation and
so tends to be advised more often for younger men whose general health
is good, especially if the cancer grade means the cancer is likely to
spread in the future. Side-effects such as impotence and/or
incontinence of urine may occur following a prostatectomy.

Radiotherapy

Radiotherapy is a treatment
which uses high energy beams of radiation which are focused on
cancerous tissue. This kills cancer cells, or stops cancer cells from
multiplying. See separate leaflet called 'Radiotherapy' for more details.

Radical
radiotherapy may be used as an alternative to surgery. Two types of
radiotherapy are used for prostate cancer - external and internal.
Again, the type chosen depends on various factors such as the size,
grade and stage of cancer.

Radiotherapy is often more suitable for men who are not fit enough or choose not to have an operation.

• External
  radiotherapy. This is where radiation is targeted on the prostate
  cancer from a machine. (This is common type of radiotherapy used for
  many types of cancer.)
• Internal radiotherapy (brachytherapy). This treatment involves
  inserting a small radioactive implant into the cancerous tumour, or
  next to the tumour. Sometimes radioactive 'seeds' are placed into the
  prostate gland. The 'seeds' are left in place permanently but lose
  their radioactivity over time. Sometimes a larger radioactive implant
  is inserted into the prostate for a short time and then removed.
  External radiotherapy may be also given with this type of brachytherapy.