Treating prostate cancer is often a team-based decision. The health care provider will explain options and give advice. But in many cases, what type of treatment to use is the patient's call.
The good news is that there are several treatment options with high success rates. You can pick which one fits best with your goals, schedule and values.
The bad news is that with several good options, making a decision can be difficult. Here's what you should know.
What are common treatment options for prostate cancer?
Not all prostate cancer requires treatment. For most intermediate-risk cancers that have not spread outside the prostate, there are 3 common treatment options.
- Surgery (prostatectomy) removes the prostate in a single procedure.
- External beam radiation aims high-energy beams at your prostate to kill cancer. Sessions take 15 to 30 minutes and are spread out over the course of several weeks.
- Brachytherapy uses radioactive sources placed directly in the prostate. It can usually be completed in 1 to 2 sessions.
All 3 treatments have similar rates of success. For many people, the decision comes down to logistics and side effects.
Which treatment works with your schedule?
For many people, getting treated for prostate cancer doesn't have to disrupt a busy life. Here are examples of how people with intermediate-risk cancer decide on a treatment that works for them.
- Victor needs to travel to a hospital 3 hours away from his home for treatment. He decides to have surgery, so that he can complete treatment in just one trip.
- Jamar loves his job as a nonprofit executive. He doesn't want to take time off during a busy year. He chooses external beam radiation because he can get treatments during his lunch breaks.
- Charles wants to avoid surgery. But he doesn't want to have to keep going to radiation appointments. So he chooses brachytherapy, which best meets his needs and works for his schedule.
Which treatment could make your daily life better?
For example, some people with prostate cancer have an enlarged prostate that causes discomfort or pain. Surgery to remove the prostate may offer immediate relief.
What about side effects?
It's not possible to predict how treatment will affect you, but it can be helpful to know the most common side effects. Many patients make treatment decisions based on which symptoms they want to avoid.
- Erectile dysfunction may happen after surgery and external beam radiation. It's typically easier to treat with medication if it's caused by radiation.
- Leaking urine (incontinence) is common after surgery. In some cases, it may not go away.
- Loose bowels are common after external beam radiation or brachytherapy. This symptom typically gets better within a few weeks.
- Frequent or urgent urination may happen after external beam radiation or brachytherapy. It typically only lasts a few weeks.
If your cancer is aggressive, your provider may recommend hormone therapy along with radiation. It can cause several temporary side effects, including fatigue, erectile dysfunction and weight gain.
Reflect on these questions:
- How would each of these side effects change your daily life?
- Which side effect sounds most tolerable?
- Which side effect do you want to try to avoid?
- Do you already have any of these issues in your daily life? For example, if you already experience erectile dysfunction, the risk of that side effect may not concern you.
What's important to you matters
Choosing a treatment for prostate cancer is a personal decision, but you and your care team are partners in this process. Let your provider know what's most important to you. Whatever your values or preferences, there is a treatment option for you.