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Prostate cancer is very treatable, and it has almost a
Some treatments are more aggressive than others, but most will have side effects. Let’s learn more about your treatment options and how you can best weigh the pros and cons of each.
Many treatments have been developed for prostate cancer, and each comes with benefits and risks. There’s rarely only one correct option.
Factors that can influence which treatments a doctor might recommend include:
- the stage of your prostate cancer
- your age
- how quickly your cancer is predicted to grow
- whether you have other health problems such as diabetes or heart disease
- if you’ve had previous surgery for an enlarged prostate
- the resources available in your geographic region
- the preference of you and your loved ones
- the possible side effects of and issues from treatment
The stage of your cancer is one of the most important factors for guiding treatment. The most common staging system is the American Joint Committee on Cancer (AJCC)’s tumor–node–metastasis (TNM) system. This system divides cancer from stages 1 to 4 and considers:
- Tumor: This looks at the size of your cancer.
- Node: This looks at whether your cancer has spread to nearby lymph nodes.
- Metastasis: This looks at whether your cancer has spread to distant parts of your body.
- Your prostate-specific antigen (PSA levels): When you receive a diagnosis of prostate cancer, elevated levels can indicate cancer or other conditions that affect your prostate, such as prostatitis or a urinary tract infection.
- Your Grade Group: Based on your Gleason score, this measures how likely it is that your cancer will grow or spread quickly.
The stages of treatment
Because the stage of your cancer is the most influential factor in how your treatment will progress, we’ve divided the rest of this article into segments based on the stage of your cancer:
- Stage 1
- Stage 2
- Stage 3
- Stage 4
Stage 1 prostate cancer is the least advanced stage. This means your cancer is small and hasn’t advanced past your prostate.
In this stage, PSA and Grade Group levels are low.
Active surveillance and watchful waiting
Active surveillance means that no treatment is administered. Instead, you’re given routine tests to monitor how the cancer changes over time.
Doctors
Watchful waiting may also be used if you’re older or have any other serious health issues. You won’t receive treatment or routine tests during watchful waiting, but you may be given treatment to help relieve symptoms and improve your quality of life.
Surgery
A doctor may recommend a type of surgery called a radical prostatectomy to remove your prostate and seminal vesicles. This surgery is usually combined with a pelvic lymphadenectomy to remove your lymph nodes and check for cancer.
You may also receive radiation therapy after surgery.
Radiation therapy
Radiation therapy uses high-energy rays to kill cancer cells. It may be combined with androgen deprivation therapy (ADT), a
Two types of radiation therapy may be recommended:
- External radiation therapy: A machine outside your body focuses a beam of high-energy rays on the area with the cancer. This type of radiation therapy is the most common.
- Internal radiation therapy: Small pieces of radioactive material are placed into your prostate.
Clinical trials
You may be eligible for clinical trials that use newer treatment techniques. If researchers find these techniques are more effective than the current standard treatments, they become the new standard treatment.
A doctor can help you find clinical trials in your area that you may be eligible for. You can also search on ClinicalTrials.gov. Clinical trial treatments may include:
- Cryosurgery: An extremely cold liquid is used to freeze and destroy cancerous tissue.
- Photodynamic therapy: The cancer cells are destroyed with drugs that are activated by light exposure.
- High-intensity-focused ultrasound therapy: High-energy sound waves are used to create heat and destroy cancer cells.
Keep in mind that clinical trials are experimental and won’t necessarily be more effective than any established treatments. Talk with a doctor about what you can realistically expect when you enter into a clinical trial for prostate cancer. They’ll also be able to ensure the trial doesn’t interfere with treatments for any other health condition you may have.
Stage 2 prostate cancer is still limited to your prostate gland, but your PSA and Grade Group levels are higher. A doctor may be able to feel the tumor during a digital rectal exam at this stage.
The AJCC staging system breaks stage 2 into 2A, 2B, and 2C depending on how big your tumor is and how the cells look under a microscope. A doctor may factor in these distinctions when helping to identify the best prostate cancer treatment options for you.
- Active surveillance: Your PSA levels are checked, and an occasional tissue sample is taken to look for cancerous cells.
- Watchful waiting: This looks to relieve symptoms and sustain your quality of life if you’re older or have other health issues.
- Radiation therapy: This treatment kills cancerous cells.
- Radical prostatectomy surgery: Possibly with radiation, this process removes your prostate and the tissue around it.
- Clinical trials: These investigate newer treatments.
Active surveillance is usually only recommended in stages 2A and 2B.
Prostate cancer resources
If you want to learn more about prostate cancer and its treatments, check out some of the other work we’ve done at Healthline:
- The Four Stages of Prostate Cancer: What You Need to Know
- Why Black Men Benefit From Immunotherapy for Prostate Cancer
- Prostate Cancer: Delaying Treatment
- New Ultrasound Treatment for Prostate Cancer Revealed
- Proton Therapy for Prostate Cancer: Benefits, Risks, and More
- Will Prostate Cancer Affect Your Sex Life?
- Does Diet Affect Your Prostate Cancer Outlook?
- Prostate Cancer: Hormone vs. Non-Hormone Treatments
- Why Exercising Like an Astronaut Can Help People with Cancer
People with stage 3 prostate cancer still have a
Stage 3 is divided into stages 3A, 3B, and 3C. Cancer in stage 3B or 3C may have spread beyond your prostate to nearby tissue, such as your seminal vesicles (glands that help produce semen for ejaculation) or lymph nodes that carry lymph fluid throughout your body. Prostate cancer in these stages is harder to treat effectively.
- External radiation therapy: This helps to kill cancerous cells.
- ADT: This lowers the levels of androgens such as testosterone. Lowering androgen levels can help slow the growth of cancerous tumors.
- Radical prostatectomy surgery: This removes your prostate and the tissue around it.
- Active surveillance: This monitors your PSA levels and examines the tumor tissues for cancerous cells.
- Watchful waiting: This treats your symptoms if you’re older and you have a high risk of side effects from other treatments.
Treatment may include a type of surgery that cuts away part of your prostate called transurethral resection of the prostate (TURP). This surgery can help manage symptoms such as frequent urination or sudden urge to pee caused by your prostate putting pressure on your urethra.
A doctor may also recommend internal radiation or clinical trials. But keep in mind that clinical trials are experimental and may not always be more effective than any other available treatments.
Talk with a doctor about the possible side effects that can result from these treatments, including:
- incontinence (losing control of your bladder)
- diarrhea
- tender breast tissue
- growth of breast tissue (gynecomastia)
- sudden hot flashes
- feeling a lowered desire to have sex
- having trouble getting or keeping an erection
- being more likely to fracture or break a bone due to bone loss
- having seizures after never experiencing them before treatment
- feeling dizzy
Stage 4 prostate cancer is the most advanced form of prostate cancer, so the survival rate is lower.
It’s divided into stages 4A and 4B:
- Stage 4A cancer: This is when the cancer has spread to nearby lymph nodes and possibly to other nearby tissues such as your rectum, bladder, or pelvic wall.
- Stage 4B cancer: This is when the cancer has spread to distant parts of your body such as your bones or distant lymph nodes.
The 5-year relative survival rate
- External beam radiation treatment with ADT: This kills cancerous cells and stops androgens such as testosterone from causing the tumors to grow faster.
- Abiraterone: This helps to lower the levels of androgens in your body that can promote tumor growth.
- Radical prostatectomy with pelvic lymph node dissection: This process removes your prostate, the affected tissue around your prostate, and the cancerous tissue in your nearby lymph nodes.
If you don’t have symptoms or other serious health problems, a doctor may recommend:
- Watchful waiting: This looks to relieve your symptoms and keep up your quality of life if other treatments are too risky.
- Active surveillance: Your PSA levels are monitored, and your prostate tissue is examined for cancerous cells.
- Hormone therapy: This lowers your androgen levels and slows the tumor growth.
Most stage 4B cancers can’t be completely gotten rid of. But treatment can help keep your cancer under control and improve your quality of life. Treatment
- ADT: This can be alone or combined with:
- abiraterone to lower your androgen levels and slow tumor growth
- apalutamide in combination with other ADT options to improve your outlook
- chemotherapy (usually with docetaxel) to kill cancerous cells
- enzalutamide to slow tumor growth
- external beam radiation therapy, which uses x-rays or proton beams to break down cancerous tissue
- TURP: This surgery treats symptoms such as urinary obstruction.
- External radiation: This kills cancerous cells.
- Watchful waiting: This looks to minimize your symptoms if other treatments are too risky.
- Active surveillance: Your PSA levels are monitored, and your prostate tissue is examined for cancerous cells.
- Bisphosphonate therapy: This is treatment for bone pain.
- Alpha emitter radiation therapy: This is for treating prostate cancer that’s spread to your bones.
- Radical prostatectomy with testicle removal: This treatment is also called an orchiectomy.
Many of these treatments can slow the progress of your tumor growth and help you live longer. But keep in mind that these treatments may also have painful or disruptive side effects that can decrease your quality of life,
- incontinence (losing control of your bladder)
- bloating
- feeling depressed
- feeling a lowered desire to have sex
- having trouble getting or keeping an erection
- gaining or losing weight quickly without any diet or lifestyle changes
- a heart rate that’s too fast or too slow
- feeling extremely tired all the time
- chest tightness
- having trouble getting enough air
- feeling nauseous or throwing up
Talk with a doctor about whether treatment will be effective enough for you to proceed with the risk of side effects or problems.
For some people, active surveillance and watchful waiting may the best ways to lower pain and discomfort from the spread of cancer cells when other treatments may be ineffective or too risky to attempt, especially if they’re older or have other serious health issues.
Living with prostate cancer
Receiving a prostate cancer diagnosis can be stressful. Even though most people who receive a diagnosis of prostate cancer live for many years after receiving the diagnosis, treatment can be exhausting and cause side effects that impact your quality of life.
Many resources are available to help you get through these difficult times:
- Prostate Cancer Foundation created a list of treatment centers
- CancerCare keeps a list of community programs
- American Cancer Society runs a
24/7 helpline - ZERO has a list of organizations offering financial support
- National Cancer Institute provides a
list of support groups - ClinicalTrails.gov has an index of ongoing trials in the United States
Many treatment options have been developed to treat prostate cancer. Common treatment options include watchful waiting or active surveillance, radiotherapy, surgery, and hormone therapy.
It’s important to discuss treatment options with a doctor to decide what the best prostate cancer treatment is for your specific needs. Usually, there’s no one right or single option. A doctor can let you know what your options are and inform you about the pros and cons of each.
And no matter what type of treatment you choose, consider looking for mental health support resources as well. This can help you continue to live as healthy and happy a life as you can after receiving the diagnosis and during treatment.
