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Treating prostate cancer

Te whakarauora i te mate pukupuku repe tātea

If your prostate biopsy shows that you have prostate cancer, there are several treatment options. Your urologist will discuss the treatment options with you. Most men will also be offered an appointment to discuss the treatment options with a radiation oncologist.

Active surveillance

Active surveillance is an option if doctors consider your cancer to be low risk.

Active surveillance means that you'll have repeat tests at regular intervals. The tests are likely to include PSA tests, digital rectal examinations and biopsies.

Most men will have an MRI scan within six months of their diagnosis to confirm that it's safe for them to stay on active surveillance.

If the tests show that your cancer is getting worse, your doctor may recommend surgery or radiation therapy. But many men with prostate cancer never need treatment.

Watch and wait

Watch and wait is an option if you only have a small amount of cancer and it appears to be slow growing.

It's also used if your age or medical condition makes it unlikely that the cancer will cause you any problems within your expected lifetime.

Watch and wait usually involves fewer tests than active surveillance. You'll usually have check-ups from your general practice team rather than at the hospital. You're unlikely to have further prostate biopsies.

At some point, your doctor might recommend hormone treatment. You're unlikely to have surgery or radiation to cure the cancer.

Surgery (radical prostatectomy)

Radical prostatectomy (pross-ta-tek-tom-ee) is an attempt to cure your cancer.

In a radical prostatectomy operation, the surgeon removes your prostate.

The surgery can be done through a long cut in your stomach (open prostatectomy) or several smaller cuts (keyhole surgery).

Side effects from surgery include trouble controlling your bladder and erection problems (erectile dysfunction).

Radiation therapy

Radiation therapy is an attempt to cure your cancer by killing the cancer cells within your prostate.

You need to have the radiation therapy daily (for about 15 minutes) for seven to eight weeks. You can usually keep working while having the treatment and carry on with your normal activities.

In some cases, radioactive seeds can be used to apply the radiation. This is called brachytherapy (brak-i-therapy). Surgeons implant the seeds into your prostate under a general anaesthetic. Brachytherapy generally has less side effects than conventional radiation therapy.

Brachytherapy is only done privately, which means you have to pay for it.

Possible side effects from radiation therapy include trouble with your bowels such as diarrhoea, trouble with your bladder and erection problems.

Hormonal treatment

Hormonal treatment aims to control your cancer rather than cure it.

Male hormones help prostate cancer grow. Reducing the male hormones in your body can slow down the growth of your cancer.

Hormone therapy comes in many forms, including oral tablets, injections and an injectable implant that you get every one or three months.

Side effects from hormone treatment include weight gain, mood changes, hot flushes, thinning of your bones, loss of sexual desire and erection problems.

Chemotherapy

Chemotherapy uses drugs to shrink the cancer cells and slow the growth and spread of the cancer. You may need it if the cancer has spread outside your prostate or if hormone therapies are no longer working.

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Uses information written by Urology Associates, Canterbury Urology Research Trust and Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed July 2022.

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Review key: HIPRH-45800