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Treatment

Treatments for prostate cancer differ and are influenced by how much the tumour has spread outside the prostate (the ‘stage’ of the cancer) and by how aggressive or fast growing the tumour is found to be in a tissue sample (the ‘grade’ of the tumour). A doctor may use one or more of the tests discussed earlier to determine the stage of the tumour.

The decision to pursue one or a combination of treatments depends not only on the stage and grade of the tumour, but also on other factors such as the age of the patient and the patient's individual preferences.

Prostate cancer is typically treated using one or more of the following methods: ‘watchful waiting’, surgery, radiation therapy and hormone treatment. Chemotherapy is rarely used for prostate cancer, but may be used in advanced cases that are unresponsive to hormone therapy.

Watchful waiting, surgery and radiation are most often used when the tumour is contained and has not spread to other areas. As many prostate tumours grow slowly, a programme of watchful waiting may result in an unaffected life span that is largely symptom-free and uncompromised by side effects. This programme will be likely to include regular PSA testing and rectal examination.

Surgery can remove the entire tumour in early cases, and may be used to ease urination in more advanced cases. Cryosurgery, a relatively new surgical option, freezes and kills the affected tissue with liquid nitrogen. Radiation may be delivered as targeted rays from outside the body, or by inserting tiny radioactive seeds in the prostate, or by injection. Radiation can also be coupled with hormone treatment to provide pain relief.

Hormone therapy is most commonly used to treat prostate cancer that has metastasised to other areas of the body. While it is not a cure at this stage, the treatment can shrink tumours, relieve symptoms and extend the life of the patient. Hormone therapy is also used to treat less advanced stages of prostate cancer - either in conjunction with radiation therapy or to shrink a tumour prior to surgery. Men with decreased testosterone levels due to hormone treatment for prostate cancer are at an increased risk for developing osteoporosis. Your doctor can tell you whether you should undergo testing for such a loss in bone density, or whether measures or treatments to prevent osteoporosis should be considered.

The side effects of different prostate cancer treatments can range from none to fatigue, hair loss, incontinence and the inability to have an erection. Your doctor can make treatment recommendations based upon your test results and particular circumstances.