Treatment Options for Localized Prostate Cancer

When prostate cancer is confined to the prostate or has only spread to nearby areas, it is called early-stage prostate cancer. It’s also called localized prostate cancer. Your doctor may suggest one or more of these treatments if you have localized prostate cancer.

• Watchful waiting (also known as active surveillance or expectant management). The goal of watchful waiting is to monitor or check cancer that is growing very slowly and will not likely do any harm for a long time, if ever. Sometimes the treatments for prostate cancer can cause more harm than living with the disease. This may be a strategy for you as long as the cancer seems to be: (1) localized to the prostate, (2) not bothersome, and (3) not likely to shorten your life. Other treatments, such as surgery, radiation therapy, or hormone therapy, may be considered if at some point it becomes clear that the cancer is growing or if it begins to cause symptoms. 

• Surgery. The main goal of surgery is to cure you of prostate cancer by removing the tumors. This requires removing your prostate and possibly the surrounding tissue and lymph nodes. This operation is known as a prostatectomy. When the cancer cannot be surgically removed, your doctor may suggest other surgical procedures, such as transurethral resection of the prostate (TURP), to ease symptoms.

• Cryotherapy. This treatment is also called cryosurgery. The goal of cryotherapy is to freeze the cancer cells before they have a chance to spread. The doctor freezes them by making a tiny incision and inserting a probe into the prostate that sends nitrogen to freeze the cancer cells. Most doctors still consider this experimental as a first treatment for prostate cancer.

• Radiation therapy. There are two ways to get radiation. You may have a machine direct radiation from the outside of your body. This is called external radiation or XRT. Or you may receive it internally with the use of tiny radioactive seeds your doctor places into your prostate using thin, hollow needles. Internal radiation is also called brachytherapy. Local treatments may include XRT alone, brachytherapy alone, or the two of them together. The goal of radiation is to kill or shrink cancer cells. If the cancer has spread to areas near the prostate, you may also have hormonal therapy along with the radiation.

You should also learn all you can about your disease and treatment choices so that you can help make decisions about your care. One of the best ways to get the information you need is to ask your doctor and other health care professionals. Make sure that you ask how the treatment will change your daily life. Find out how your diet might have to change and how you will look and feel. Ask how successful the treatment usually is and find out about the risks and possible side effects.