Treatments and questions/options

Our primary knowledge is the experience of receiving treatment. So here we list the treatments and give web links and suggest you contact us. Each of the links below includes questions you might ask your GP or specialist. Also, the Prostate Cancer UK Education Advisory Group has outlined ways in which primary care physicians can ensure that PSA testing is targeted at those who are most likely to benefit. This information is directed at medical professionals but is useful for patients – it can guide what level and kind of service you should expect from your GP, and can help you to formulate the kinds of questions to ask. See the article.

Active surveillance – pro-active monitoring of early stage cancer with the intent to cure.

Watchful waiting – regular check ups possibly leading to hormone treatment or palliative care. This is offered to men who are likely to die from other causes.

Surgery – an operation to remove the prostate, suitable for localised cancer.  There are currently 3 methods: open surgery, keyhole (laparascopic) surgery or robotically assisted surgery.

External Beam Radiotherapy – uses radiation to destroy the cancer cells.

Permanent Seed Brachytherapy – radioactive seeds are implanted long term in the prostate.

Hormone treatment – used either as an additional treatment to radiotherapy or where the cancer has spread outside the prostate.

Cryotherapy or cryosurgery – freezing of the prostate; may be used after failed radiotherapy.

High Intensity Focused Ultrasound (HIFU) – cancer cells are heated and destroyed by ultrasound.
Cryrotherapy and HIFU are fairly new treatments and may be offered as part of clinical trials. Each case can be considered by individual Primary Care Trusts.

Bisphosphonate chemotherapy – drugs that help manage bone pain

Orchidectomy (also called orchiectomy) is an operation to remove your testicles (testes). It is an alternative to chemical castration by hormone therapy and is effective in shrinking the cancer in 90% of men.

External beam radiotherapy High energy X-ray beams treat the cancer.

High dose-rate brachytherapy Temporary brachytherapy, also known as high dose-rate (HDR) brachytherapy, involves inserting a source of high dose-rate radiation into the prostate for a few minutes at a time to destroy cancer cells. It is not available at every UK treatment centre, but Bristol Haematology and Oncology Centre specialises in it.