Deciding Treatment

Treatment Options

Once the results of the biopsy and scans are known they will be reviewed at a special meeting by a team of urologists, oncologists (cancer specialists), radiologists (X-ray specialists), pathologists (tissue specialists) and specialist nurses. This is called a Multi-Disciplinary Team Meeting (MDT). Based on a review of these results treatment options will be recommended and relayed to men by their specialist team. Any recommendations will be based on the team’s clinical experience and national guidelines.

Many men and their partners can also benefit from prostate cancer support groups where they can meet other men who have been in a similar situation. For a list of prostate cancer support groups around the UK please click the link below. 

 

 

 

There are many treatment options for prostate cancer and these will depend on the results of all of the staging investigations, the stage of prostate cancer and other factors such as how active the prostate cancer appears to be (measured by the PSA blood test).

Prostate cancer treatment in the UK is performed in line with guidance from The National Institute for Helath and Care Excellence (NICE). NICE has classified prostate cancer into low, medium and high risk groups:

Low risk   PSA less than 10 and Gleason score less than or the same as 6 with a clinical stage of T1–T2a

Intermediate risk PSA between 10-20 and Gleason score of 7 or a clinical stage of T2b-T2c

High risk PSA above 20 with a Gleason score of 8-10 or a clinical stage of T3-T4

For a full summary of NICE guidance please follow this link

Which treatment should I have?

Many men diagnosed with prostate cancer are diagnosed with low or medium grade cancer which is confined or localised to the prostate gland (T1 or T2). In this situation there are likely to be several treatments which could be used to treat the cancer that could lead to a potential cure. These are called radical treatments and include surgery or radiotherapy (including brachytherapy).

Theoretically for localised disease any of these treatments should be able to offer a cure for prostate cancer with a very similar success rate. They will all have potential side effects that could affect a man’s quality of life and therefore it is up to an individual to decide which treatment they would prefer.

Sometimes certain treatments may not be suitable for some men due to factors such as an inappropriate PSA level, size of the prostate or other health conditions. Every man’s case will have been discussed at an MDT meeting where health professionals will have recommended treatment options.

In this situation men need to be as well informed as possible on their options and should make their decision based on their preference.

The following tips may help;

  • Always remain in contact with the Clinical Nurse Specialist or Keyworker who can often help answer questions that they may have.
  • Try and ensure that they see both a urologist who performs surgery and an oncologist who performs radiotherapy to discuss the individual options.
  • Try and ensure that they have their partner or another family member present during their consultations in case they forget some of the information that may be explained to them.
  • Ask for details of side effects.
  • It may be useful to find a local prostate cancer support group where you can discuss treatments first hand with other men who have been through treatment. Details of local prostate cancer support groups can be found here.
  • Men who have surgery to remove the prostate gland usually have the option of radiotherapy as a further possibly curative treatment if needed. Men who have had radiotherapy to the prostate are much more likely to develop urinary incontinence or other problems which could affect their quality of life if they go on to have surgery and surgery is not usually recommended. Salvage treatments such as HIFU or Cryosurgery may be available to treat men after radiotherapy.

 

Last reviewed November 2019. Next review November 2020.

References available on request.

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