Prostate Cancer Treatments

Treatment options for prostate cancer vary depending on whether the cancer is localized, locally advanced or advanced at the time of diagnosis. Each type of procedure has its pros and cons, which is why it’s crucial to do your research beforehand and find a doctor whose experience and knowledge you can trust.



Localized prostate cancer

Localized prostate cancer is cancer that has not spread outside the prostate gland to other parts of the body. It is also known as early prostate cancer or organ-confined prostate cancer (T1-T2/N0/M0). Localized prostate cancer often grows very slowly or does not grow at all and, thus, it does not affect a man’s life span. This type of prostate cancer might not even need treatment, regular monitoring being sufficient (T1-T2a/N0/M0).

However, there are also localized prostate cancers that are more aggressive and need immediate treatment in order to avoid spreading outside the prostate (T2b – T2c/N0/M0).

Based on the diagnostic and prognosis test performed (PSA level, DRE exam, biopsy – Gleason Grade, Score, Grade Group and Stage) the doctor will determine whether the cancer is low-risk, moderate or high-risk.

Treatment options for localized prostate cancer

Due to the fact that localized prostate cancer often grows slowly, there are ways of monitoring the activity of the cancer, that do not involve treatment and avoid the side-effects usually caused by prostate cancer treatment. There are also surgical and non-surgical treatment options available that aim at getting rid of the cancer.

Ways of monitoring localized prostate cancer


Treatment options for localized prostate cancer

Locally advanced prostate cancer

Locally advanced prostate cancer is cancer that has just started to break out of the prostate. It may have spread to the prostatic capsule, seminal vesicles, pelvic lymph nodes, bladder or the rectum. It has not spread to distant areas, such as the distant lymph nodes or bones. In TNM staging system, it can be represented like this – T3-T4/N1/M0

Treatment options for locally advanced prostate cancer

  • External beam radiotherapy with hormone therapy (and sometimes with high dose-rate brachytherapy)
  • Hormone therapy
  • Surgery (Radical Prostatectomy)
  • Cryotherapy
  • HIFU
  • Watchful waiting

Advanced prostate cancer

Advanced prostate cancer is cancer that has already spread from the prostate to other distant parts of the body. It develops when cancerous cells migrate through the bloodstream or the lymphatic system. It is also called metastatic prostate cancer, even though it can be found in another part of the body.

Prostate cancer can spread to many parts of the body, but, usually, it spreads to the bones. Another common place for prostate cancer to spread is in the lymph nodes, which are part of the lymphatic system. In TNM staging, it can be represented like this: Any T stage/N0/M1 or any T stage/N1/M1.

Advanced prostate cancer generally causes bone pain, urinary problems or fatigue. It can not be cured, but there are treatments that can help to keep it under control and to manage the associated symptoms.

Treatment options for advanced prostate cancer

  • Hormone therapy
  • Chemotherapy with hormone therapy

Treatment to control advanced prostate cancer

  • More hormone therapy – abiraterone (Zytiga®) or enzalutamide (Xtandi®)
  • More chemotherapy
  • Radium-223 (Xofigo®)
  • Steroids

Treatment to manage the symptoms of advanced prostate cancer

  • Pain-relieving drugs
  • Radiotherapy5
  • Drugs called bisphosphonates

Continue your reading with a more thorough approach of each of the treatment methods:


1. Prostate Cancer, Types of Treatment, Cancer.net, Web, March 2018
2. Treating Prostate Cancer, American Cancer Society, Web
3. Treatment options for prostate cancer, American Family Physician, Web, 15 May 2005
4. Prostate Cancer Treatment, American Cancer Institute, Web, 12 Jun 2019

Dr. David Samadi | Robotic Prostate Surgeon