Prostate cancer usually is treated with radiation therapy or surgery. You may also choose watchful waiting (surveillance). Your decision about treatment depends on:

• Your age, overall health, and life expectancy.
• The grade of the cancer, or how clearly the cancer cells can be distinguished from normal cells. Higher-grade cells are more likely to grow rapidly and spread to other parts of the body (metastasize).
• The extent of growth (stage) of the cancer.
• The side effects of treatment.
• Your personal beliefs and concerns.

Prostate cancer is curable if it is discovered and treated in an early stage. However, prostate cancer, unlike many other cancers, is usually slow-growing. Most men will die with prostate cancer but not of prostate cancer. Decisions about additional testing and treatment start with the decision to get a screening test, which in many cases will result in the discovery of slow-growing prostate cancer. ¹⁴

Initial treatment

If your health professional diagnoses prostate cancer, you will have many questions to ask your health professional before and during treatment. Your health professional will explain what type of cancer you have, what stage it is in, and the potential for curing it. Prostate cancer is often a curable disease. About 85% of newly diagnosed cases of prostate cancer will be diagnosed in early stages, and 100% of men with these early-diagnosed cancers survive at least 5 years. ⁴ You and your health professional will discuss your treatment options and the possible results of those treatments. Treatment options for prostate cancer that is confined to the prostate gland (localized) are:

• Watchful waiting. This refers to a period of time in which you are being monitored by your health professional but are not receiving treatment. It is also called observation or surveillance.
• Radiation therapy.
• Surgery, usually prostatectomy (removal of the prostate).

Your treatment options will be different if you are diagnosed with prostate cancer that has come back or has spread outside of the prostate. For more information, see the topic Prostate Cancer, Advanced or Metastatic.

Age is not a reason to not have surgery. However, if you are 70 or older, it is important to consider other medical conditions, such as heart disease, as you make your treatment decisions. This is especially important if you have early-stage cancer, which generally is slow-growing and less likely to cause problems in older men.

It is important to consider the potential side effects as you make your treatment decisions.

• Side effects of prostatectomy (removal of the prostate gland) may include urinary incontinence and erection problems.
• Side effects of radiation therapy may include inflammation of the rectum (proctitis), inflammation of the bladder (cystitis), and erection problems.

Should I have a prostatectomy or radiation therapy to treat localized prostate cancer?

Prostate cancer and the treatment of prostate cancer may cause nausea, pain, or other side effects. You can use home treatment to manage some of these side effects. If you experience nausea, wait for 1 hour after vomiting has stopped and then sip a rehydration drink to restore lost fluids and nutrients. Constipation and diarrhea may be eased if you drink enough fluids.

You may experience a wide variety of emotions after being diagnosed with prostate cancer. Most people will experience some denial, anger, and grief. Others may have fewer emotions. There is no "normal" or "right" way to react to a diagnosis of cancer. There are many things you can do to help with your emotional reaction to prostate cancer. You may find that talking with family and friends helps you with your emotions. Some people may find that spending time alone is what they need.

If your reaction is interfering with your ability to make decisions about your health, it is important to talk with your health professional. Your cancer treatment center may offer psychological or financial services. You may also contact your local chapter of the American Cancer Society to help you find a support group; talking with other people who have had similar feelings can be very helpful.

A diagnosis of prostate cancer usually means that you will be seeing your health professional regularly for years to come, so it's a good idea to develop a relationship based on full and honest information. Your health professional may give you some advice on changes to make in your life to help treatment be successful.

For more information about specific treatments, see the following topics:

• Prostate Cancer – Health Professional Information [Cancer.gov]
• Prostate Cancer – Patient Information [Cancer.gov]

Ongoing treatment

Watchful waiting is a treatment choice that means you are being monitored by your health professional but are not receiving treatment for prostate cancer. If you choose watchful waiting after initial diagnosis, you will have regular digital rectal exams and PSA tests every 6 months to monitor the cancer. If there is no change in your condition, you may continue watchful waiting. If the cancer is beginning to grow or spread, you may consider treatment with medications, surgery, or radiation therapy.

If you choose surgery or radiation therapy to treat your prostate cancer, it is important to receive follow-up care, which may lead to early identification and management of recurrent prostate cancer. Your regular follow-up program may include:

• Physical examinations.
• Prostate-specific antigen (PSA) tests, to monitor PSA levels and to measure the speed of any changes.
• Digital rectal exams (DREs).
• Biopsies as needed, to examine suspicious tissue.

Treatment if the condition gets worse

Prostate cancer can be a progressive condition. For more information on prostate cancer that grows outside of the prostate, comes back, or spreads to other parts of the body, see the topic Prostate Cancer, Advanced or Metastatic.