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Am Fam Physician. 2011;84(4):424

See related article on prostate cancer treatments.

What are the pros and cons of treating prostate cancer?

Prostate cancer is usually found in the early stages, when treatment can cure it. Some men have more aggressive cancer that spreads quickly; treatment can be life-saving in these cases. However, treatment can also cause urinary, sexual, and bowel problems.

Why is treatment not recommended for some people?

In most men, prostate cancer grows so slowly that it will not lead to death within 10 years, even if the cancer is not treated. Prostate cancer is usually found late in life, so men who are expected to live less than 10 years and who have a slow-growing cancer will probably not benefit from treatment.

How do I know how aggressive my prostate cancer is?

Your doctor will do a biopsy and a blood test to find out your risk. These tests will also tell you whether the cancer has spread outside the prostate. Treatment is recommended if the risk of the cancer spreading is high, or if it has already spread.

What treatment options are there?

The two most common options are surgery and radiation therapy. Your doctor can help you choose which treatment is best for you. After either treatment, about two out of three patients have problems getting an erection. However, many of these patients usually had this problem before the cancer was found. Surgery is more likely to cause urinary problems, and radiation therapy is more likely to cause bowel problems. One type of radiation therapy, called brachytherapy (BRAY-kee-THER-uh-pee), has fewer side effects. In brachytherapy, radioactive seeds are put inside the prostate gland.

What happens if I choose not to treat my prostate cancer?

If you choose not to treat your cancer, your doctor will have you follow a program called active surveillance. In this program, you will have blood tests and biopsies done on a regular basis. If these tests find that your risk has increased, your doctor may recommend that you consider treatment.

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