Am Fam Physician. 2018;97(12):online
See related article on prostate cancer
What are the pros and cons of treating prostate cancer?
Prostate cancer is usually found early in the disease, when it can be cured. Some men have more aggressive (or faster-spreading) cancer. In these men, treatment can be lifesaving. However, treatment can also cause side effects, like 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 without treatment. Men who have a slow-growing cancer and aren't expected to live for at least 10 years (for example, because of older age) will probably not benefit from treatment.
How do I know how aggressive my prostate cancer is?
Your doctor will do a blood test and take a small piece of your prostate for testing (this is called a biopsy) to find out if your cancer has a high risk of spreading outside the prostate. These and other tests will also tell your doctor whether the cancer has already spread.
How is prostate cancer treated?
Treatment is recommended if there is a high risk of the cancer spreading or if it has already spread. The two most common options are surgery and radiation therapy. Your doctor can help you choose which treatment is best for you.
What are the possible side effects of treatment?
About two out of three patients who are treated for prostate cancer have problems getting an erection. However, many of these patients had this problem before they got cancer. 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 than other types. In brachytherapy, radioactive “seeds” are put inside the prostate gland.
What happens if I choose not to get treatment?
For very low-risk and low-risk prostate cancer that has not spread, you may choose active surveillance instead of medical treatment. If you choose this option, you will have blood tests and biopsies done regularly. If any of these tests find that your risk has increased, your doctor may recommend that you consider treatment.
Where can I get more information?
Your doctor
American Cancer Society
National Cancer Institute
Adapted with permission from Mohan R, Schellhammer PF. Prostate cancer: who should be treated? [patient handout]. Am Fam Physician. 2011;84(4):424. https://www.aafp.org/afp/2011/0815/p424.html. Accessed January 9, 2018.
