Prostate cancer

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Treatments for localized prostate cancer

Localized prostate cancer is prostate cancer that is only in the prostate. The cancer hasn’t grown into nearby tissues or to distant parts of the body. Localized prostate cancer includes stage 1 and stage 2.

 

Low-risk localized prostate cancer is unlikely to grow or spread for a long time, if at all.

Medium-risk (intermediate-risk) localized prostate cancer may grow or spread in a few years.

High-risk localized prostate cancer has the greatest chance of starting to grow or spread.

Find out more about risk groups for localized prostate cancer.

The following are treatment options for localized prostate cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Low-risk localized prostate cancer

Low-risk localized prostate cancer grows slowly and almost never causes symptoms. The following are treatment options for low-risk localized prostate cancer.

Active surveillance

Treatments for prostate cancer can cause long-term side effects so doctors don’t give treatment right away for low-risk localized prostate cancer. Your doctor will likely suggest that they monitor the cancer with regular tests and exams to check if the prostate cancer is starting to grow or cause symptoms. This is called active surveillance. Active surveillance may be offered to men with prostate cancer who have a very low risk of the cancer growing quickly or spreading.

But if the cancer starts to grow while you are having active surveillance, you may be offered the following treatments.

Surgery

A radical prostatectomy removes the prostate and some tissue around it. It is the only surgery used to treat localized prostate cancer. A radical prostatectomy may be offered if you are in good health and have a life expectancy of at least 10 years. It is not usually offered to men older than 75 years of age. The surgeon may also remove lymph nodes from the pelvis (called a pelvic lymph node dissection) at the same time as doing a radical prostatectomy.

Radiation therapy

External beam radiation therapy may be offered instead of a radical prostatectomy. It may be preferred in men over the age of 70 who would have a higher risk of complications with surgery.

It is sometimes given after a radical prostatectomy (called adjuvant radiation therapy) to lower the risk that the cancer will come back.

Brachytherapy may be offered instead of external beam radiation or surgery. Brachytherapy is a form of radiation therapy that uses a radioactive substance (radioactive isotope) placed directly into the tumour or very close to it (called an implant).

Medium-risk localized prostate cancer

Medium-risk localized prostate cancer may grow or spread in a few years. The following are treatment options for medium-risk localized prostate cancer.

Surgery

A radical prostatectomy removes the prostate and some tissue around it. It is the only surgery used to treat medium-risk localized prostate cancer. A radical prostatectomy may be offered if you are in good health and have a life expectancy of at least 10 years. It is not usually offered to men older than 75 years of age. The surgeon may also remove lymph nodes from the pelvis (called a pelvic lymph node dissection) at the same time as doing a radical prostatectomy.

Radiation therapy

You may be offered radiation therapy for medium-risk localized prostate cancer.

External beam radiation therapy may be offered instead of a radical prostatectomy. It may also be given after a radical prostatectomy (called adjuvant radiation therapy) to lower the risk that the cancer will come back.

Brachytherapy may be offered instead of external beam radiation or surgery. Brachytherapy is a form of radiation therapy that uses a radioactive substance (radioactive isotope) placed directly into the tumour or very close to it (called an implant).

Hormonal therapy

If you have radiation therapy you will also be given hormonal therapy before, during or after radiation therapy. The following types of hormonal therapy are most often used to treat medium-risk localized prostate cancer:

Active surveillance

Active surveillance may be offered to men with medium-risk localized prostate cancer if you can’t have surgery or radiation therapy because of other health problems. During active surveillance, the healthcare team watches for any signs and symptoms that mean the cancer is progressing. You will begin treatment if there are signs that the disease is starting to grow or spread.

High-risk localized prostate cancer

High-risk prostate cancer has the highest risk of starting to grow or spread. The following are treatment options for high-risk localized prostate cancer.

Surgery

A radical prostatectomy removes the prostate and some tissue around it. It is the only surgery used to treat high-risk localized prostate cancer. A radical prostatectomy may be offered if you are in good health and have a life expectancy of at least 10 years. It is not usually offered to men older than 75 years of age. The surgeon will also remove lymph nodes from the pelvis (called a pelvic lymph node dissection) at the same time as doing a radical prostatectomy.

Radiation therapy

You may be offered radiation therapy for high-risk localized prostate cancer.

External beam radiation therapy may be offered instead of a radical prostatectomy. It may also be given after a radical prostatectomy (called adjuvant radiation therapy) to lower the risk that the cancer will come back.

Brachytherapy may be offered with external beam radiation instead of surgery. Brachytherapy is a form of radiation therapy that uses a radioactive substance (radioactive isotope) placed directly into the tumour or very close to it (called an implant).

Hormonal therapy

If you have radiation therapy you will also be given hormonal therapy before, during or after radiation therapy. Sometimes hormonal therapy may be used alone without other treatments for high-risk localized prostate cancer. The following types of hormonal therapy are most often used:

Active surveillance

Active surveillance may be offered to men with high-risk localized prostate cancer if you can’t have surgery or radiation therapy because of other health problems. During active surveillance, the healthcare team watches for any signs and symptoms that mean the cancer is progressing. You will begin treatment if there are signs that the disease is starting to grow or spread.

Clinical trials

Many clinical trials in Canada are open to men with localized prostate cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

luteinizing hormone–releasing hormone (LHRH)

A hormone that controls the production of sex hormones in males and females.

The hypothalamus produces luteinizing hormone–releasing hormone (LHRH), which stimulates the pituitary gland to produce luteinizing hormone (LH). In turn, LH stimulates the testicles to produce testosterone and the ovaries to produce estrogen and progesterone.

Also called gonadotropin-releasing hormone.

luteinizing hormone–releasing hormone (LHRH)

A hormone that controls the production of sex hormones in males and females.

The hypothalamus produces luteinizing hormone–releasing hormone (LHRH), which stimulates the pituitary gland to produce luteinizing hormone (LH). In turn, LH stimulates the testicles to produce testosterone and the ovaries to produce estrogen and progesterone.

Also called gonadotropin-releasing hormone.

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