Prostate cancer is often curable. About 90% of new cases of prostate cancer are caught early. Almost 100% of men with these early cancers survive 5 years or more after being diagnosed.¹

Choosing treatment for prostate cancer can be confusing. Not all men are treated the same way. Any treatment can cause serious side effects.

You and your doctor have two choices: You can treat your cancer, most likely with surgery or radiation, or you can wait and watch to see what happens.

Watchful waiting may be a good option if you are around age 70 or older. During watchful waiting, you have regular checkups with your doctor to see if your cancer has changed.

In general, healthy men who are younger than 60 and whose cancer has not spread are treated with surgery or radiation. Surgery removes the prostate gland and its cancer. Radiation destroys the cancer and may damage nearby healthy cells. With these treatments, there is a chance of having erection problems, some chance of having urine leakage problems, and a small chance of having bowel problems.

Because of these side effects, some men, especially some older men, may decide that the cure is worse than the disease. Studies show that some men are willing to accept the risk of a shorter life span in return for a better quality of life than what they would have with treatment.¹⁰

Your treatment decision will depend on:

• Your age, overall health, and life expectancy.
• Your PSA level.
• What kind of cancer cells you have. This is called the grade or Gleason score of your cancer. Most prostate cancer cells grow very slowly, but some types of cells grow quickly and spread to other areas of the body.
• How far your cancer has spread. This is called the stage of your cancer.
• The side effects of treatment.
• Your personal feelings and concerns.

Prostate cancer is curable if it is discovered and treated early. Unlike many other cancers, it is usually slow-growing. Most men will die with prostate cancer but not of prostate cancer. This slow growth means you have time to learn all you can before deciding whether to have treatment or which treatment to have.

Initial treatment

There are three main choices for treating prostate cancer: surgery, radiation, and watchful waiting, also called observation.

Surgery involves removing the cancer by removing the prostate gland. This operation is called a prostatectomy. Before removing the prostate, the surgeon may remove some lymph nodes in the area to see if the cancer has spread.

There are nerves along the side of the prostate that affect your ability to have an erection. Sometimes these nerves are removed along with the prostate to make sure that all the cancer is removed. Sometimes a surgeon may be able to avoid damaging those nerves; this is called nerve-sparing surgery. The surgeon will only do that if he or she feels sure that there is little chance of leaving some cancer cells behind.