Choosing treatment for prostate cancer can be confusing. Not all men are treated the same way. Any treatment probably will cause serious side effects. It's important to learn all you can about your choices and talk to your doctor about them.

Your decision depends 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. Some prostate cancer cells grow more quickly than others.
• How far your cancer has spread. This is called the stage of your cancer.
• The side effects of treatment.
• Your personal feelings and concerns.

Treatment for locally advanced or metastatic prostate cancer may include hormone therapy, surgery, radiation therapy, chemotherapy, and pain medicine. You may want to talk with your doctor about entering a clinical trial of new cancer treatment options.

You may experience a wide variety of emotions after being diagnosed. Most men feel some denial, anger, and grief. Others may have fewer emotions. There is no "normal" way to react. 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 men 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 doctor. 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 men who have had similar feelings can be very helpful.

Prostate cancer and its treatment may cause nausea, pain, or other side effects. You can manage some side effects at home. 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. Pain does not have to be an accepted part of treatment for prostate cancer. For tips on handling pain, see:

Controlling cancer pain.

For more information, see the topic Cancer Pain.

Localized prostate cancer is cancer that is small and has not spread outside the prostate. For more information on treatment of localized prostate cancer, see the topic Prostate Cancer.

Treatment for locally advanced prostate cancer

Prostate cancer that has spread to tissues around the prostate may be treated with:

• Hormone therapy. Prostate cancer often needs your body's male hormones to survive. Hormone therapy decreases the amount of testosterone and other male hormones in your body. This often causes tumors to shrink. Shrinking the tumors also can ease severe bone pain caused by the spread of cancer to the bones. Hormone therapy usually is combined with radiation therapy. The most common drugs are:
  • LH-RH agonists and GnRH agonists. These drugs stop the body from making testosterone.
  • Antiandrogens. These often are used along with LH-RH agonists. Antiandrogens help block the body's supply of testosterone.
• Radiation therapy. This treatment uses high-energy rays, such as X-rays, to destroy the cancer. It usually is combined with hormone therapy.
• Prostatectomy. This operation takes out your prostate gland and the cancer in and around it. Surgery can be successful if the tumor has not spread beyond the outside of your prostate and is easily removed.