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Prostate Cancer Treatments

The treatments of prostate cancer are many and varied. Ultimately our surgeons will tailor their recommendations based on your imaging and biopsy findings. Many of the treatment options are covered below. Prostate Cancer UK also is a very good source of information. Your clinician should provide you with a toolkit outlining treatment options suitable for you. These are available electronically here: PCUK Tool kit

Active Surveillance

Not all prostate cancer needs immediate treatment. In fact, some can be monitored for many years without needing treatment. Men who have been diagnosed with low volume Gleason score 6 cancers and for some with Gleason 3+4 cancers will usually be recommended Active Surveillance. This allows slowly progressing cancers to be monitored and avoid the potential side-effects of treatment. Each patient on surveillance will have their own follow up protocol individualised. However, through a combination of PSA monitoring, repeat MRI scans and occasionally biopsies many men can safely avoid treatment. If, however, the cancer is seen to progress then it can safely be treated without risk of ‘missing the boat.’

Find out more here: BAUS Active surveillance information

Robot Assisted Radical Prostatectomy

Our two prostate cancer surgeons at SCU are both high volume and very experienced. They will discuss with you the pros and cons of different treatment options for your cancer.

Robotic prostatectomy involves removal of the prostate and seminal vesicles using the latest minimally invasive techniques. After the procedure you will have a catheter to allow the join between bladder and urethra to heal.

The main risks specific to this operation are incontinence and erectile dysfunction. These occur due to the proximity of surgery to the urethral sphincter and the nerves and blood vessels that run next to the prostate that support erections. Where possible we help preserve these structures (i.e. nerve sparing, bladder neck and fascial reconstruction) and this allows early functional recovery.

Find out more here: BAUS Robotic Prostatectomy (RALP)

Focal Therapy

Focal therapy is performed using HIFU or Cryotherapy and is undertaken in the context of clinical trials or the UK HIFU registry.

More information is available here: PCUK HIFU Information


There are a number of prostate cancer radiotherapy treatments. These include external beam radiotherapy, low dose rate brachytherapy and high dose rate brachytherapy. These are delivered by clinical oncologists. The team at SCU will refer you to our expert colleagues to discuss which are the most suitable options for you. More often than not radiotherapy treatments require you to go on hormone treatment, see more below.

Find out more by clicking on the links above.

Watchful Waiting/Hormone Therapy

Sometimes, particularly in older men, a prostate cancer may not need treatment but will need monitoring. Watchful waiting differs from active surveillance in that these men are unlikely to need to be cured from their cancer but may ultimately need some treatment to put the brakes on the cancer. This usually takes the form of hormone treatment. Hormone treatment alone is not a curative treatment but can certainly delay progression of cancer.

Hormone treatment is associated with some side effects and therefore is used only when necessary. These side effects can include hot flushes, weight gain, mood swings, loss of libido, fatigue and changes to memory and concentration.

Click on the links to find more information about watchful waiting and hormone therapy.

Systemic Therapy

For men who are diagnosed with metastatic disease the mainstay of treatment is hormone therapy in conjunction with either chemotherapy or newer drugs called androgen receptor targeted agents (ARTA). Examples of these treatments include: Enzalutamide, Abiraterone and Docetaxel. In these circumstances your SCU clinician will likely refer you to one of our expert medical oncology colleagues:

For more information on systemic therapies and the treatment of metastatic prostate cancer click here.