Treatments for localised prostate cancer are intended to completely eradicate, or cure, the cancer. The options include surgery to remove the prostate or radiotherapy to kill the cancerous cells.

It is often felt that the side effects of treatment are worse than the prostate cancer itself. So if you have low-risk prostate cancer (i.e. localised prostate cancer and a low biopsy Gleason score), you might be offered the following management options:

  • Watchful waiting: For some men, particularly older men with major health issues, treatment might not be appropriate. They will be regularly monitored and if symptoms develop (e.g. bone pain), treatment will be offered to manage these symptoms. The intent is to treat symptoms as they arise.
  • Active surveillance: For men who have low-risk prostate cancer, active surveillance is an option. Men are regularly monitored by the Prostate Specific Antigen (PSA) test, digital rectal examination (DRE) and occasional further biopsies. The results from these tests and procedures will show if the cancer has changed. If the disease progresses, they are offered treatment with the intent to cure, usually by surgery or radiotherapy. The thinking behind this strategy is that because treatments have side effects that affect quality of life, it can be better to delay treatment as long as possible. Men on active surveillance might never need treatment.
  • Active treatment: treatments with the intention of completely eradicating, or curing, the cancer.

When the cancer does need to be actively treated, you will most likely be offered surgery or radiotherapy.

To find out more about the treatment options, please see another booklet
in this series: Treatment.