Prostate | Fondationnoevyitoua

The localized prostate cancer

is found only in the prostate. It is divided into risk categories based on the risk of the cancer coming back (recurring) after treatment. The treatment is based on these risk categories. Localized prostate cancer in a low risk category grows very slowly and is unlikely to become life-threatening. Localized prostate cancer in a high risk category is more likely to develop or spread.

Choosing treatment for localized prostate cancer can be complicated, especially if the disease is in a low risk category and grows slowly. Prostate cancer treatments can really affect your quality of life and cause side effects like erectile dysfunction (difficulty getting and keeping an erection) and incontinence (loss of bladder control).

It's important to consider how likely the cancer is to cause problems before deciding what to do. You may not need treatment right away. You will also need to take into consideration the possible impact of treatment side effects on your quality of life. Some people worry less about the side effects and more about the cancer they want to get rid of.

Cancer classified as high risk is usually treated aggressively. Cancer classified as low risk may be actively monitored without immediate treatment.

If you are older or have other serious health problems and the cancer grows slowly, you may consider prostate cancer a chronic disease when evaluating your treatment options. If you are younger and still healthy, you may be more willing to accept possible side effects if treatments offer you a better chance of recovery.

It may be helpful to discuss treatment options with someone you trust. You may also want to talk to other people who have had prostate cancer. It's important to know that everyone's experience is different. You might also think about getting more than one medical opinion.

Your care team will suggest treatments based on your needs and will discuss with you to develop a treatment plan.

Very low or low risk localized prostate cancer

Favorable intermediate risk localized prostate cancer

Unfavorable intermediate risk localized prostate cancer

Localized high or very high risk prostate cancer

Very low or low risk localized prostate cancer

Very low or low risk localized prostate cancer usually grows slowly and often does not cause symptoms.

Treatment options for very low or low risk localized prostate cancer include:

active surveillance;
vigilant observation;
surgery;
radiotherapy.

Active monitoring

Active surveillance is standard treatment for localized, slow-growing prostate cancer. Prostate cancer treatments are likely to cause long-term side effects, so you may not want to be treated right away. Active surveillance involves closely monitoring the cancer with regular tests and scans to check if it starts to grow or cause symptoms. If the cancer starts to grow or you experience symptoms during active monitoring, you will be offered treatments.

Learn more about the active surveillance of prostate cancer.

Vigilant observation

You may be offered watchful observation if you are elderly and do not want to experience the side effects of treatments or if you are unable to be treated because you have other medical conditions. Vigilant observation is less intensive than active surveillance. It does not involve routine tests and relies more on changes in symptoms. If you start experiencing symptoms while you are under watchful observation, your doctor may talk to you about treating the symptoms.

Learn more aboutvigilant observation of prostate cancer.

Surgery

Surgery is a standard treatment for localized prostate cancer. Radical prostatectomy involves removing the prostate and some of the tissue around it. You may be offered radical prostatectomy if you are in good health and expected to live at least 10 years. This treatment is not usually offered to anyone over 75 years old.

If certain unfavorable features are observed during surgery, radiation therapy or hormone therapy, or both, may be given after surgery. Unfavorable features include positive surgical margins, the presence of cancer in the seminal vesicles, or cancer that has penetrated the capsule.

Learn more about the prostate cancer surgery.

Radiotherapy

Radiotherapy is a standard treatment for localized prostate cancer. High-energy rays or particles are used to destroy cancer cells.

You may be offered external beam radiotherapy if you are over 70 and your risk of complications from surgery is high.

Brachytherapy may be offered instead of external beam radiotherapy or surgery. Brachytherapy is a form of internal radiotherapy which involves placing a radioactive substance (radioisotope) directly into or very close to the tumor, called an implant.

Learn more about the radiotherapy for prostate cancer.

Favorable intermediate risk localized prostate cancer

Favorable intermediate-risk localized prostate cancer usually grows slowly and often does not cause symptoms.

Treatment options for favorable intermediate-risk localized prostate cancer include:

active surveillance;
vigilant observation;
surgery;
radiotherapy.

Active monitoring

Active surveillance is standard treatment for localized, slow-growing prostate cancer. Prostate cancer treatments are likely to cause long-term side effects, so you may not want to be treated right away. Active surveillance involves closely monitoring the cancer with regular tests and exams to check if it starts to grow or cause symptoms. If the cancer starts to grow or you experience symptoms during active monitoring, you will be offered treatments.

Learn more about the active surveillance of prostate cancer.

Vigilant observation

Learn more aboutvigilant observation of prostate cancer.

Surgery

Surgery is a standard treatment for localized prostate cancer. Radical prostatectomy involves removing the prostate and some of the tissue around it. You may be offered it if you are in good health and are expected to live at least 10 years. This treatment is not usually offered to anyone over 75 years old. The surgeon may also remove lymph nodes from the pelvis (pelvic lymph node dissection) during radical prostatectomy.

If certain unfavorable features are observed during surgery, radiation therapy or hormone therapy, or both, may be given after surgery. Unfavorable features include positive surgical margins, seminal vesicle invasion, or cancer that has penetrated the capsule.

Learn more about the prostate cancer surgery.

Radiotherapy

Radiotherapy is a standard treatment for localized prostate cancer. High-energy rays or particles are used to destroy cancer cells.

You may be offered external beam radiotherapy if you are over 70 and your risk of complications from surgery is high.

Learn more about the radiotherapy for prostate cancer.

Unfavorable intermediate risk localized prostate cancer

Unfavorable intermediate-risk localized prostate cancer may develop or spread within a few years.

Treatment options for localized unfavorable intermediate-risk prostate cancer include:

surgery;
radiotherapy with or without hormonal therapy;
vigilant observation.

Surgery

If certain unfavorable features are observed during surgery, radiation therapy or hormone therapy, or both, may be given after surgery. Unfavorable features include positive surgical margins, seminal vesicle invasion, or cancer that has penetrated the capsule.

Learn more about the prostate cancer surgery.

Radiotherapy

Radiotherapy is a standard treatment for localized prostate cancer. In radiotherapy, high-energy rays or particles are used to destroy cancer cells. Radiotherapy is often combined with hormone therapy.

External radiotherapy may be offered instead of radical prostatectomy. It can also be administered after a radical prostatectomy (this is called adjuvant radiotherapy) to reduce the risk of the cancer coming back (recurring). It could also be combined with brachytherapy.

Brachytherapy can be offered as an irradiation complement to external radiotherapy. Sometimes we only administer additional irradiation rather than resorting to external radiotherapy or surgery. Brachytherapy is a form of radiotherapy which involves placing a radioactive substance (radioisotope) directly into or very close to the tumor, what is called an implant.

Learn more about the radiotherapy for prostate cancer.

Hormone therapy

If you are given radiation therapy, you may also receive hormone therapy before, during, or after radiation therapy. Hormone therapy changes hormone levels or blocks certain hormones in an effort to slow the growth and spread of cancer cells.

A single hormonal therapy can be administered or combined, including:

lutein-releasing hormone (LHRH) analogue
LHRH antagonist;
antiandrogen;
orchiectomy (surgery to remove the testicles).

Learn more abouthormonal therapy for prostate cancer.

Vigilant observation

active monitoring

. It does not involve routine tests and relies more on changes in symptoms. If you start experiencing symptoms while you are under watchful observation, your doctor may talk to you about treating the symptoms.

Learn more aboutvigilant observation of prostate cancer.

Localized high or very high risk prostate cancer

Treatment options for localized high or very high risk prostate cancer include:

radiotherapy and hormonal therapy;
surgery;
vigilant observation.

Radiotherapy

You may be offered radiotherapy for localized high or very high risk prostate cancer. In radiotherapy, high-energy rays or particles are used to destroy cancer cells. Radiotherapy is usually combined with hormone therapy. If you are being treated to relieve your symptoms but not to cure your cancer, you may be given only radiation therapy or hormone therapy.

External radiotherapy may be offered instead of a radical prostatectomy. It can also be administered after a radical prostatectomy (this is called adjuvant radiotherapy) to reduce the risk of the cancer coming back.

Brachytherapy can be offered in combination with external radiotherapy. It is a form of radiotherapy which consists of placing a radioactive substance (radioisotope) directly in the tumor or very close to it, what is called an implant.

Learn more about the radiotherapy for prostate cancer.

Hormone therapy

Hormone therapy is often combined with radiotherapy. It can be administered before, during or after radiotherapy. Hormone therapy changes hormone levels or blocks certain hormones in an effort to slow the growth and spread of cancer cells. Hormone therapy is usually combined with radiotherapy. If you are being treated to relieve your symptoms but not to cure your cancer, you may be given only radiation therapy or hormone therapy.

A single hormonal therapy can be administered or combined, including:

lutein-releasing hormone (LHRH) analogue
LHRH antagonist;
antiandrogen;
orchiectomy (surgery to remove the testicles).

Learn more abouthormonal therapy for prostate cancer.

Surgery

Radical prostatectomy involves removing the prostate and some of the tissue around it. You may be offered radical prostatectomy if you are in good health and expected to live at least 10 years. This treatment is not usually offered to anyone over 75 years old. The surgeon may also remove lymph nodes from the pelvis (pelvic lymph node dissection) during the radical prostatectomy.

If certain unfavorable features are observed during surgery, radiation therapy or hormone therapy, or both, may be given after surgery. Unfavorable features include positive surgical margins, seminal vesicle invasion, or cancer that has penetrated the capsule.

Learn more about the prostate cancer surgery.

Vigilant observation

active monitoring

. It does not involve routine tests and relies more on changes in symptoms. If you start experiencing symptoms while under watchful observation, your doctor may talk to you about treating the symptoms.