Oncology
Prostate Cancer Treatment
From active monitoring to surgery, radiotherapy and hormone therapy — the choice rests on the Gleason score, the stage and how much treatment your life can absorb.
From active monitoring to surgery, radiotherapy and hormone therapy — the choice rests on the Gleason score, the stage and how much treatment your life can absorb.
At a glance
- In hospital
- 5 days
- Total stay
- 21 days
- Cost
- Quoted after clinical assessment
Prostate cancer is the most commonly diagnosed cancer in men, and most of it is adenocarcinoma, which typically grows slowly. That single fact shapes everything: for some men close monitoring is a legitimate plan rather than a delay, while aggressive disease needs treating promptly. The Gleason score and the stage are what separate the two.
How it is diagnosed and graded
A PSA blood test and a digital rectal examination usually come first. Multiparametric MRI identifies suspicious areas and guides a needle biopsy, and a pathologist grades the two commonest cell patterns to give the Gleason score: six or below is low grade, seven intermediate, eight to ten high grade and more likely to spread. The TNM system describes how far it has gone, and a PSMA PET scan can find spread that other imaging misses. Testing is generally advised from around 55, earlier for men with a father or brother affected, and for men of African descent, whose risk is substantially higher.
The treatments available
Radical prostatectomy removes the whole gland, by open, laparoscopic or robot-assisted surgery, and takes roughly two to four hours under general anaesthetic; nerve-sparing technique is used where the cancer allows, to protect urinary control and sexual function. TURP relieves urinary obstruction rather than curing cancer. Radiotherapy comes as IMRT over many sessions or SBRT in as few as three to five, and proton therapy and HIFU are available in selected cases. Hormone therapy (androgen deprivation) lowers the testosterone that fuels growth and is used for advanced disease, and PSMA-targeted radioligand therapy exists for metastatic cancer.
Recovery and what to expect
Before surgery expect blood tests, imaging and often an ECG, along with advice to stop smoking, adjust medicines and start pelvic floor exercises — those exercises genuinely help afterwards. After the operation you go to recovery for observation and build activity gradually. Urinary control and erectile function are the two effects to discuss frankly beforehand rather than discover afterwards; both improve over months for many men, and neither should be glossed over. PSA is then checked on a schedule for years.
Before you agree to anything
Ask what your Gleason score and stage actually are, whether active surveillance is reasonable for you, whether nerve-sparing surgery is planned, and what the realistic effect on continence and sexual function is in the surgeon's own hands. We put those four questions in writing before you travel, and we do not quote survival figures — only the oncologist holding your biopsy can discuss outlook honestly.
This page is general information, not medical advice. Whether a procedure is right for you is a decision for a qualified clinician who has seen your reports.