In short
Prostate cancer treatment depends on how aggressive the cancer is and whether it has spread. Slow-growing cancers are often managed with active surveillance — monitoring closely and treating only if it changes. Other options are surgery, radiotherapy and hormone therapy. Because treatments can affect urinary and sexual function, the choice is weighed up carefully with your specialist team.
Unlike many cancers, prostate cancer often grows very slowly. This changes how it is treated: for a significant number of men, the wisest course is not to treat straight away at all, but to monitor the cancer closely. For others with faster-growing or more advanced disease, active treatment is important.
Because the prostate sits next to nerves and muscles involved in bladder control and erections, treatments can have side effects in these areas. A specialist team helps each man weigh up the benefits and risks based on his cancer and his priorities.
What are active surveillance and watchful waiting?
For low-risk, slow-growing prostate cancer, active surveillance is often recommended. This means keeping a close eye on the cancer with regular PSA tests, scans and occasional biopsies, and starting treatment only if there are signs it is growing. The aim is to avoid the side effects of treatment for cancers that may never cause harm.
Watchful waiting is a less intensive approach, generally used for older men or those with other health problems, where the focus is on managing symptoms if and when they appear rather than aiming to cure.
What are surgery and radiotherapy?
Surgery to remove the prostate (a radical prostatectomy) is an option for cancer that has not spread beyond the prostate, often carried out using keyhole or robot-assisted techniques. Radiotherapy uses targeted radiation to destroy cancer cells and can be given from outside the body (external beam) or by placing radioactive seeds inside the prostate (brachytherapy).
Both surgery and radiotherapy can be very effective for localised prostate cancer. Both can also affect bladder control and erections, though techniques have improved and side effects vary from person to person. Your team will explain what to expect.
What are hormone therapy and advanced disease?
Prostate cancer usually depends on the male hormone testosterone to grow. Hormone therapy lowers testosterone or blocks its effect, slowing the cancer. It is often combined with radiotherapy, or used when the cancer has spread beyond the prostate.
For advanced prostate cancer, hormone therapy is frequently combined with chemotherapy or newer targeted treatments, which have significantly improved how long and how well men live with the disease. Even when prostate cancer cannot be cured, it can often be controlled for a long time.
What are the key takeaways?
- Prostate cancer often grows slowly, so 'active surveillance' — monitoring rather than treating — is sometimes the best choice.
- Surgery (removing the prostate) and radiotherapy are both effective treatments for localised cancer.
- Treatments can affect bladder control and erections, so the choice is weighed up carefully with your team.
- Hormone therapy slows prostate cancer by reducing testosterone and is often used for advanced disease.
- Even advanced prostate cancer can often be controlled for many years.
Care like this is out of reach for millions
The diagnosis, screening and treatment described here are routine in the UK. In Pakistan, Indonesia and Malaysia, poverty puts them out of reach — so a treatable cancer too often becomes a fatal one. World Aid Network funds treatment through locally-licensed oncologists for patients who cannot pay.
Frequently asked questions
Why might my doctor recommend not treating my prostate cancer straight away?
Many prostate cancers grow so slowly that they would never cause harm in a man's lifetime. For these low-risk cancers, active surveillance — monitoring closely with regular tests and treating only if it changes — avoids the side effects of treatment while keeping you safe. It is a recognised, evidence-based approach, not a case of doing nothing.
Will prostate cancer treatment affect my sex life or bladder?
It can. Because the prostate sits close to the nerves and muscles involved in erections and bladder control, surgery and radiotherapy can cause erection difficulties or urinary problems. The risk varies between individuals and treatments, and techniques have improved. Your team will discuss the likely effects and the support available.
Can advanced prostate cancer be treated?
Yes. Even when prostate cancer has spread and cannot be cured, it can often be controlled for a long time with hormone therapy, sometimes combined with chemotherapy or newer targeted drugs. These treatments can help men live longer and maintain a good quality of life.
This guide is general information, not medical advice. It was reviewed by the World Aid Network editorial team for accuracy against NHS and World Health Organization sources. Always speak to a GP or qualified clinician about your own health.