Your prostate cancer will need to be diagnosed and given a proper stage in order to discuss treatment options with your doctor. You may decide to do one treatment, or you and your doctor may decide it’s best to combine several treatments. These treatments will be based on your specific diagnosis, your age, and any other health problems you may have. Some men find it helpful to get a second opinion to ensure they’re making the right decision about their prostate cancer treatment. What are the treatments for prostate cancer?

1. Active Surveillance

You and your doctor may consider this option if you’ve been diagnosed with a slow-growing form of prostate cancer and if your cancerous cells are contained within the prostate. If your cancer cells are spreading to other areas of your body, active surveillance is likely not the option for you. Active surveillance involves closely monitoring your prostate cancer for any changes, such as if the symptoms are getting worse or the cancer is spreading at a more rapid pace. This monitoring involves getting protein-specific antigen (PSA) blood tests along with a digital rectal exam (DRE) approximately every three to six months. Your doctor may also want to combine these tests with ultrasounds or biopsies just to ensure your prostate cancer is not getting worse. If you’re not experiencing any of the symptoms of prostate cancer, or if you’re elderly and have other serious health problems that would not respond well to any more aggressive forms of treatment, active surveillance may be for you.

2. Radiation Therapy and Chemotherapy

These treatments may be used if your prostate cancer has been diagnosed early and if it is slow-growing. It may also be used in the event that your prostate cancer has spread or if your cancer did not go away completely after surgery. Radiation therapy is done by either external beam radiation or internal radiation, called brachytherapy. External radiation involves a machine that points a beam at your prostate to administer radiation while internal radiation involves small radioactive beads inserted directly into your prostate. Both of these treatment methods have side effects that can affect your bowels, urinary habits, and erections, so discuss thoroughly with your doctor. Chemotherapy involves drugs given either intravenously or by mouth to combat the cancer. This could be more effective for cancers that have spread or if other treatment options are not successful.

3. Hormone Therapy

Your doctor will likely want to use hormone therapy in combination with other treatments, as hormone therapy alone will not treat prostate cancer. Hormone therapy targets the male hormones—such as testosterone—that are primarily made by the testicles. Testosterone along with other male hormones can promote the growth of prostate cancer cells, so the goal of hormone therapy is to decrease the amount of testosterone the body makes. This is done by physically removing the testicles, which will minimize testosterone production, or by using drugs that can be injected or placed under the skin for a period of time which will hinder testosterone production but will shrink the testicles. These treatments will affect fertility, sexual performance, and the appearance of your scrotum. Discuss different hormone therapy options with your doctor.

4. Surgery

If your prostate cancer is aggressive, you and your doctor may discuss surgery options. The side effects resulting from prostate cancer surgery can be life changing, so be sure to consider all options and even get a second opinion before you opt for the surgical approach. Of course in some prostate cancer cases surgery will be necessary. The surgeon will remove your prostate, and may check the lymph nodes close to the prostate during surgery. If cancer is found in the lymph nodes, the lymph nodes may be removed or the surgery may be stopped, as the cancer will have spread and removing the prostate may do more harm than good at that point. Side effects of surgery for prostate cancer include incontinence, impotence (since the nerves around the prostate control erections, and may be affected by the surgery or they may need to removed), decrease in intensity or total loss of orgasm, loss of fertility, and size of the penis, as a part of the urethra will need to be removed with the prostate.

Treating prostate cancer will be unique to you and the stage of your cancer as well as your overall health. With all factors taken into consideration, you and your doctor can decide on the treatment options that will be right for you. While the best treatment is prevention, treating prostate cancer once it’s diagnosed is equally important.