Comparing prostate cancer treatments

There is a wide range of different prostate cancer treatments, offering a greater degree of patient choice than many other forms of cancer treatment programmes.

While this is beneficial, allowing for patients to make choices according to their individual preferences, reflecting their wishes, lifestyle and priorities, some patients find it difficult to decide which treatment is best for them. This guide has been developed by Harley Street Urology specialists. It may be helpful as a starting point for discussions and consideration of the advantages and disadvantages of different prostate cancer treatments.

Radical prostatectomy

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

Radical prostatectomy is the traditional open non-nerve sparing prostate surgery.

Laparoscopic and da Vinci (robotic) prostatectomy

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

Laporoscopic and da Vinci (robotic) prostatectomy use a minimally invasive 'keyhole' technique.

External beam radiotherapy

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

External beam radiotherapy (also known as teletherapy), is the most frequently used form of radiotherapy, where an external source of radiation is focused at an affected part of the body.

Brachytherapy^[1]

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

Brachytherapy involves the use of radioactive seeds to deliver radiotherapy directly into the cancerous prostate gland.

HIFU

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

High Intensity Focused Ultrasound (HIFU) involves focusing a beam of ultrasound onto a tumour site. This beam heats and destroys cancer cells but passes easily through healthy tissue which is left unharmed.

Active monitoring

Over 90% likelihood of PSA less than 0.01
Hormone manipulation
Less than 50% likelihood of erectile dysfunction at one year
Day case

Less than 90% likelihood of incontinence pads at six months
Minimal time off work
Overall ten year survival more than 80%
Use of radiation

Active monitoring involves the regular surveillance of your individual cancer risk, with intervention only carried when and if necessary.

Notes

[1] It is recommended that brachytherapy is suitable for patients with a PSA of 10 or below, Gleason score of less than six and Stage T1c to T2a. Patients with obstructive urinary symptoms and previous TURP are excluded from this treatment.