Prostate Cancer Treatments

How Do You Choose?

Choosing which of the Prostate Cancer Treatments depends upon many factors. The type of cancer, whether or not the cancer has spread (metastasized), a patient’s age, general health status, and prior prostate cancer treatments the patient may have undergone. There are three standard prostate cancer treatments for men with organ-confined prostate cancer: Active Surveillance, Surgery and Radiation Therapy .

We suggest consultations with several specialist who can describe the pros and cons of each prostate cancer treatment. So plan to schedule consults with experts in each field of treatment. A Urologist is a trained surgeon who can review the surgical options for a prostatectomy. A Radiologist is a medical doctor who can lead you through the options of external beam or brachytherapy, seed implants. If your cancer is more advanced, you may also want to meet with a Medical Oncologist, an expert in the treatment of various types of cancer.

Patients are encouraged to compare prostate cancer treatments by looking at treatment effectiveness. Why, because for some, prostate cancer comes back. This is called recurrence. By monitoring the yearly PSA levels of thousands of patients treated for prostate cancer, year after year, long term effectiveness is revealed for low to high risk patients. See which patients remained in remission at year 5, 10, and 15, verses those whose experienced cancer recurrence. Prostate Cancer Free provides treatment comparisons in an interactive form, or printable study.  To download or print this Study, click on the 'Get The Study' button below. 

Watchful Waiting or Active Surveillance

In select patients with prostate cancer, the best choice may be active surveillance, also is called “watchful waiting.”  Of the prostate cancer treatments, active surveillance may be recommended only if a cancer is not causing any symptoms and is expected to grow very slowly. This approach is sometimes suited for men who are older or have other serious health problems. Because some prostate cancers spread very slowly, older men who have the disease may never require treatment. Other men choose active surveillance because they feel the side effects of treatment outweigh the benefits. The cancer is regularly and carefully monitored with PSA, clinical evaluation and intermittent prostate biopsies to ensure that the cancer is not becoming more aggressive. If progression of the cancer is evident, active treatment can be started.


Surgical treatment for prostate cancer involves removing the entire prostate as well as the seminal vesicles, a procedure called radical prostatectomy. There are two prostate cancer treatments classified as radical prostatectomy, open radical retropubic prostatectomy and laparoscopic radical prostatectomy.

Radical Retropubic Prostatectomy (RRP)

The surgeon makes a skin incision in the lower abdomen. The prostate is removed from both the bladder and the urethra. After the prostate is removed, the bladder is connected to the urethra with suture. Takes 2-3 hours to perform with a hospital stay of 2-3 days.

Robotic Assisted Laparoscopic Radical Prostatectomy (RALP)

Minimally invasive surgical technique to remove the prostate and seminal vesicles. The surgeon performs the procedure through five 1-cm incisions spread in the shape of a fan across the lower abdomen. The surgeon performs the procedure using a robotic surgical assist device called the daVinci® Surgical System. Takes 2.5-3.5 hours to perform with a hospital stay of 24-48 hours.

Radiation Therapy

Radiation therapy is either a non-invasive, or minimally invasive treatment for prostate cancer that uses x-rays or gamma-rays to eradicate prostate cancer cells. Prostate cancer treatments have several forms of radiation therapy that may be recommended. Each patient receives a customized treatment plan depending on the nature of the cancer, the patient’s unique symptoms and overall health.

External Beam Radiation

Delivered using an x-ray machine called a linear accelerator. Treatment is delivered on a daily basis, 5 days per week, for up to 8 or 9 weeks. Listed below are the four primary techniques.

  • Intensity Modulated Radiation Therapy (IMRT)
  • Volumetric Arc Therapy (VMAT)
  • Image Guided Radiation Therapy (IGRT)
  • Proton Beam Radiation Therapy – Proton beam radiation therapy utilizes particle radiation (protons) instead of electromagnetic (photon or x-ray) radiation to destroy tumor cells

Prostate Seed Brachytherapy

The implantation of small radioactive pellets, or “seeds,” into the prostate. The radioactive seeds deliver high doses of radiation to a very confined region, making it possible to deliver a higher dose of radiation to tumor cells within the prostate. Seed placement is determined, by use of previous ultrasound to map, or use of ultrasound image during the actual procedure to place radioactive seeds.

High Dose Rate Radiation

High dose rate (HDR) brachytherapy is a procedure similar to seed brachytherapy, but instead of permanently placing radioactive seeds into the prostate, catheters are attached to empty needles placed into the prostate and a highly radioactive source is placed temporarily (for approximately 5-15 minutes) into the needles to deliver radiation to the prostate.

Other Prostate Cancer Treatments


Cryotherapy (also called cryoablation or cryosurgery) can be used to treat localized prostate cancer by freezing the cancerous cells. This procedure is performed under general or spinal anesthesia and may be performed as an outpatient or may require an overnight stay. The probes are placed through skin incisions located between the anus and scrotum. Guidance and monitoring of therapy is performed using transrectal ultrasound.


HIFU or High Intensity Focus Ultrasound procedure may be an option for men diagnosed with organ-confined prostate cancer. During the procedure, precisely focused ultrasound waves raise the temperature of the targeted prostate tissue to 195 degrees Fahrenheit in 2-3 seconds.


Chemotherapy utilizes drugs injected intravenously or by mouth to stop the growth of cancer cells. It is usually used in cases where prostate cancer has spread outside the gland (metastasized) or is resistant to androgen deprivation therapy. Chemotherapy is given in cycles in which the drug is given over a few days to week followed by a rest period to allow the body time to recover. Each cycle typically lasts several weeks to a month.

ADT or Hormone Therapy

Hormone therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy. Androgens, (like testosterone), are produced mainly in the testicles and stimulate prostate cancer cells to grow. While not curing prostate cancer, lowering androgen levels often stops or significantly slows the growth of prostate cancer cells. Reducing androgen levels is accomplished mainly by oral or injected medications, called chemical castration. This can also be achieved by removal of the testicles (castration).

Have you or a loved one been recently diagnosed with prostate cancer?

We've reviewed the data from over 100,000 patients so you can compare your treatment options and talk to your doctors about the results.
Compare Now

Have you or a loved one been recently diagnosed with prostate cancer?

We've reviewed the data from over 100,000 patients so you can compare your treatment options and talk to your doctors about the results.
Compare Now

Prostate Cancer Free

Thirty Six Prostate Cancer Experts have analyzed the treatment outcomes of over 129,000 patients across the globe, following these patients for up to 15 years. The success of a treatment is determined by monitoring PSA for years after treatment. This data is presented to you, so you can see which treatments leave patients prostate cancer free. Watch this video to learn more.


Prostate Cancer

What is Prostate Cancer?

What is Prostate Cancer, the Symptoms, Risk Factors? What does the Prostate do, where is it located?

Prostate Cancer Tests and Diagnostics

Diagnosed with Prostate Cancer?

What tests confirm the presence of prostate cancer? Learn how doctors diagnose prostate cancer.

Prostate Cancer Treatments

Prostate Cancer Risk Groups

PSA, Gleason Score and Stage, match patients with appropriate treatment choices. What is your Risk Group?

Remission versus Recurrence?

Relapse of prostate cancer is way more common than you might think. Many men treated for prostate cancer have their cancer return, which can lead to a lifetime of treatment. Prostate Cancer Free studies treatment outcomes documented in "The STUDY", recently updated for 2021. Take this Study to your doctor, and discuss your chance of cancer recurrence. The Study is available with the new, just released booklet, to help you learn about prostate cancer. Both the Prostate Cancer Free Study and the booklet, “What You Need to Know About Prostate Cancer” are available NOW for you to VIEW, PRINT or DOWNLOAD.

Get The Study

Help To Continue the Work!

The Prostate Cancer Free Foundation, reviews the results of hundreds of thousands of men treated for prostate cancer. Tracking them for years. This information is available to you, and others like you, to help find the best prostate cancer treatment. This work takes time, effort, resources all of it done by volunteers. Please help us continue. Please Donate!