Once a man is diagnosed with prostate cancer, a decision needs to be made on which form of therapy is best suited for that particular patient.

The problem is that there are many different factors that have to be taken into account for each individual patient: the age of the man, the Gleason score (how active the cancer cells are), the Stage of the cancer (how much the tumour has spread), other diseases the patient may have and possible risks of therapy and the patient’s lifestyle. All these need to be taken into consideration before making a decision.

Surgery or Radiotherapy?

The main forms of treatment available today are Surgery, which attempts to remove the cancerous organ via an operation and Radiotherapy - which attempts to destroy the cancer cells using radiation.

It must be admitted that while most surgeons prefer to operate and most radiotherapists are biased towards radiotherapy, neither group of specialists can unequivocally claim a superior cure rate. In fact, if the disease is detected early enough (which is where undergoing an annual PSA Test + Digital Rectal Examination helps early diagnosis) a patient has a very high chance of being cured whether he has surgery or radiotherapy.

Today, prostate cancer surgery is more sophisticated than it was twenty years ago. We have the standard Radical Retropubic Prostatectomy (where the prostate gland is removed via an incision made in the lower abdomen) as well as robotic prostatectomy and "nerve-sparing" prostatectomy. The latter techniques are designed to remove the prostate with minimum damage to surrounding organs.

Radiotherapy too can take different forms in this 21st century. External Beam Radiotherapy is where beams of high dose radiation are focused from outside onto the cancerous prostate. Guided with a precise degree of accuracy, radiation to the healthy tissues around the prostate can be minimized, which helps avoid damage to the nerves and the bladder - so avoiding side effects like erectile dysfunction and incontinence. Another method is termed Brachytherapy - which involves implanting radioactive pellets, each the size of a seed of rice, into the prostate. These seeds emit radiation which destroys cancerous cells.

Other options

Sometimes, doctors recommend starving the cancer of the male hormone Testosterone - referred to as Androgen Deprivation Therapy. Prostate cancers being dependent on this hormone for growth, blocking the body’s production of testosterone with certain medications - or even removing the patient’s testicles to stop testosterone production - can inhibit growth of the tumour.

In some older men with small cancers confined to the prostate gland, it may be decided to do nothing - a policy termed "Watchful Waiting". This policy is based on the assumption that these prostate cancer grows so slowly, the man will succumb to some other disease - like a heart attack or heart failure - long before the prostate cancer can spread and kill him..

Whether it is surgery, radiation, hormone therapy or even watchful waiting, treatment for a man’s prostate cancer needs to be individualized to suit each particular patient.