Prostate cancer treatment (Multidisciplinary treatment of prostate cancer)

What is prostate cancer treatment?

Prostate cancer treatment is the overall plan to monitor or treat the cancer in a way that balances controlling it against the side effects of treatment. It is not a single operation or drug, and for many men it does not start with active treatment at all.

Prostate cancer often grows slowly and may never cause harm in a man's lifetime. So for low-risk, early cancer, the plan may be active surveillance — careful monitoring with PSA blood tests, scans and sometimes repeat biopsies — with treatment only if tests suggest the cancer is changing. This avoids or delays the side effects of treatment. For older or less fit men with other health problems, watchful waiting takes a similar but less intensive approach. Choosing to monitor is a legitimate, evidence-based option, not 'doing nothing'.

When treatment is needed, the main options are surgery (radical prostatectomy), radiotherapy (external beam or internal radiotherapy called brachytherapy), and hormone therapy, which lowers or blocks testosterone that prostate cancer needs to grow. Chemotherapy and newer drugs are used mainly when the cancer has spread. Decisions are made by a multidisciplinary team (MDT) based on the risk group, stage, PSA level, scans and your general health and preferences.

There is no single best treatment for localised prostate cancer, and each option has its own balance of benefits and side effects, including effects on urinary control and erections. Your team should help you weigh these honestly for your situation.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Active surveillance compared with immediate treatment (localised, low-risk)

For low-risk, early prostate cancer both can be reasonable. The right choice depends on the cancer's risk, your health and how you feel about monitoring versus treatment. Your team will help you decide.

Preparing for your treatment

• Ask your team to explain your cancer's risk group and stage and whether monitoring is a safe option for you.
• Make sure scans (such as MRI) and biopsy results are complete, as these guide the plan.
• Ask honestly about the effects of each option on urinary control, erections and bowel function.
• Bring a list of your medicines, supplements and allergies.
• Take someone to appointments and write down your questions.
• If considering treatment that affects fertility or erections, ask about options before starting.
• If having surgery or some radiotherapy, follow the specific preparation advice for that procedure.

What happens

After diagnosis, your case is discussed by an MDT that includes urologists, oncologists, radiologists, pathologists and specialist nurses. They use your PSA level, scans, biopsy results and general health to work out a risk group and recommend options, which they discuss with you.

For low-risk, early cancer, the recommendation is often active surveillance — regular PSA tests every few months, an MRI scan every year or two, and sometimes a repeat biopsy — with treatment offered only if tests suggest the cancer is progressing. This is a careful plan, not neglect.

When treatment is chosen, surgery removes the prostate, usually with a hospital stay and a recovery period. Radiotherapy is given either as a course of external beam sessions or as brachytherapy, sometimes combined with a period of hormone therapy. Hormone therapy is given as injections or tablets over months or years. Chemotherapy and newer drugs are used mainly when the cancer has spread. Throughout, you have regular reviews, mainly using PSA blood tests, to check how the cancer and treatment are doing.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The biggest decisions in prostate cancer are about balancing benefit against side effects, particularly effects on urinary control, erections and bowel function, which differ between surgery, radiotherapy and hormone therapy. For many men with low-risk cancer, monitoring avoids these side effects, at the cost of repeat tests and some anxiety. Ask your team to be specific about the likely effects of each option for you, and about how reversible or lasting they are.

Published figures to discuss

Outcomes and side-effect rates vary widely depending on the risk group, stage, the treatment chosen and the man's age and health, so single percentages can mislead. Effects on urinary control and erections differ between surgery, radiotherapy and hormone therapy and are an important part of the decision. Reliable general statistics are published by Cancer Research UK and broken down by stage; your own outlook should be discussed with your team. We have not quoted survival or side-effect percentages here because they depend so strongly on individual circumstances and the treatment chosen.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

What happens afterwards depends on the path you choose. Active surveillance has no physical recovery but means ongoing monitoring; surgery and radiotherapy have their own recovery and side-effect patterns; hormone therapy is about living with longer-term effects. Your team will set out what to expect.

• Living with a monitored cancer and attending regular checks (active surveillance)
• A period with a catheter and gradually improving urinary control after surgery
• Erection changes that may improve over months, or may persist
• Urinary, bowel and tiredness effects that settle after radiotherapy
• Hot flushes, tiredness and reduced sex drive on hormone therapy

Aftercare

• If on active surveillance, attend all monitoring appointments, PSA tests and scans — this is what keeps it safe.
• Take hormone therapy and other treatments as prescribed and report side effects rather than stopping on your own.
• Do pelvic floor exercises after surgery as advised to help urinary control.
• Ask for help with erection problems or urinary leakage — there are effective treatments and support.
• Look after bone and heart health if on long-term hormone therapy, as advised.
• Report new urinary, bowel or bone symptoms promptly.
• Keep your general health up: stay active, eat well and stop smoking.

• A written summary of your plan, including the monitoring schedule if on surveillance
• Contact details for your urology or oncology nurse
• A schedule of PSA tests, scans and any biopsies
• Pelvic floor exercise advice after surgery
• Information on help for erection and urinary problems
• A list of your current medicines, including hormone therapy
• Your GP informed and included in your care

Scars and how they heal

Surgery to remove the prostate leaves small keyhole scars (or a larger scar with open surgery) that fade over months. Radiotherapy and hormone therapy do not leave surgical scars. A prostate biopsy does not leave a visible scar. Your surgeon will explain what to expect from any operation.

⚠ Get urgent help if…

• Being unable to pass urine at all (a full, painful bladder) — seek urgent help
• Heavy bleeding, or blood clots blocking the flow of urine
• Fever, shivering or feeling very unwell after surgery, a biopsy, or during chemotherapy (possible serious infection)
• New severe back pain, leg weakness or numbness, or problems controlling your bladder or bowels — seek urgent help, as spread to the spine needs prompt assessment
• A wound that becomes red, hot, swollen or leaks fluid after surgery
• Breathlessness, chest pain or a hot, swollen, painful leg (possible clot)
• A severe allergic reaction during drug treatment (rash, breathlessness, swelling)

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result depends on the plan. For active surveillance, success means safely avoiding or delaying treatment while keeping the cancer under close watch. For surgery or radiotherapy in localised disease, the aim is to cure or control the cancer while limiting side effects. For advanced disease, success means controlling the cancer and symptoms and keeping you well.

No treatment can guarantee a cure or that the cancer will not return, and honest teams will not promise this. Progress is mostly followed with PSA blood tests over time. Outcomes depend on the risk group, stage and how the cancer behaves. Cancer Research UK publishes general survival statistics by stage; your own outlook should be discussed with your oncologist or urologist. For published statistics, see Cancer Research UK rather than any single clinic's figures.

Prostate cancer often grows slowly, which is why monitoring is safe for many men and why follow-up continues for years. After treatment with curative intent, PSA tests are used over a long period to check the cancer has not returned. Hormone therapy controls the cancer for as long as it works; if the cancer becomes resistant, treatment may be changed. Your team will explain the expected length of any treatment and the follow-up plan.

Related tests, treatments or support

Treatments are often combined — for example radiotherapy with a period of hormone therapy, or several drug treatments in sequence for advanced disease. Active surveillance may later lead to treatment if monitoring shows a change. Supportive care helps with side effects and bone health. Your MDT decides the combination and sequence for your cancer.

Follow-up & long-term care

Follow-up is mainly through regular PSA blood tests, with scans or further tests if needed. On active surveillance this includes periodic MRI and sometimes repeat biopsies. After treatment, PSA is checked over years to watch for return. Care is often shared between hospital teams and your GP. Report new urinary, bowel or bone symptoms promptly between appointments.

• Regular PSA tests and, on surveillance, periodic MRI scans and sometimes repeat biopsies
• Bone-density and heart-health monitoring if on long-term hormone therapy
• Pelvic floor exercises and ongoing help for urinary or erection problems after treatment
• Healthy lifestyle measures: activity, weight, diet and stopping smoking
• Prompt reporting of new symptoms and clear shared records across all teams

Repeat, follow-on and what comes next

• Active surveillance may lead to treatment later if monitoring shows the cancer is progressing.
• Further treatment (for example radiotherapy or hormone therapy) may be needed if PSA rises after surgery.
• Hormone therapy may be changed if the cancer becomes resistant.
• For advanced disease, the plan is reviewed regularly and the aim of treatment can change over time.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A named urology or oncology nurse and a clear plan for follow-up PSA testing.
• For surveillance, a written monitoring schedule and clear triggers for treatment.
• Honest support for urinary, erection and bowel side effects, including referral where needed.
• Bone and heart-health monitoring for men on long-term hormone therapy.
• Records shared so your GP and any NHS and private teams work from one plan.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Which path is taken — monitoring, surgery, radiotherapy, hormone therapy or chemotherapy
• Surgeon, oncologist and facility fees for any treatment
• The technique used (for example robot-assisted surgery, type of radiotherapy)
• Scans, biopsies and PSA tests needed to plan and monitor care
• Specific drugs used and how long hormone therapy continues
• Ongoing monitoring appointments, scans and repeat biopsies on surveillance
• Management of side effects and support for urinary or erection problems

• Which treatment or monitoring plan is included and its fees
• Surgeon, oncologist and facility costs, and the technique used
• Scans, biopsies and PSA tests, and who reports them
• Drugs and how long hormone therapy will continue
• Follow-up appointments and the monitoring schedule
• Support and any cost for managing urinary or erection side effects
• What happens, and who pays, if you need treatment for a complication, and how care is shared with the NHS

On the NHS? Prostate cancer treatment is widely available on the NHS when clinically indicated; paying privately does not change the standard treatment or buy a better outcome, but may be used for speed, choice of surgeon or technique, and should be coordinated with your NHS team.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• What is my cancer's risk group and stage, and is monitoring (active surveillance) a safe option for me?
• What are the chances and likely severity of effects on urinary control and erections with each option?
• If I choose monitoring, exactly what tests will I have and how often?
• What is the aim of treatment for me, and how will you follow it with PSA tests?
• What support is there for erection or urinary problems if they happen?
• How will my care be coordinated between any private treatment and the NHS?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for prostate cancer treatment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Prostate cancer: treatment Prostate Cancer UK — Choosing a treatment Prostate Cancer UK — Active surveillance Cancer Research UK — Active surveillance and watchful waiting Cancer Research UK — Treatment options for prostate cancer Macmillan — Prostate cancer treatment

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.