Treatments for Localized Prostate Cancer

Treatments for localized or early stage prostate cancer include active surveillance, surgery, and radiation. Focal therapy might also be an option.

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Early stage, or localized, prostate cancer refers to cancer that is still confined to the prostate—either Stage I or Stage II. If you have been diagnosed with early stage prostate cancer you will be able to choose which kind of treatment is best for you. You have time to do the research you need to make the right decision for you. Consider including those you love and respect as part of your journey, as they can provide support, insight, and help.

Some prostate cancer treatment options may impact your sexual function so it is important to be open and honest with your partner. Ask your doctor questions and try to talk to other men who have been diagnosed with prostate cancer.

Most men with early stage prostate cancer have several treatment options. To learn more about your options, visit our treatment section. The most common treatment options for early stage, or localized, prostate cancer include:

Active surveillance is the close monitoring of the status of low-risk prostate cancer through regular office visits and repeat medical tests, such as the PSA test and the prostate biopsy.
Local therapy options such as surgery and radiation. Local therapy is treatment that is directed to a specific organ or limited area of the body, such as the prostate.
- Surgery usually involves a radical prostatectomy, which is the removal of the entire prostate by a surgeon.
- Radiation therapy uses radiation to destroy the cancer cells in the prostate while leaving the prostate in the body.

While all prostate cancer treatment can have side effects, the most common side effects of surgery and radiation are erectile dysfunction (loss of erections) and urinary incontinence (leaking urine). It is important to talk with your doctor to understand potential side effects of each treatment option available to you.

Difference between treatment options for localized prostate cancer

Dr. Shaakir Hasan dives into the different treatment options for localized cancer including active surveillance, surgery, and radiation. Learn about the pros and cons of these treatments.

Other experimental treatment options

Active surveillance, surgery, and radiation remain the standard treatment for localized prostate cancer. However, there are several experimental treatment options that have emerged, many of which are still under study.

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Focal therapy is a broad term used to describe a variety of noninvasive techniques for targeting and destroying small tumors inside the prostate while sparing the normal tissue. Focal therapy uses energy sources to generate extreme temperatures that help destroy the tumors.
Options that may be available to prostate cancer patients include:
- HIFU/ultrasound uses heat to kill the prostate cancer cells
- Cryotherapy is the freezing of the tumor to destroy the cancer cells
- Focal laser ablation (currently available only in clinical trials)
Focal therapy may be a treatment option for early stage prostate cancer that is visible using imaging scans. Focal therapy is thought to “bridge the gap” between radical prostatectomy and active surveillance treatment options.
Advantages to focal therapy include:
- Improved accuracy of treatment
- Reduced urinary and sexual function side effects
- Increased likelihood of preserving normal prostate tissue and function
- Often performed as an outpatient therapy
Researchers in clinical trials are working to better understand which prostate cancer patients are the best candidates for focal therapy and how long patients remain disease-free after treatment.
Hormone therapy, also known as androgen deprivation therapy (ADT), stops or slows the body’s ability to make testosterone, aiming to stop tumor growth and/or shrink the tumor. It has always been an important treatment for advanced prostate cancer, and is increasingly used in combination with radiation therapy to treat early stage prostate cancer. Studies have shown that ADT combined with radiation increases long-term survival.
However, hormone therapy alone is not effective in treating localized prostate cancer. Hormone therapy alone has been shown in long-term studies to have worse survival than when it is used in combination with radiation.

Which treatment is best for you?

Your treatment options will depend on many factors, most importantly the characteristics of your cancer, including stage, grade, and risk category. Other factors that are unique to you include:

Other health problems, such as heart disease, diabetes, or other chronic conditions
Previous prostate surgery
Age
Your personal preferences

Get a second opinion

Asking for a second opinion is common practice. Gathering more knowledge about your diagnosis and the available treatment options may help you feel more comfortable with the decisions you make.

At ZERO, we suggest that anyone diagnosed with prostate cancer consider having a consultation with a medical oncologist before making treatment decisions, particularly if you have high risk disease. While your treatment will most likely be managed by a urologist or radiation oncologist, meeting with a medical oncologist will help you to have a full picture of all treatment options available to you. This is especially important should your cancer return at some point in the future.

Want to learn more?

Visit the webinars and videos section of our website to find upcoming webinars as well as more educational videos about prostate cancer, treatment options, side effects, and treatment advances.

View educational videos