Early stage prostate cancer: What’s the best treatment?

There's a number of different options for treating early stage prostate cancer and choosing the "right" one can be difficult

Early prostate_843x403A common question nurses at the Cancer AnswerLine™ receive from men with early stage prostate cancer is: “Which should I have, radiation therapy or surgery?” Oncologists often give men a variety of options to treat their prostate cancer and, for many, the decision can be hard to make. Each choice has benefits and possible problems, so it’s not always easy to choose the treatment.


  • Take the time you need to research your treatment choices before making a decision. There’s often no need to rush.
  • Your spouse or partner plays an important role in the treatment that you choose and will be affected by your choice. Try to be open and honest with each other about your concerns.
  • Make the treatment choice that is right for you.

The choice of early stage prostate treatment depends on many factors:

  • Your prostate cancer risk group (low-risk, medium-risk or high-risk)
  • Health problems other than prostate cancer. Having heart problems, diabetes, or other illnesses may affect your treatment options.
  • If you have already had surgery for an enlarged prostate. If you have had prostate surgery, this may affect the treatment choices you have.
  • Age. The benefits and risks of different treatments may vary with age.
  • Thinking about what you value most. Your unique experiences in life shape your feelings and thoughts about how to deal with prostate cancer.
  • Spouse or partner. Even though the treatment choice is yours, involving your spouse, partner, or other loved ones can help you sort out what is most important to you and your family.

Types of Treatment for Early Stage Prostate Cancer

Active surveillance or expectant management (watchful waiting)

  • Active surveillance is often used to monitor the cancer closely with prostate-specific antigen (PSA) blood tests, digital rectal exams (DREs), and ultrasounds at regular intervals to see if the cancer is growing.
  • Watchful waiting is sometimes used to describe a less intensive type of follow-up that may mean fewer tests and relying more on changes in a man’s symptoms to decide if treatment is needed.

Surgery and radiation are two other treatment choices. They may cure you, but they may also cause side effects, such as:

  • Trouble controlling your bladder
  • Trouble controlling your bowels
  • Trouble having an erection

Surgery is a treatment choice for men with early-stage prostate cancer who are in good health. Surgery to remove the prostate is called prostatectomy. There are different types of surgery for prostate cancer. They include: open prostatectomy, laparoscopic surgery and perineal prostatectomy. Cryosurgery (also called cryoablation or cryosurgical ablation) is a type of treatment that involves freezing the prostate to destroy cancer cells. In this type of treatment, the doctor delivers liquid nitrogen to the prostate through a special probe.

Radiation uses high doses of radiation energy to treat cancer. Radiation therapy is a good choice for many men with early-stage prostate cancer. It is also a useful treatment for older men or those who have other health problems. There are different types of radiation therapy: external beam radiation and brachytherapy. External beam radiation therapy (including Intensity-Modulated Radiation Therapy) and brachytherapy can be used together.

Don’t be pressured; read, ask questions, think – then decide.

• Each man is different. There is no right or wrong decision.

• You can get a second medical opinion. Ask if your insurance pays for it.

• Try to make the decision that is best for you — one you can live with.

If you have had early stage prostate cancer, what helped you with your decisions about treatment?  Please feel free to share with us.


Treatment Choices for Men With Early-Stage Prostate Cancer

Making the Choice:  Deciding What to Do about Early Stage Prostate Cancer

Prostate Cancer Diagnosis & Treatment at the U-M Comprehensive Cancer Center

U-M Robotic Urologic Surgery

U-M Radiation Oncology


The Cancer AnswerLine™ is a dedicated phone line at the Comprehensive Cancer Center that is staffed by oncology nurses five days a week, 8 a.m. – 5 p.m. at 800-865-1125. They have a combined 105 years of experience helping patients and their families who have questions about cancer.


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The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.