Medications

Hormones are drugs that can affect the growth of prostate cancer cells. Hormone therapy is sometimes used with radiation treatment or surgery to help make sure that all cancer cells are destroyed.

Chemotherapy is the use of powerful drugs—either injected or taken as pills—to destroy cancer cells. Many men decide to have chemotherapy for treatment of late-stage prostate cancer, but researchers are studying whether chemotherapy should be used before or after surgery to treat early-stage, high-risk prostate cancer.²

Surgery

Surgery is one of two main treatments for early-stage prostate cancer. Radiation is the other. Surgery may be done to remove the prostate and its cancer. It may done to remove and test lymph nodes in the area to see whether the cancer has spread (pelvic lymphadenectomy). It also may be done to fix urinary problems that are caused by a tumor pressing on the urethra (transurethral resection of the prostate, or TURP).

The stage of your prostate cancer along with your age and general health will affect the type of surgery you choose.

Surgery Choices

Radical prostatectomy is an operation to remove the entire prostate and any nearby tissue that may contain cancer. It can be done as open surgery through an incision (cut) in the belly, or as laparoscopic surgery through several very small incisions in the belly. Laparoscopic surgery is done with a tiny camera and special instruments to remove the prostate. Sometimes lymph nodes in the area also are removed so that they can be checked for signs of cancer. This is called a lymph node biopsy

Nerve-sparing surgery helps preserve the nerves that are along the side of the prostate and that are needed for an erection. This is only done when there is little chance of leaving cancer cells behind. If you already have sexual function issues, nerve-sparing surgery may not be the best choice for you.

Laparoscopic surgery may be done by hand, but some doctors now do this surgery by guiding robotic arms that hold the surgery tools. This is called robot-assisted prostatectomy.

What to Think About

Removing the prostate can cause erection problems and bladder problems. But for many men, these problems get better over time. If you and your doctor decide that you need surgery, be sure to choose a highly skilled surgeon at a hospital that has a good success rate. Studies show that men have fewer side effects from prostate surgery when they have a skilled and experienced surgeon.⁸

Surgery may completely remove your prostate cancer. But it is not possible to know for sure before surgery whether the cancer has spread beyond the prostate. When cancer has spread, it cannot always be cured with surgery alone.