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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
The treatment options for advanced prostate cancer include hormonal therapy|, surgery| (to relieve symptoms), chemotherapy|, radiotherapy| (to relieve bone pain) and controlling symptoms|.
Deciding on the best treatment is not always straightforward and a number of factors need to be taken into account.
The most important of these are:
The possible treatments for your situation are likely to be discussed by a group of doctors working together. This is known as a multidisciplinary team (MDT) and includes a doctor who specialises in treating conditions of the prostate (urologist), and doctors who are specialists in radiotherapy, hormonal therapy and chemotherapy treatments (clinical oncologists).
The team may also include specialist nurses, social workers, and physiotherapists. It is common to see a surgeon, an oncologist and a specialist nurse to help you to make a decision about treatment.
Some men find it helpful to have another medical opinion to help them decide about their treatment. Doctors can refer you to another specialist for a second opinion if you feel that this would be helpful.
When prostate cancer has spread beyond the prostate gland and is affecting other parts of the body, it can no longer be cured. However, treatment can usually be given to control the cancer for several years, relieve any symptoms and improve quality of life.
Most men with advanced prostate cancer arerecommended to have hormonal therapy|. A range of hormonal therapies are available.
Surgery| to remove the prostate gland is not suitable for men with advanced prostate cancer, but occasionally a trans-urethral resection of the prostate (TURP) can be useful to relieve problems with passing urine.
Chemotherapy| may be used if hormonal therapy is no longer able to control the cancer. Radiotherapy |is sometimes used to treat bone pain.
Treatments to relieve symptoms|, such as painkillers, may also be given.
Your doctor will explain the possible advantages, disadvantages and side effects of the treatments to you. You can then decide what is best for your particular situation. The benefits and disadvantages of the treatments for advanced prostate cancer are outlined in the different treatments information in this section|. Before you have any treatment it’s important that you are fully aware of them.
It isn’t possible for doctors to predict accurately who is going to be affected by the side effects of each treatment, so you need to be given full information about the risks beforehand and have plenty of opportunity to discuss them. Remember, there are often choices to be made about which treatment you should have, or even whether to have treatment. You can take as large or small a part in those choices as you wish.
Your doctor will explain any treatment’s aims before you have it. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment.
No medical treatment can be given without your consent, and before you are asked to sign the form you should receive full information about:
If you don’t understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
It’s often a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.
You may feel that the hospital staff are too busy to answer your questions, but it’s important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision about the treatment when it is first explained to you.
You are also free to choose not to have treatment. The staff can explain what may happen if you don’t have it. It is essential to tell a doctor or the nurse in charge, so that they can record your decision in your medical notes. You don’t have to give a reason for not wanting to have treatment, but it can help to let the staff know your concerns so that they can give you the best advice.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.