Choosing which treatment to have

Your multidisciplinary team (MDT) may ask you to choose between different treatments.

If your doctor asks you to choose between treatments that are equally effective make sure that you have all the information about the treatments before making your decision. There may be advantages and disadvantages to consider.

Your doctors may suggest that your cancer is monitored rather than treated. This is because very early-stage prostate cancers may not grow and cause symptoms. Having treatment for prostate cancer can cause side effects, which for some men, may be worse than the effects of the cancer.

If your doctor asks you to choose between having surgery and radiotherapy, you may want to talk to them about what treatment you could have if the cancer ever came back. If you have radiotherapy, it may not be possible for you to have surgery at a later date.

Make sure that you understand your treatment options and ask any questions you need to help.

Treatment decisions

You may be advised not to have treatment straight away but to be monitored instead with active surveillance or watchful waiting.

Although blood tests and biopsies can find prostate cancer at a very early stage, it isn’t possible to tell whether the cancer is going to grow and cause symptoms. The risk group of your cancer can give your doctors more information, but they will not be able to predict the exact outcome.

Many prostate cancers grow very slowly and a small, early stage prostate cancer may never cause any problems in a man’s lifetime.

The treatments for prostate cancer can cause side effects such as erection problems or incontinence. For some men, these may be worse than the effects of the cancer. Your doctors may advise waiting to see whether the cancer is likely to cause problems rather than giving treatment straight away.


Choosing between radiotherapy and surgery

You may be asked to choose between having surgery or radiotherapy. Although your treatment is aimed at curing the cancer, you may want to think about the treatment you could have if the cancer came back.

If you have radiotherapy, it isn’t usually possible to have surgery at a later date. This is because scar tissue from the radiotherapy makes surgery difficult. However, if you have surgery, you can have radiotherapy afterwards. It’s important to talk this through with your doctor or nurse before making your decision.

We have more information on making treatment decisions.


Giving consent

Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent.

Before you are asked to sign the form, you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations.

It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion.

You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know 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 when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

Back to Coming to your decision

Finding out your treatment options

Knowing basic information about your type of cancer and different treatments options can help you to make an informed treatment decision.

Making your decision

If  you’re struggling to come to a decision about treatment, try following these five steps.