Prostate cancer treatment

After your test results, you and your doctor start to talk about your treatment. Your doctor usually meets with other specialists to get their opinions too.

A team of specialists meets to talk about the best treatment for you. This is called a multidisciplinary team (MDT).

The MDT looks at national treatment guidelines or the latest evidence for the type of cancer. If you have any treatment preferences, your doctor will tell them about this.

The MDT meeting will usually include the following professionals:

• Urologist or urological surgeon is a doctor who treats problems with and does surgery on the prostate, kidneys, bladder and male reproductive system.
• Clinical oncologist is a doctor who uses radiotherapy, chemotherapy and other anti-cancer drugs to treat people with cancer.
• Medical oncologist is a doctor who uses chemotherapy and other anti-cancer drugs to treat people with cancer.
• Clinical nurse specialist is a nurse who gives information about cancer, and support during treatment.
• Radiologist is a doctor who looks at scans and x-rays to diagnose problems.
• Pathologist is a doctor who looks at cells or body tissue under a microscope to diagnose cancer.

The MDT may also include:

• Pathway co-ordinator, who can provide information and guidance for other needs, such as financial support.
• Advanced nurse practitioners, who are specialist nurses for types of cancer and treatments –for example, surgical advanced nurse practitioners.
• Advanced clinical practitioner, who is an expert healthcare professional, such as a nurse, who works with doctors to help assess people with cancer and manage their treatment and care.
• Other healthcare professionals – for example, physiotherapists, occupational therapists or pharmacists, who are specialists in cancer and treatments.

Other people will be involved in your care. This includes medical and nursing staff on the wards or in different departments. If you have radiotherapy, you will meet a therapeutic radiographer. They are an expert in radiotherapy and are specially trained to give you treatment. They can also give you support, advice and information.

You and your doctor can decide together on the best treatment plan for you. Your doctor is an expert in the best treatments. But you know your preferences and what is important to you. You can decide how involved you want to be in your treatment plan.

You can use the online decision aid called Predict. You can also read more and compare treatments on the infopool.

Sometimes doctors need to review a treatment plan. This may be when more information about the cancer becomes available – for example, when the doctor knows the results of surgery to remove the cancer. It may mean making more decisions with your doctor.

When you make treatment decisions, there are different things you may want to think about:

• How you feel about different treatments.
• How you might cope with treatments if you have other health conditions. For example, you may prefer not to have surgery if you have heart problems. Or you may want to avoid radiotherapy if you have a bowel condition – some bowel problems mean that radiotherapy is not suitable.
• How much side effects are likely to bother you – for example, erection difficulties. If active surveillance is suitable, you may be able to avoid erectile dysfunction (ED) caused by surgery or radiotherapy. After surgery, you are more likely to get ED straight away.
• Whether the cancer is very unlikely to cause you problems over your lifetime. If it is unlikely, monitoring the cancer with active surveillance or watchful waiting may be more suitable for you.
• What your treatment options would be if the cancer came back. You may be able to have radiotherapy after surgery. But it may not be possible to have surgery if you have already had radiotherapy.

Most treatments for prostate cancer are likely to cause infertility. This means you will no longer be able to make someone pregnant. If fertility is a concern for you, contact your healthcare team before treatment. We have more information about fertility.