If early prostate cancer is detected, what treatments are used?

Approximately two out of every three men who have a prostate biopsy will not have prostate cancer. The initial treatment options for men with early localised prostate cancer are:

Watchful waiting

This involves the conscious decision to avoid treatment unless symptoms develop. Those men who do develop symptoms of progressive disease are usually managed with hormonal therapy.

Active surveillance

With active surveillance the treatment of slow growing cancers is avoided by only treating those whose cancers show early signs of progression. Serial PSA measurements and prostate biopsies allow the cancer to be monitored and surgery or radiotherapy is offered in the event of disease progression. The disadvantage is that the cancer may grow to a more advanced stage. Some men find the uncertainty difficult to cope with.


This involves an operation to remove the prostate gland. The aim is to cure, although there are possible side effects. These include incontinence which is experienced by up to 2 in every 10 men. Up to 8 in every 10 men experience impotence following the surgery. Four or five men in every 1,000 who have major surgery for prostate cancer may die.

Radiotherapy external beam

This involves a course of radiotherapy treatment on the prostate gland at an outpatient clinic and usually follows a course of hormonal therapy. The aim is to cure, although there are possible side effects. Impotence may be experienced by up to 6 in every 10 men. Bowel problems are experienced by 3 in every 10 men and incontinence by 4 in every 100 men.

Radiotherapy brachytherapy

This involves placing radioactive seeds or wires directly into the prostate. Possible side effects include urinary problems and impotence in up to 2 in every 10 men.

What are the Prostate Cancer Risk Management Programme’s referral guidelines?

The Programme recommends that the following age related cut-off values are used for the PSA test:

Age PSA cut-off (ng/ml)
50-59 ≥ 3.0
60-69 ≥ 4.0
70 and over > 5.0

And the benefits of the PSA test?

It may provide reassurance if the test result is normal and may find cancer before symptoms develop. If prostate cancer is detected at an early stage, treatment could be beneficial. If treatment is successful, the consequences of more advanced cancer are avoided.