2018 recommendations for the treatment of localized prostate cancer: Part II

This article reviewed treatment guidelines that have been recommended for patients with early-stage prostate cancer.

This analysis of existing treatment guidelines was done by the leading experts in prostate cancer research. They have made recommendations on the treatment of early-stage prostate cancer. 

Low-risk patients who have active surveillance as a treatment option should have accurate staging of the disease including a sample of cancer tissue (biopsy). They should also have routine PSA (prostate-specific antigen) testing. PSA is a chemical made by the prostate gland used to monitor cancer growth. 

Intermediate-risk and high-risk patients can be offered prostate-removing surgery. Patients should be told that nerve-sparing surgery is associated with better erectile function recovery than non-nerve sparing. Older men experience higher rates of permanent erectile dysfunction and urinary problems after surgery. 

Radiation therapy is another treatment option for low, intermediate and high-risk localized prostate cancer. Hormone therapy can be used with radiation treatment. Hormone therapy lowers the level of male hormones, like testosterone, active in cancer growth. The use of hormone therapy with radiation treatment increases the risks of side-effects such as erectile dysfunction. 

It was recommended that all patients be told about possible side-effects from treatments. Erectile dysfunction can happen following prostate-removing surgery or radiation treatment. Long-term urinary symptoms such an inability to empty the bladder can happen after radiation treatment or active surveillance, whereas surgery can help with this. Irritation of the rectum can happen after radiation treatment. 

After treatment, it was recommended that PSA measurements can be used to monitor prostate cancer growth. Patients should be informed of the risk of their cancer recurring. Patients should also be supported and encouraged to engage with professional or community-based resources.

This study reviewed recommendations for early prostate cancer treatment.

These guidelines are general. Not every patient will fall into one of these categories. Doctors will make decisions based on a patient's specific circumstance.