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Your decision, your future

Treatments aimed at curing the cancer are called 'curative treatments.' They include surgery and radiation. These treatments can get rid of the cancer from a specific area of the body. For men diagnosed with early or localised prostate cancer, these treatments may get rid of the cancer completely.

Curative treatments also have the risk of side effects. These side effects can include failing to stop the spread of the cancer, not being able to get an erection (although this is not uncommon in men aged over 50 years without prostate cancer). Surgery also carries the risk of leaking urine. How well a curative treatment works is affected by other health problems a man may have such as diabetes, obesity, cardiovascular disease and respiratory problems.

If the cancer has spread outside the prostate, other types of treatment called systemic treatments may be needed to get rid of cancer cells located in other parts of your body. These treatments usually include androgen deprivation therapy and chemotherapy. These treatments also have side effects however these usually go away once treatment has finished. 

Cancer and its treatment often cause side effects. As well as treatment to slow, stop, or get rid of the cancer, an important part of your care is treating the symptoms of prostate cancer and any side effects from treatment. This is called palliative care and any man, regardless of age or type and stage of cancer, may benefit from palliative care.

Radiation Therapy

Radiation therapy is the use of high energy rays to get rid of cancer cells. There are two different types. 

External-beam radiation therapy uses a machine outside the body to focus a beam of x-rays on the area of the body with the cancer.

Internal radiation therapy is called brachytherapy. Brachytherapy uses small radioactive 'seeds' inserted directly into your prostate. These 'seeds' give off radiation just around the area where they are inserted to get rid of cancer cells. As with radical prostatectomy, radiation therapy will often cure the cancer.

The early side effects after radiation therapy may include tiredness, infection and inflammation, urethritis, cystitis, and proctitis. The later side effects may include trouble getting an erection, rectal bleeding, and lower urinary tract symptoms.

Surgery

A radical prostatectomy is a surgery that involves removing the entire prostate gland, along with part of the urethra within the gland and the seminal vesicles. The rest of the urethra is then joined to the bladder. This surgery can be done either as an 'open' operation or by a 'keyhole' surgery where only a small incision is made.

The side effects may include infection, leaking urine, and trouble getting an erection. Infections get better quickly with antibiotic treatment. Leaking urine and trouble getting an erection may last for a longer time, but there are treatments that can help.

Androgen deprivation therapy

Androgen deprivation therapy (ADT) is also called hormone therapy. It reduces the level of male hormones in the body. Lowering the levels of these hormones often makes prostate cancers shrink or grow more slowly, but by itself does not cure prostate cancer. The most common androgen is testosterone and most of this is made by the testicles. ADT lowers testosterone levels in the body by surgically removing the testicles, or by using drugs that turn off the function of the testicles.

Chemotherapy

Chemotherapy involves the use of anti-cancer drugs. These are either injected into a vein or given by mouth. These drugs enter the bloodstream and go throughout the body. This makes them useful for treating cancers that have spread (metastasized) around the body. Chemotherapy is usually used only if hormone therapy isn't working. Sometimes, men can benefit from both hormone therapy and chemotherapy being used at the same time.

Palliative care

Palliative care is any treatment that focuses on reducing your symptoms, improving your quality of life, and supporting you and your whānau. Any man, regardless of age or type and stage of cancer, may benefit from palliative care. Often men get treatment for their cancer and treatment to ease side effects at the same time. Palliative care can include medication, changes to your diet, relaxation techniques and emotional support. You may also get palliative treatments like the ones used to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.