Prostate cancer treatments include active surveillance, hormone therapy, and surgery. The best treatment will depend on the individual’s case, but doctors may recommend radiation therapy for the early stages.

Prostate cancer is the most common cancer in males in the United States. However, when doctors catch it early, it is highly treatable with an excellent overall outlook.

This article looks at the different risk groups and stages of prostate cancer, the treatment options available for prostate cancer in the early stages, outlook and survival rates, and more.

A doctor recommending the best treatments for prostate cancer in the early stages. Share on Pinterest
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For prostate cancers that have not spread far — typically stages 1–3 — many doctors now further categorize them into risk groups.

Different treatments are better options for different risk groups.

Below is a brief outline of risk groups according to the American Cancer Society (ACS):

  • Very low risk group: Cancer is small and only in the prostate. Cancers in this group grow slowly and are unlikely to cause symptoms or other health problems.
  • Low risk group: Cancer is slightly larger than the very low risk group and has not grown outside of the prostate.
  • Intermediate risk group: Doctors can feel the cancer during an exam or see it on an imaging test. It might cover more than half of one or both sides of the prostate.
  • High risk group: Cancer has grown outside the prostate.
  • Very high risk group: Cancer has spread to the seminal vesicles — the glands that produce semen — or into other tissues near the prostate. These prostate cancers have a very high risk of the tumor growing, returning, or spreading to the nearby lymph nodes.

A person’s grade groups and Gleason score can also affect which risk group they are in. A person should ask a doctor about their specific grade group for prostate cancer.

Learn more about Gleason scores and grades for prostate cancer.

Doctors often use active surveillance for people in the very low risk and low risk groups.

Typically, active surveillance involves closely monitoring the cancer with regular prostate-specific antigen (PSA) blood tests and yearly digital rectal exams (DREs).

PSA is a protein that appears at higher levels when there is a problem with the prostate. DREs involve a medical professional inserting a finger into the rectum to feel the prostate.

Doctors also may order prostate biopsies and imaging tests every 1–3 years.

If a person’s test results change, their doctor may discuss beginning treatment options for trying to cure the cancer.

When someone in the very low risk or low risk group has additional health problems affecting their life span, doctors may recommend observation.

Observation is less intensive than active surveillance and is typically meant to manage the cancer’s symptoms rather than cure the cancer.

Generally, radiation therapy is an option for people in any risk group.

In the early stages, a doctor may recommend radiation therapy as the first treatment for cancer located only in the prostate.

They may also recommend it alongside hormone therapy for cancer that has grown outside the prostate.

Types of radiation therapy for early stage prostate cancer include:

  • External beam radiation therapy (ERT): An external linear accelerator (i.e., a radiation machine) focuses radiation beams on the prostate gland.
  • Brachytherapy: This internal radiation therapy involves placing small radioactive pellets directly into the prostate.

Additionally, each type of radiation therapy has its own methods and techniques. A person should discuss these with a medical professional.

Learn more about radiation therapy for prostate cancer.

Radical prostatectomy, a main type of prostate cancer surgery, may be an option for people whose cancer has not spread outside of the prostate. It is suitable for groups with very low risk or low risk disease and, in certain cases, those with higher risk disease.

There are different types of radical prostatectomy, but the surgeon generally removes the entire prostate gland, the seminal vesicles, and nearby tissues.

Someone considering radial prostatectomy may want to talk with their doctor about possible risks, such as urinary incontinence and erectile dysfunction.

Additionally, a radical prostatectomy causes infertility. Someone interested in having children may want to explore options, such as “banking” their sperm before the surgery.

Learn more about surgery for prostate cancer.

Hormone therapy for prostate cancer aims to reduce the levels of androgens in the body or block them from working.

Androgens, which are male sex hormones, stimulate the growth of prostate cancer cells. Lowering their levels or stopping them from entering prostate cancer cells can help shrink or slow the growth of prostate cancer.

A doctor may recommend hormone therapy alongside radiation therapy in the early stages.

There are different kinds of hormone therapy, and they all carry their own risks and side effects, including nausea, fatigue, and sexual dysfunction.

Hormone therapy does not work indefinitely; eventually, a person’s prostate cancer may become hormone-resistant.

Researchers have considered intermittent hormone therapy as a way to delay hormone resistance, though more research is necessary.

Learn about Lupron, a hormone medication for prostate cancer.

When cancer has spread outside the prostate, and hormone therapy is not working, doctors may suggest chemotherapy as an option. It is not a standard treatment for early prostate cancer.

If cancer has spread to nearby lymph nodes, doctors may recommend a radical prostatectomy with a pelvic lymph node dissection (PLND). This involves removing the prostate and the surrounding lymph nodes.

In later stages, doctors may still continue to use hormone therapy and observation. They may recommend participating in a clinical trial testing newer treatments for prostate cancer.

Learn more

Learn more about prostate cancer and its treatments.

The 5-year relative survival rating system offers insight into how many people with the same type and stage of cancer are still alive after 5 years.

The National Cancer Institute (NCI) outlines the most recent 5-year relative survival rates for people with different stages of prostate cancer:

SEER stage Stage description 5-year relative survival rate
LocalizedCancer is confined to the prostate. 100%
RegionalCancer has spread to regional lymph nodes.100%
DistantCancer has metastasized, spreading to different organs. 32.3%
Unknown Unstaged. 85.8%

Survival rates do not guarantee an outcome, but they do help people understand the likelihood of successful treatment.

From active surveillance to surgery, there are several treatment options for prostate cancer in the early stages.

The best treatment option will depend on individual factors such as the exact stage and the cancer’s risk group, but typically, when prostate cancer is caught early, people have an excellent outlook.