What are the alternatives to prostate removal surgery?

Active surveillance uses planned prostate tests, examinations and imaging to monitor a cancer that may be suitable for observation. External radiotherapy directs radiation at the prostate from outside the body. Brachytherapy places radioactive sources in or near the prostate; it may be used alone or with external treatment in selected cases. Hormone treatment reduces the effect of testosterone on prostate cancer and may be combined with radiotherapy or used when cancer has spread. The choice depends on grade, stage, prostate size, urinary symptoms, other illnesses and personal priorities. Each approach has its own possible effects, including changes in urinary, bowel or sexual function.

Ask for the purpose of each option: monitoring, cure-focused treatment, control of cancer, or symptom relief. Discuss the expected treatment schedule, follow-up tests, catheter or bowel preparation needs, and how urinary continence and erections may be affected. A radiation oncologist and urologist can explain different approaches; a specialist nurse can discuss practical support. If sexual changes are a concern, ask about Sexual Health Support After Cancer. Compare the options using your biopsy findings and imaging rather than a general internet description.

Contact your care team for inability to pass urine, new blood in the urine, fever with urinary symptoms, worsening bone or back pain, leg weakness, or loss of bowel or bladder control. Sudden leg weakness or new loss of bladder control needs emergency assessment. Do not wait for a routine review if these symptoms appear.

Is active surveillance appropriate for my cancer? Would radiotherapy or brachytherapy treat the prostate and nearby disease? Could hormone treatment be combined with radiation? Which urinary, bowel or sexual effects are most relevant to me?