At UCLH, our specialist urology team will care for you. Your clinical nurse specialist (CNS) can offer your emotional support and advice. They can speak to you in person when you're at the hospital or by phone between appointments.
We personalise prostate cancer treatment to meet your needs. The best treatment for you depends on the cancer stage, your general health and preferences. Your healthcare team will discuss the options to help you decide what’s best for you.
Localised prostate cancer treatments
If you have localised prostate cancer, our aim is to delay treatment or cure the cancer. If the cancer returns, there are often other treatment options available.
If you have low-risk prostate cancer, you may not need treatment straight away. We may offer you active surveillance where we monitor your cancer and only start treatment if it grows.
This involves surgically removing your prostate gland. At UCLH, we do most prostatectomies using a robotic technique. Very rarely, if a robotic prostatectomy isn’t suitable, we may offer open surgery.
Radiotherapy uses x-rays to kill or control cancer cells. We often combine it with hormone therapy.
For some small prostate cancers, we can use stereotactic ablative radiotherapy (SABR). It’s a precise type of radiotherapy that gives high doses of radiation while protecting healthy tissue around it.
High-dose rate brachytherapy is a type of internal radiotherapy. We place tiny radioactive seeds or tubes into your prostate. This lets us safely deliver targeted radiation straight to the cancer.
Cryotherapy is a type of focal therapy that only treats the area of the prostate where the cancer is. It works by freezing the cancer cells to destroy them. Because it targets a smaller area, you may have fewer side effects than with other treatments.
HIFU is a type of focal therapy that only treats the area of the prostate where the cancer is. It uses focused sound waves to heat and destroy the cancer cells. Because it targets a smaller area, you may have fewer side effects than with other treatments.
Nanoknife is a type of focal therapy that only treats the area of the prostate where the cancer is. It uses electrical pulses to create tiny holes in the cancer cells, which causes them to die. Because it targets a smaller area, you may have fewer side effects than with other treatments.
Hormone therapy can shrink or slow cancer cell growth. We can give hormones before radiotherapy to improve results or after to reduce the risk of the cancer returning. We don’t often use it alone to treat localised prostate cancer as it doesn’t cure cancer.
We often use this approach for older men when it’s unlikely that the cancer will affect their life span. We may also use this approach if you’re not well enough for treatment. If the cancer is early-stage and not causing symptoms, we can delay treatment until any appear. If the cancer progresses, we usually offer pain relief and hormone therapy to manage it.
Locally advanced prostate cancer treatments
If the cancer has begun to spread outside the prostate, we offer the following treatments.
- Radiotherapy (often combined with hormone therapy)
- High-dose rate brachytherapy
Advanced prostate cancer treatments
We can’t cure advanced prostate cancer, but can offer you treatments to slow it down, relieve symptoms, and improve your quality of life. Options include:
- Chemotherapy
- Hormone therapy
- Radiotherapy — for symptom control such as pain, bleeding or pressure
- Relugolix — an oral medicine which lowers testosterone levels. This helps to slow the growth of the cancer cells
- Steroids — when hormone therapy no longer works
- Targeted therapies:
- Radium 223 — for prostate cancer that has spread to the bone
- Olaparib — to treat prostate cancer in people with the defective BRCA gene
Clinical Trials
We lead and take part in a wide range of clinical trials to improve prostate cancer care. Your healthcare team will tell you about any trials that are suitable for you. Your choice to take part in a clinical trial is always up to you.
