What treatments are there for recurrent prostate cancer?
Treatments for recurrent prostate cancer are called second-line (or salvage) treatments. Many of the treatments used to treat prostate cancer when it’s first diagnosed can also be used as second-line treatments.
Making a decision about treatment
Your doctor might offer you one treatment, or a choice of treatments for recurrent prostate cancer. You may also be able to have your cancer monitored rather than treated (see below).
All treatments have advantages, disadvantages and side effects. All men are different and a particular side effect might be a problem for one man but not for another. It’s important to discuss your options with your doctor before deciding on a treatment. You could also talk through your options with your partner, family or friends, or speak to our Specialist Nurses.
What second-line treatments are there?
There are two main types of treatments – those that aim to get rid of the cancer (curative treatments) and those that aim to delay the cancer growing but won’t get rid of it.
Treatments aiming to get rid of the cancer
- External beam radiotherapy uses high-energy X-ray beams to destroy cancer cells. You might have it with or without hormone therapy.
- Permanent seed brachytherapy involves implanting tiny radioactive seeds into your prostate.
- High intensity focused ultrasound (HIFU) uses ultrasound waves to heat and destroy cancer cells in your prostate. HIFU is newer that some other treatments, so isn’t available everywhere.
- Cryotherapy uses freezing and thawing of your prostate gland to destroy cancer cells. Like HIFU, it's newer than other treatments and so we don't have as much information on how well it works and its possible side effects.
- Surgery (radical prostatectomy) to remove your prostate and the cancer inside it.
Treatments aiming to control the cancer
- Hormone therapy works by either lowering the amount of testosterone in the body or by stopping it from reaching the cancer cells, wherever they are in the body. Prostate cancer cells usually need testosterone to grow.
- Chemotherapy uses anti-cancer drugs to kill cancer cells, wherever they are in the body. You may be offered chemotherapy alongside hormone therapy. It can cause some serious side effects so you will need to be fit enough to cope with these.
Some men who have recurrent prostate cancer decide to take part in clinical trials of new treatments or new combinations of existing treatments. If you are interested in taking part in a clinical trial, ask your doctor if there are any that would be suitable for you.
Monitoring your prostate cancer
You may be able to have your cancer monitored, instead of having second-line treatment straight away. For many men, prostate cancer is slow-growing and may not cause any problems or symptoms, even without treatment. The aim of monitoring is to avoid or delay treatment, and the side effects that treatment can cause.
If you decide to have your prostate cancer monitored, your doctor and nurse will monitor you and your cancer closely for any changes. You will have regular PSA tests. You may also have other tests and scans.
If the tests show that your cancer is growing more quickly than expected, or if you have symptoms, talk to your doctor about starting second-line treatment.