Prostate cancer is one of the most curable cancers. Over 90% of patients with early stage prostate cancer survived for at least 10 years after receiving treatment. Prostate cancer is treated based on the risk and stage of the cancer. In general,

a. Localised or organ confined disease (the cancer is confined within the prostate gland), treatment options are:

• Surgery (radical prostatectomy)
• Radiotherapy
• Active surveillance
• Watchful waiting

The decision on which treatment option to choose involves a decision between patient and doctor (shared decision making). Ask your doctor:

• What are the treatment options for my cancer?
• What are the advantages on survival and quality of life of each treatment option?
• What are the disadvantages / side effects of each treatment option?

b. Locally advanced prostate cancer (the cancer has spread just outside the prostate): There is no consensus as to the best management for locally advanced prostate cancer. Currently, the most common option is radiotherapy plus androgen deprivation therapy (ADT). Surgery (radical prostatectomy) is also applicable to selected patients with favourable features.

c. Metastatic prostate cancer (the cancer has spread to other parts of the body including bones, lymph nodes, liver or lungs): The recommended treatment is ADT. This can be done by orchidectomy (a surgery to remove the testes) or taking medication to reduce the level of testosterone in the body. This will lead to shrinkage of the cancer, as the growth of prostate cancer is dependent on testosterone.

To date, additional therapy with chemotherapy or hormonal therapy (abiraterone, enzalutamide or apalutamide) may be recommended in certain situations as they improve the chance of patients’ survival.