Making decisions about treatment for advanced cancer

Deciding about treatment can be difficult when you have advanced prostate cancer. Treatment can help to reduce symptoms, make you feel better and can help you to live longer.

Deciding which treatment you need

Your doctor will talk to you about the treatment they suggest. They will explain its benefits and the possible side effects.

Your treatment will depend on:

• where your cancer is
• how big it is and whether it has spread (the stage)
• the type of cancer
• how abnormal the cells look under a microscope (the grade)
• your general health and level of fitness

The aim of treatment for advanced prostate cancer is to control it, relieve symptoms and maintain your quality of life. Many men can live a normal life for a number of years.

When prostate cancer is advanced it can no longer be cured. But most men with prostate cancer are older and the cancer often develops very slowly.

Treatment can control your symptoms for many years. 

Treatment overview

The main treatments are:

• chemotherapy
• hormone therapy 
• radiotherapy 
• steroids
• symptom control - for example treatments to help with bone pain

You might have a combination of these treatments. And you might have other treatments, depending on where your cancer has spread to. 

If you have 3 or less, very small areas of cancer spread (oligometastases) your doctor might suggest you have surgery or radiotherapy to the prostate

Your choices

Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

• whether you need extra appointments
• if you need more tests
• the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.

Emotional support

Finding out that cancer has spread can be a big shock. It might help to talk to a close friend or relative about how you feel. Your specialist nurse can also offer support and talk to you about what is available for you.