Treatment options depend on the tumor's stage (its size and degree of spread to other sites) and grade (the aggressiveness of the particular tumor cells). If the cancer can be caught while still confined to the prostate it can be cured. If it has spread, it can be treated but not cured. If it is low grade it is less likely to have spread than if it is high grade.
Surgery and radiation therapy are the treatments of choice if the tumor is going to be cured. The decision depends on the patient's age, medical condition and personal desires. Therapy with hormones , removal of the testicles (orchiectomy) and chemotherapy may relieve symptoms of advanced disease but will not produce a cure.
Surgery Surgical removal of the prostate and the seminal vesicles—a radical prostatectomy—is the
only certain way to remove all of the cancerous gland. This will lead to a cure if the cancer is confined to the prostate.
The surgeon will often sample lymph nodes—in a procedure called a pelvic lymphadenectomy—during the operation but before the prostate is removed. If the lymph nodes are positive for cancer, the prostate will usually not be removed, for there will be little benefit for the patient and there may be significant side effects.
The newest procedure for lymph node sampling is called laparoscopic lymphadenectomy. A long telescope (laparoscope) is inserted through a tiny opening in the abdomen and is used to observe and guide the sampling of pelvic lymph nodes to see if they contain cancer. If the lymph nodes contain cancer, most surgeons would not
