Making a treatment decision

In making your decision, your doctor and nurse will support and advise you. It’s important to ask your doctor and nurse as many questions as you like, no matter how small or trivial you think they are. All questions are important.

Your doctor will try to tell you if one treatment is better than another at getting rid of your cancer, but often the treatment options are all thought to be equally good at treating early prostate cancer and so it will be a personal decision based on your own lifestyle and preferences.
It is good to take time to talk to the urologist and a radiation oncologist before you make up your mind. Taking time to talk things through with doctors and nurses, family and friends can help you to reach the right decision. You will need to think about what the treatment involves for you, the impact on work or daily activities and relationships, and which side-effects you feel you can live with. 
One way to help make a decision may be to weigh up the pros and cons of each treatment first. Then talk the decision through with your doctors, nurses and family.

Things to think about when deciding are:

  • How do I feel about monitoring my prostate cancer?
  •  How long does the treatment take?
  • How do I feel about staying in hospital?
  • What is the recovery period for each treatment?
  • What are the side-effects of each treatment?
  • How will those side-effects change my daily life?
  • How many times will I need to visit the hospital?
  • How far will I have to travel to the hospital for treatment?
  • How long will I need to take off work?
It may be helpful to:
  • Know your results and write down your PSA and Gleason score and the stage of your cancer 
  • List each of the options that are available to you
  • Write down what you like and don’t like about each option
  • Ask your self how important these points are to you (individually) and to your family.
  • Write down what is the most important goal for your  treatment 
  • Talk to other men who have received these treatments and hear their experiences and how they managed the side-effects 
You may  find our making a decision checklist helpful. Download the Making a decision (pdf, 127 KB) checklist here

How do other men decide?

There is no one right or wrong way to decide about which treatment to have. Some men like the doctor to make the decision for them; others like to research, ask a lot of questions and to speak to a range of people before making the decision. There are also special tools available to help make a decision about which treatment will be more effective for you, such as decision aids and nomograms .

Tools to help you make a decision 

Decision aids

Online decision aids for early prostate cancer involve a step-by step process during which you can enter information about your own diagnosis to help you decide about your treatment. Here are some examples:
This is a decision aid tool for early prostate cancer and it also includes detailed tables that compare the possible benefits and disadvantages of different treatments for early prostate cancer. Unfortunately submitting your individual details into the tool is not possible outside of the UK.
Nomograms and predictive tools
Certain features of the cancer like PSA, Gleason grade and stage as well as other prostate biopsy details can be combined to create a mathematical expression called a nomogram which can then predict the probability of remaining cancer free after certain treatments, or help you decide which treatment approaches will result in the greatest benefit to you. The mathematical expressions are drawn up based on the past experiences of many thousands of patients, usually drawn from hospitals based in the USA.
They may have certain limitations in that if a nomogram is developed in one country, it may not predict well in a country where the treatment is delivered more or less effectively. 
Click here for an example of a nomogram
It is important to discuss it with your doctor first if you plan to use an online predictive tool to help guide you in your decision making. This is to ensure that it is an appropriate tool for you to use and so they can further advise you in its correct use and possible limitations.

Can I seek other medical opinions ?

You might find it reassuring to have another medical opinion to help you decide about your treatment. Do not worry that you are offending your doctor by doing this. He or she will gladly refer you to another specialist for their opinion if you feel that this would be helpful. If you are suitable for brachytherapy or external beam radiotherapy  it might be helpful to talk to a radiation oncologist before making a decision.
You have the right to find out what a treatment option means for you, and the right to accept or refuse it. If you want to refuse treatment, let your doctor or nurse know your concerns first. It may help to talk to your GP as well. The important thing is that you are fully aware of the benefits and risks.

Prostate Cancer Patients’ Charter

The Prostate Cancer Patients’ Charter outlines the standard of service that men with prostate cancer in Ireland should be entitled to from the time of diagnosis and treatment, through to learning to live with the potential effects of the illness or its treatment.
For more information on the Prostate Cancer Patients’ Charter please see our information leaflet Prostate Cancer Patients’ Charter (pdf, 524 KB)
It can help to talk to another man who has prostate cancer and who has been in a similar situation.  Call the National Cancer Helpline on 1800 200 700 and we can put you in contact with another man who has had prostate cancer who is a trained Survivors Supporting Survivors prostate cancer volunteer. 
You could also join our online message board and post messages anonymously online to other male members undergoing or who have finished treatment for prostate cancer. Visit the cancer support forum here.
If you forget to ask a question while you are with the doctor or would like more explanations or information, call the National Cancer Helpline on 1800 200 700 and talk to one of our specialist cancer nurses confidentially. Or if you prefer, you can also visit a Daffodil Centre if one is located in your hospital. Find your nearest Daffodil Centre here.  
Note: There are links to external websites on this page. The Irish Cancer Society is not responsible for the contents of external websites