What are the treatment options for locally advanced prostate cancer?

Surgery

Radical prostatectomy plus pelvic lymphadenectomy to remove lymph nodes from the pelvis is a treatment option for men with locally advanced prostate cancer (Parker et al., 2015).

Radiotherapy

As an alternative to surgery, locally advanced disease can be treated with external beam radiotherapy in combination with hormone therapy (Parker et al., 2015).

Locally advanced prostate cancer is typically treated with surgery or radiotherapy

Hormone therapy

Neoadjuvant and concurrent androgen deprivation therapy is typically administered for 4–6 months in combination with external beam radiotherapy in the treatment of locally advanced prostate cancer, and adjuvant androgen deprivation therapy may be given for 2–3 years in patients who are thought to be at high risk of dying from their cancer (Parker et al., 2015).

Locally advanced

prostate cancer

Radical prostatectomy + pelvic lymphadenectomy

Neoadjuvant + concurrent ADT

Radiotherapy

(external beam)

Adjuvant ADT in patients at high risk of death

Flowchart showing curative treatment approaches for locally advanced prostate cancer. ADT, androgen deprivation therapy.

Watchful waiting

Some men with locally advanced disease are not suitable for, or may choose not to undergo, the curative treatments described above. In these patients, watchful waiting may be an appropriate approach, followed by hormone therapy to treat symptoms if/when they arise.