Earlier detection of the disease and better patient outcomes from early treatment are lessening many of the concerns that were raised in the past about prostate cancer detection and treatment. Well-differentiated cancers which are still confined to the prostate gland have the greatest chance of successful treatment. Cancers that have spread beyond the prostate are much less likely to be eradicated. Cancer that has metastasized to the bone will nearly always be fatal. Once we know the stage and grade of the cancer, as much as can be determined from our clinical evaluation, we discuss treatment options with the patient and his family.
Survival is quite good, and only a minority of men have complications.
Outcomes and complications are generally similar to those for surgery. With this approach, surgery or radiation will be withheld unless the disease begins to progress. Treatment of advanced prostate disease cannot cure the cancer, but it has been shown to extend life expectancy and improve quality of life for men with late stage cancer. In a perfect world, we would limit surgery to cases in which we were sure the cancer was entirely confined to the prostate. Unfortunately, we cannot always be sure of the stage prior to surgery.