Deciding on the best treatment for prostate cancer is specific to each patient. That’s why your urologist, primary care physician, and oncologist, will help you decide on the treatment that is best for you. You will want to consider the benefits of each treatment against its possible outcomes, side effects, and risks. The following are some variables that should be considered.
Age
Generally, patients younger than 70 are more likely to fare better with more aggressive treatments, such as surgery. Whereas patients older than 70 may fare better with the less invasive therapies, such as radiation. And those older than 80 are probably the best candidates for watchful waiting, which includes regular prostate-specific antigen (PSA) tests, digital rectal exams (DRE), or other tests whose results indicate whether the cancer has developed enough to require treatment.
Co-existing medical conditions
Because prostate cancer is often slow to progress, many patients with other medical conditions such as heart disease, diabetes, or neurological conditions, may be more likely to suffer complications from those illnesses rather than from the prostate cancer itself.
Prior pelvic radiation
Previous radiation treatments to the pelvic area would limit the use of radiation for the treatment of prostate cancer, because normal neighboring tissue (mainly from the rectum) can receive only a limited amount of cumulative radiation.
Inflammatory bowel disease
Patients with irritable bowel or inflammatory bowel disease do not tolerate radiation treatments well; however, seed implants may be a possible alternative.
Stage and grade of tumor
Doctors will rate the patient’s tumor in a system that measures the tumors spread and aggressiveness. This is called "staging" or "grading" the tumor.
From: emoryhealthcare.org
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