Prostate problem treatments
If you have an enlarged prostate, then you will need treatment only if it is causing you problems. The treatments include medication and surgery.
Treatment for prostate disease depends on the condition and how severe the symptoms are. Sometimes, no treatment is required.
If you have prostatitis then medications, including antibiotics, can help.
If you have prostate cancer, then there is a choice between waiting to see if it will grow quickly or not (some prostate cancers don't) and having treatment like surgery, chemotherapy and radiotherapy. You will need to talk to your doctor in detail about this.
You may be able to reduce the symptoms of prostate problems by:
avoiding alcohol and caffeine, which can both make you urinate more often
avoiding spicy or acidic foods, which can irritate your bladder
avoiding drinking late in the evening to reduce the chances of having to urinate during the night
avoiding sitting or bicycling for too long, as these can irritate the prostate
making sure you drink plenty of water to flush bacteria from your bladder
increasing the amount of fruit and fibre you eat to avoid constipation, which can put pressure on your bladder and your prostate
avoiding the unnecessary use of cold and allergy medicines such as decongestants and antihistamines, which can affect muscles in the bladder
sitting in a warm bath to ease symptoms.
Not sure what to do next?
If you are still concerned about your prostate problem treatments, why not use healthdirect’s online Symptom Checker to get advice on when to seek medical attention.
The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).
Men with advanced prostate cancer and painful bone metastases are a difficult group of patients to treat. Data from recent randomised trials of chemotherapy suggest an improvement in overall survival, pain relief, and quality of life with this form of therapy. Side effects are common and can be severe. Chemotherapy offers a treatment option for men with hormone-refractory prostate cancer (HRPC), but the decision to treat should be carefully considered by the patient and clinician. More studies are needed to find new and better agents.
Low-dose rate brachytherapy for men with localized prostate cancer | Cochrane
Localized prostate cancer has not spread outside the prostate gland. LDR-BT is short-distance internal radiotherapy. Low-energy radioactive sources with a short half-life are implanted permanently into the prostate. We reviewed the published research on this treatment to investigate how effective and safe it is. Unfortunately, we identified only one randomized controlled trial comparing LDR-BT versus RP. The results were considerably prone to bias. Important survival outcomes were not reported. Due to lack of research studies, it has not been proven whether patients treated with this procedure live longer than patients treated with treatment alternatives. In this single study, after the intervention, a rise in prostate-specific antigen (PSA) was similarly likely to occur after LDR-BT and RP, but this finding does not resolve the question of whether cancer was truly present again in both groups. Urinary incontinence was less frequent after LDR-BT and urinary irritation was less frequent after RP at a short-term follow up at 6 months. No results were reported at 12 and 60 months. Significant differences after long-term follow up were not identified for patient-reported outcomes. At present, the question whether LDR-BT is a favorable treatment compared to other treatment alternatives in patients with localized prostate cancer remains unanswered.
Neo-adjuvant and adjuvant hormone therapy for localised and locally advanced prostate cancer | Cochrane
The management of early prostate cancer is one of the most controversial areas in the field of cancer medicine with surgery, radiotherapy, primary hormonal therapy (achieved either by medication or by the surgical removal of the testes - orchidectomy) and watchful waiting, all being acceptable forms of initial treatment. Treatment decision making is often based on patient and provider preferences taking into account the risks and benefits of therapies and disease progression. Since prostate cancer is driven, in part by male sex hormones, the use of hormonal treatment to reduce the level of circulating male hormones is a potentially very useful method of treating all stages of this disease. Recently, research on the use of such hormonal therapy in combination with both surgery and radiotherapy has increased. This systematic review combines the results of all the important trials looking at the role of hormones in combination with surgery and radiotherapy for localised and locally advanced prostate cancer.
This pathway provides guidance on the staging of adult male patients with biopsy-confirmed prostate cancer, prior to definitive treatment.
Read more on Diagnostic Imaging Pathways website
Interventions for sexual dysfunction following treatments for cancer | Cochrane
Cryotherapy for localised prostate cancer | Cochrane
Cryotherapy is a relatively new procedure for the treatment of localised prostate cancer. Under anaesthesia, probes are inserted into the prostate tumour that freeze the tissue, thereby killing tumour cells. This procedure is carried out on a day-patient basis and generally patients are allowed home the following day. The main complications associated with cryotherapy include impotence (inability to maintain an erection), incontinence, and tissue sloughing (making urination difficult). Studies report that cryotherapy has potential clinical benefits for many patients with no evidence of cancer postoperatively; however, the quality of the available evidence is poor.
Screening for prostate cancer | Cochrane
Prostate cancer is one of the most prevalent forms of cancer in men worldwide. Screening for prostate cancer implies that diagnostic tests be performed in the absence of any symptoms or indications of disease. These tests include the digital rectal examination (DRE), the prostate-specific antigen (PSA) blood test and transrectal ultrasound (TRUS) guided biopsy. Screening aims to identify cancers at an early and treatable stage, therefore increasing the chances of successful treatment while also improving a patient's future quality of life. This review identified five relevant studies, comprised of 341,342 participants in total. Two of the studies were assessed to be of low risk of bias, whilst the remaining three had more substantive methodological weaknesses. Meta-analysis of all five included studies demonstrated no statistically significant reduction in prostate cancer-specific mortality (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.86 to 1.17). Meta-analysis of the two low risk of bias studies indicated no significant reduction in prostate cancer-specific mortality (RR 0.96, 95% CI 0.70 to 1.30). Only one study included in this review (ERSPC) reported a significant 21% relative reduction (95% CI 31% to 8%) in prostate cancer-specific mortality in a pre-specified subgroup of men. These results were primarily driven by two countries within the ERSPC study that had very high prostate cancer mortality rates and unusually large reduction estimates. Among men aged 55 to 69 years in the ERSPC study, the study authors reported that 1055 men would need to be screened to prevent one additional death from prostate cancer during a median follow-up duration of 11 years. Harms included overdiagnosis and harms associated with overtreatment, including false-positive results for the PSA test, infection, bleeding, and pain associated with subsequent biopsy.
This is the first comprehensive national report on prostate cancer in Australia. It presents an overview of the condition and analysis of key summary measures including incidence, mortality and survival. Findings include:- Prostate cancer is the most commonly diagnosed cancer in Australia (excluding non-melanoma skin cancer), with 21,808 new diagnoses in 2009.- Prostate cancer is the fourth leading cause of mortality among Australian males, with 3,294 deaths from prostate cancer in 2011.- Around 9 in 10 (92%) males diagnosed with prostate cancer survive 5 years from diagnosis. This is higher than for all cancers (65%).