Problems and Treatments

Unfortunately in some men the initial treatment such as surgery or radiotherapy will not remove or kill all the cancer cells. Sometimes there is microscopic spread of cancer outside the prostate at the time of treatment.

If the recurrence of the cancer is confined to the prostate, then some men will be offered salvage treatment. At the British Prostate Centre and HIFU Clinic, we have treated men with this problem using cryotherapy (freezing the gland) and HIFU. The recent results with HIFU have been very encouraging with over 50% of men needing no further treatment after two years, and minimal side effects. HIFU is now considered the treatment of choice for men in this situation.

If the cancer has spread outside the prostate, Androgen Deprivation is used. Treatment is given to reduce the male hormone levels (testosterone). The prostate cancer cells are fed by the hormones and when this is removed, the cells stop multiplying and eventually die - (a process called Apoptosis).

Androgen Deprivation can be achieved by removing the hormone producing tissue from the middle the testicles by surgery. It's more common to give long acting injections (every 3 months) that stop the body’s production of testosterone. There is then the possibility of intermittent Androgen Deprivation depending on the response to this treatment. This reduces the side effects of Androgen Deprivation (hot flushes, erectile problems, reduced libido and muscle strength).

Eventually the cancer cells may "escape" the control from Androgen Deprivation. This is a serious problem, but recently new drugs have been introduced to treat men in this situation.