Diagnosis and staging
A raised PSA on its own does not mean cancer — infection, prostate enlargement and even a recent catheter can raise it. Evaluation follows a defined path: repeat PSA with free/total ratio, clinical examination, multiparametric MRI, and a targeted biopsy only when the MRI shows a suspicious lesion. Where cancer is confirmed, the Gleason grade group, PSA level and imaging determine the risk category.
Treatment by risk group
The right treatment depends on the cancer's aggressiveness, your age and your other medical conditions — not on which treatment a hospital happens to offer.
- Low risk: active surveillance with scheduled PSA, MRI and repeat biopsy
- Intermediate risk: radical prostatectomy or radiotherapy, often robot-assisted
- High risk: surgery or radiation combined with hormone therapy
- Metastatic: hormone therapy, newer agents and chemotherapy, coordinated with medical oncology
What matters to patients
Continence and erectile function after treatment are legitimate concerns and should be discussed before you choose, not afterwards. Nerve-sparing technique, surgeon volume and the stage at which you present all influence those outcomes.
If you have been advised surgery elsewhere and want a considered second opinion on whether it is needed now, bring your PSA trend, MRI and biopsy slides.
Prostate Cancer Treatment — common questions
Does a high PSA always mean cancer?
No. Prostate enlargement, infection, recent catheterisation and even cycling can raise PSA. An MRI and clinical assessment come before any decision about biopsy.
Is prostate cancer curable?
Localised prostate cancer has excellent cure rates with surgery or radiotherapy. Even advanced disease is often controllable for many years with modern hormone and systemic therapy.
What is active surveillance?
Close monitoring with PSA, MRI and repeat biopsies instead of immediate treatment, for low-risk cancers that are unlikely to progress. Treatment starts only if the pattern changes.
Will I be incontinent after prostate cancer surgery?
Most men regain control within weeks to a few months, helped by pelvic floor training started before surgery. Lasting incontinence affects a small minority.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains prostate cancer treatment in general terms; your own treatment plan depends on your reports and examination.